Talking General Practice

Emma speaks to NHS England’s director of healthcare inequalities and Midlands GP Professor Bola Owolabi about how to reduce inequity in healthcare.

Bola talks about how she became interested in health inequalities, her vision for tackling inequity and she makes the economic argument for why we must address health disparities.

Bola also explains NHS England’s CORE20PLUS5 approach to tackling inequalities, how this provides a framework for primary care networks to focus their efforts when it comes to improving population health, and why she believes this could ultimately make a big difference to patients and communities.

This episode was presented by GPonline editor Emma Bower and produced by Czarina Deen.

Useful links

●     CORE20PLUS5 for adults

●     CORE20PLUS5 for children

●     CORE20PLUS5 e-learning for health modules

●     The RCGP’s health inequalities hub

Evidence for NHS England’s five clinical priorities

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GPonline launched its new GP Insight data tool this week and our first project is a GP workforce tracker. On the podcast this week Nick and Emma look at some of the data in the tracker and what this tells us about the GP workforce in different parts of England.

They also talk about a recently published study that highlights the impact that poor GP retention has on patients and the wider NHS and discuss the government’s latest plans for the NHS and what’s going on with the current wave of strikes.

Finally, our senior reporter Ellie joins us to tell us about a good news story involving a long-serving GP who overcame a severe COVID infection and inspired a local folk band to write a song about him.

This episode was presented by GPonline editor Emma Bower, news editor Nick Bostock and senior reporter Ellie Philpotts. It was produced by Czarina Deen.

Useful links

●     GP Insight Workforce Tracker

●     Introducing GP Insight

●     GPs care for up to 800 more patients each in underdoctored areas

●     Where in England are patients per GP rising fastest?

●     GP partners in decline in almost every part of England

●     Professor Kamila Hawthorne: General practice is at breaking point – the government must act

●     Doctor Boro': GP who survived COVID-19 inspires folk song

●     Doctor Boro’ on YouTube

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The BMA is currently balloting junior doctor members on whether to take industrial action, which could see them stage a three-day walkout in March.

This week Emma speaks to chair of the BMA’s GP trainee committee Dr David Smith about why junior doctors have reached this point.

David explains why the BMA is pushing for full pay restoration for junior doctors and the impact that falling levels of pay have had on the profession.

He also talks about how the current ballot works and what happens if it is successful, what GP trainees need to know about taking industrial action and how GPs can support their junior doctors if they do go on strike.

This episode is presented by GPonline editor Emma Bower and was produced by Czarina Deen.

Useful links

●     BMA junior doctor guide to strike action

●     Pay restoration for junior doctors - full details of the industrial action ballot and other information relating to the pay restoration campaign from the BMA

●     Donate to the BMA’s strike fund here

Related stories on GPonline

●     BMA urges junior doctors to back strikes after health secretary meeting

●     Junior doctors struggling to pay bills as poll reveals impact of 26% real-terms pay cut

●     GPs back junior doctors over industrial action

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Emma and Nick talk about Labour’s plans for the NHS and general practice more specifically, which have not gone down well with a lot of GPs.

They also discuss plans to speed up patient discharges from hospitals and what this could mean for general practice as well as the RCGP’s new exam for GP trainees, which could be in place by the end of 2023.

Our good news story this week takes a look at the latest data from England’s Friends and Family Test.

This episode was presented by GPonline editor Emma Bower and news editor Nick Bostock. It was produced by Czarina Deen.

Useful links

●     GPs hit out at 'misguided' Labour plans for self-referral and practice reform

●     GP partnerships are the most cost-effective part of the NHS, GPs tell Labour

●     Vast majority of patients report positive GP experience despite soaring pressure

●     New GP exam to replace RCA by end of 2023, says RCGP

●     Patients being discharged too early in rush to free up hospital beds, GPs warn

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Kent GP Dr Chris Newman is one of the co-founders of Doctors for Extinction Rebellion, a group of healthcare professionals that campaigns for action on climate change. As part of his involvement in the group Chris has taken part in direct action and last year was arrested and charged under public order laws following a protest in central London.

In this conversation Emma talks to Chris about why he set up Doctors for Extinction Rebellion - which is in the process of changing its name to Health for Extinction Rebellion - and his experience of being arrested and appearing in court on charges.

Chris also explains why education on climate change for all NHS staff is so important and his own push to educate people in his community about the importance of taking steps to address climate change - however small.

This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.

Useful resources

●     Doctors for Extinction Rebellion

●     The Lancet Countdown on health and climate change

●     UN Climate Change reports

●     Intergovernmental Panel on Climate Change

●     Climate FRESK

●     Take the Jump

Other useful information from GPonline

●     Five steps to sustainable primary care

●     GP practices can be 'more ambitious' on tackling climate change

●     5 ways GPs can help patients affected by air pollution

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With the NHS facing unprecedented pressure and horrendous stories emerging about the impact this has had on both patients and staff, we look at what the crisis means for general practice, what representative organisations want the government to do and what steps might need to be taken to help GP practices cope.

