Does anyone have a template prebuilt that we can use to audit what people are turning up with? My local federation are thinking of asking all GPs for a day/week every time they see a patient to run a template and enter into the notes a code that breaks down what the presentation was about. e.g. was it a admin/sick note was it a minor ailment was it mental health was it about expediting an appt etc.. has anyone done anything similar and found all the relevant codes for the template.. the work we have done so far is that not everyone codes every consultation and they use such a variety of codes its a mess.. hence we want to be proactive - but we need 20/30/ codes to capture what is coming in…. any thoughts?“
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“#primarycare
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Does anyone know of a app/website/product that could help deliver the following functionality…(in the distribution list space)
My GP federation has 200 + GPs 100 nurses/HCAs plenty of managers and admin people. We have a real issue with distribution lists. Although some distribution lists exist they are rarely up to date and loads of people just add every name they can think of into emails and newsletters so some of the time - people emails get send to people who have left and sometimes/often people who dont want emails get them.
What we would like is a site where our members register - and put in their practice - their role - their interests.. e.g. PM at Surgery X. or IIF lead at surgery Y or interested in CVD or Lead for Early Cancer etc.. The GP fed could then act as a mail distributor… so for example - we were speaking to the Christie hospital recently and they would like to send out their newsletter - but they don’t want to bombard everyone with it - they want ideally each practice to get one and any cancer leads/or interested parties to get it - for IG reasons we don’t want to keep giving out peoples emails - we want to manage that so they send our comms person a newsletter and we send it out to the right people. those people get the ability to click on the site and change their roles/subscriptions whenever they want.. we can see make sure that every practice/lead is getting the info they need..
Ideally we might keep a central repository of newsletters attachments so 1. new starters can see old stuff 2. we arent filling up inboxes we send links to a central copy.
We think this might improve comms in our Fed a lot getting the right info to the right people and not clogging up others inboxes..
Anyone know anything that will do this? someone has suggested Mailchimp but that seems more aimed at companies sending advertising to customers - I may be wrong.
The GP appointment data came out yesterday - https://lnkd.in/euPACMSt .Others have linked to it already but I thought I’d have a look at it and see if it was useful in anyway.
My overnight conclusion is I’m not sure it’s really added anything. Perhaps it might put to bed the myth that GPs are not seeing anyone - 71.3% of all appointments in October were face to face. 38.9% of all appointments took place on the day they were booked. Over 30 million appointments took place.
It hasn’t captured who wanted an appointment but couldn’t get one? It hasn’t captured whether any harm came to anyone who didn’t get an appointment. It hasn’t captured whether any of the Aroles Staff have helped. It hasn’t captured how easy it is or otherwise to get through. Perhaps these measures are coming.
The data doesn’t show what people are presenting with? who else could have dealt with it? did it need to be seen? did they come back? did they go to A&E?
It hasn’t shown any of the metric around who is being seen. I heard yesterday that one ICB has done an analysis that 650 patients were responsible for 54000 GP appointments in a year (some appropriate some not..) do we need to be looking at frequent fliers more?
I’ve looked at some local data at a practice level - yes there is some variation - but again its really hard to read anything meaningful into it - one practice with low figures - is probably just coding things wrong.. we really need a better way of coding things… one practice does a total triage like system and deals with many more people on the phone - they got quite good satisfaction scores and perhaps their pts like that way of doing things? Perhaps this needs to be linked to the GP survey data?
Speaking to local practices - no one is actively trying to shirk work - all are busy - all would like more staff - all would like less paperwork - and less dumping on from other parts of the NHS does this help?
Everyone talks about big data - how is this going to help?
There is an interesting video from Matt Parker of Humble Pie fame on you tube where he challenges his viewers to improve his code. He has some code that takes hours and hours to run and currently the viewers have managed to get it to run in 300us. something like 40Billion times faster. Imagine if my clinical system ran 40billion times faster.
So should NHS D force all for NHS apps to be open source? Discuss…
I can see that some people might be worried that it would allow hackers to find vulnerabilities - but would it also allow people to fix them?
Would it allow people to add features? to improve processes? would an army of open sources get involved or would no one be interested? a recent debate on here suggested that there is no point in start-ups getting involved in primary care as there is no money - but what about lone programmers - they often do it for fame/or interest/publicity/ reputation? would a cohort of programmers want to give back to the NHS by improving its code?
If we forced existing software code to be open sourced - would coders be horrified or impressed?
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Interesting report from the institute of fiscal studies out today. https://lnkd.in/dg6ZzxAW “
“GP numbers down but activity up. Hospital consultant numbers up but activity down…
Here is a graph from Apex of the dramatic increase in workload from “Strep” cases my PCN is seeing and how it’s gone up over the last 90 days. The biggest issue is knowing which chemists have which antibiotics in. Our Pharmacy team have been ringing around several times a day trying to get up to date stock info as there is nothing worse then sending a script and having the parent turn up saying the chemist has run out…. Live stock info should be a feature added to e-prescribing. it also comes up all the time with HRT and other products.. thoughts? #pharmacy
If you were tasked with setting up a world beating track and trace system - would you choose to rely on Microsoft excel and an old version at that?
I’ve just come across this fascinating story (from the amazing Tim Harford) where PHE did exactly that and put lives at risk partly because someone didn’t understand the difference between a database and a spreadsheet and partly because presumably they didn’t have the funding to pay for the updates!