We also discuss industrial action - in particular the BMA ballot of junior doctors, which gets underway on Monday 9 January - and we look at the latest GP workforce data and some results from our recent survey that highlight how hard GPs had to work during 2022.

In our good news section we highlight the GPs – and an advanced nurse practitioner – who received awards in the New Year Honours.

Your good news stories

Things are really tough in general practice, but we are always keen to highlight positive news and the good work that is going on in primary care on both the podcast and GPonline.com.

If you are up to anything in your practice or working life that you think deserves attention - or you would like to give a shout out to an individual, practice or other organisation or group that you think is making a real difference, then please do get in touch. You can email us at [email protected].

This episode was presented by GPonline editor Emma Bower and news editor Nick Bostock. It was produced by Czarina Deen.

Useful links

●     Sunak urged to recall parliament as 'broken NHS' leaves GPs driving patients to hospital

●     NHS under 'intolerable' pressure as flu, COVID-19 and strep A deepen crisis

●     Most GPs exceed safe limit for appointments every working day, poll reveals

●     Decline in GP workforce accelerates as workload continues to surge

●     GPs among those recognised in New Year Honours

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This week the team looks at record levels of drug shortages, the latest on group A strep and how it is affecting GPs and their teams and talk about the GP workforce in the most deprived parts of England.

They also discuss why many practices are facing a precarious future because of the lack of GP partners and how inflation and the cost of living crisis is affecting GP practices – and there’s a good news story on long COVID.

Talking General Practice will be back in January 2023. Merry Christmas and happy new year from the team.

This episode is presented by GPonline editor Emma Bower and news editor Nick Bostock. It was produced by Czarina Deen.

Useful links

●     MIMS drug shortages tracker

●     NHS England and UKHSA guidance on group A strep in children

●     Shortage protocol for antibiotics imminent as penicillin prescriptions soar

●     Nine in 10 GPs say cost-of-living crisis has destabilised practice finances

●     NHS bosses ask GPs to cover for striking ambulance workers

●     Drug shortages hit new peak and add to pressure on GP practices

●     Study on pacing and long COVID

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Emma speaks to Dr Ellen Fallows a GP in Northamptonshire and vice president of the British Society of Lifestyle Medicine about what lifestyle medicine is and how it can help GPs to improve patient outcomes.

During this conversation Ellen explains how GPs can make use of lifestyle medicine in a 10-minute consultation, some of the evidence that supports the use of this approach to help improve outcomes for patients and how lifestyle medicine can help GPs tackle health inequalities.

This episode was presented by GPonline editor Emma Bower and produced by Czarina Deen.

Useful links

●     British Society of Lifestyle Medicine

●     How lifestyle medicine can help GPs tackle health inequalities

●     Diabetes DIRECT trial

●     The Food Mood Centre in Australia, Ellen mentions some research coming out from here during the interview

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This week Emma speaks to Professor Aruna Garcea, a GP partner and primary care network clinical director in Leicester. Aruna is chair of the NHS Confederation’s primary care network advisory group and she also sits on her integrated care system as a representative clinical director.

In this conversation Aruna explains the impact PCNs have had already, what makes a strong PCN and some of the key challenges networks have faced. We also talk about the introduction of integrated care systems and what these could mean for PCNs and practices as well as how PCNs can work effectively to support GP practices.

This episode was presented by GPonline editor Emma Bower and produced by Czarina Deen.

Useful links

●     GPs fear funding cuts and sidelining of LMCs as ICS model beds in

●     GP expansion hamstrung by outdated premises, warn primary care leaders

●     PCNs should evolve into 'integrated neighbourhood teams', says Fuller review

●     What does the Fuller stocktake mean for general practice in England?

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In our regular news review Emma and Nick look at what the BMA, GPs and NHS England might want from a new contract deal in England.

The current five-year deal comes to an end in March 2024, and this week English LMCs will be gathering in London to set out a vision for what they want the BMA to push for in upcoming contract negotiations that will decide what happens next.

Emma and Nick look at what we already know about the BMA’s priorities for negotiations, some of the other things LMCs will be discussing, including options of last resort if a contract agreement can’t be reached, and what could happen around primary care networks.

Elsewhere they also look at what has been up for debate at the separate England LMCs conference that took place on Thursday - including motions around the GP workforce, safety in general practice and the impact of integrated care systems.

And they talk about the latest general practice appointment data for England published this week, which for the first time will include details of appointments at individual practices.

Finally, there’s some good news about fruit and veg in London.

This episode was presented by GPonline editor Emma Bower and news editor Nick Bostock. It was produced by Czarina Deen.

Useful links

• Full coverage of England LMCs conference 2022
• How practice-level appointments data threatens unfair pressure on GPs
• Would a GP contract based on item of service payments benefit general practice?
• What forms of industrial action could GPs take?
• Doctors tell BMA to pull GP practices out of PCNs by 2023
• How practice-level appointments data threatens unfair pressure on GPs

Good news

We are always keen to highlight positive news and the good work that is going on in general practice. If you are up to anything in your practice or working life that you think deserves attention - or you would like to give a shout out to an individual, practice or other organisation that is making a difference to patient care or your local community, then do get in touch. You can email us at [email protected].

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