So this week GP funding is out: https://lnkd.in/e8NhTDsF“
“Quite a variance between practices in similar locations. Ignore dispensing practices and special “practices” that deal with a few patients and it’s really odd how practices vary. Still trying to understand why. For example if my practice was funded the same as a practice down the road from us - we’d have an additional £1Million to spend on more doctors/nurses - is that why they offer more appointments than us? or is it more complicated than that? #funding #primarycare
The ups and downs.. 2 emails from EMIS yesterday - one very welcome saying they are trying to improve their searches and reports functionality/performance.. which is very welcome“
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“the 2nd - not their fault - but they are removing the built in QRISK calculator as apparently the algorithm is now considered a medical device and its not been tested!!! we use this all time…”
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“here is an opportunity for an app along EMIS that extracts data and runs QRISK and or other scores and puts the data back into EMIS - perhaps… pinging the pt for missing info or generating an action plan…
Im being told that Roche is now offering its Diabetes Risk Strat Dashboard for free to GP practices.. Really interested to have a look at it.“
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“It purportedly shows you which patients have the most to gain from intervention - meaning you can target your action on those that need it. “
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“#primarycare #diabetes”
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This is very interesting - I love a good info graphic - I guess the question is what difference will it make?
My surgery has 27000 pts - I know the detailed demographics of all of them - shouldn’t I be able to accurately predict at some level - how many appointments I need to cater for them? Do practices with poor access just not have enough capacity? (for whatever reason)
I’ve also often wondered if we could analyse patterns more at a practice level to improve care - it’s a form of risk strat. How many times does the average diabetic attend my surgery versus - the average surgery or my peer surgeries? why is my average higher or lower? do I deliver better care? cheaper care? or not? who is delivering the best outcomes for the least attendances and cheapest cost (prescriptions etc) what are they doing that we aren’t?
looking at patients if the average 60 year old diabetic attends 3 times a year (ok there is some variation but I don’t know what it is?) why is Bob coming 8 times? is it something he’s doing or something we aren’t? does he have other risk factors or issues that if we recognise and address?
We need someone who can manipulate the data and time to digest and implement any changes..
This last week there has been an interesting battle going on in primary care land. Many of you will know that full prospective access to GP records was about to be turned on (again). This was NHS England instructing the IT systems suppliers to add this feature. However.. the BMA and others pointed out that the GP practices are the data controller and the system suppliers are only controllers - so in theory they couldn’t do this without the explicit permission of the practices..
So many letters went in from practice to say DON’T do this…- as many practices felt they were not ready for this access (I should point out - I’m 95% in favour of this access but I agree it could be a lot of work for practices at a time when they don’t need it).
It appears that the response has been if you sent in a letter - we will give you an extra 30 days but we are being forced to turn it on by NHS England.
Now.. NHS E could have make it a contractual requirement for practices to do this.. and probably will but they haven’t - they have just forced the IT system suppliers to do this? OK maybe but what if the practices say they aren’t ready and the access is turned on - what happens and who is responsible if a third party IG breach occurs?
You may understand this more than me.. in which case please explain. Have I just lost my status as the data controller? Who gets sued if something goes wrong and I said I’m not ready?
I was reflecting on the IT system my surgery had 22 years ago when I joined. We had our own server and back up server in the surgery - they never went down - a couple of ISDN links that gave us good connectity - we had a DOS based EPR that did pretty much everything the current system does with some advantages - it was fast and reliable… we had templates - and searches - and remote access. The only major change I can really see is E-prescribing - getting rid of the paper and being able to send scripts direct to a chemist is a real change - though the current interface could do with an upgrade.
What else? e-referrals - not convinced its really added anything? Advice and Guidance - I used to know all the local consultants and could ring any of them at lunchtime for advice - current system seems worse.. document management - well.. I used to have a pile of paper letters to go through every day - now I have a pile of on screen letters to read - and sometimes id argue the onscreen are slower to read and annotate..
Perhaps I’m having a downer - but what real leaps forward in IT do you think we have had? other industries have had real disruptive innovation… has primary care? don’t say SMS… while its been a huge change - really SMS.. is the major innovation? Video… no ones doing it? remote GPs - its not working… big data - extracting data still seems to not work properly.. no one has really made the most of smartphone/pad working - people have laptops with VPNs that just give them the same desktop client… banks / shops are really innovating with apps. User interface - well its WIMP and GUI but is it really any better? AI… not really happening.. working at scale… clunky and expensive and not really there yet..
In the recent “future of general practice” document it talked about the importance of continuity of care - a significant reduction in mortality and morbidity if you have named GP care - even if thats in a supervisory role. The document talked about having a named GP in charge of X pts perhaps supervising the ARoles and other staff looking after that patient but knowing whats going on - being able to track care.
Do we need to completely rethink out EPRs to enable/improve this?
We currently have few current tools to ID who is looking after who - if ive seen a pt 5 times are they mine? if ive referred them are they mine? do we let pts choose who is their GP do we distribute them equally? some pts need more care than others are my 2300 pts needing as much care as someone elses? Can we add tools to our existing systems to enhance named care
However the whole current concept of how our EPRs work doesn’t give a GP a view of how their patients are doing - who is seeing them - what is happening to them…
Do we need dashboards? can we learn from project management software - think of each patient as a project - where are they on their Gannt chart - who is stable - who is being investigated who is requiring treatment - who is the highest risk - who was admitted last night - who has seen the DNs - who is on a pathway and is breaching the limits of that pathway?
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Many electronic records are a mess. If you look at a summary of problems - it should be a neat tidy list of active and past problems split into major and minor. Perhaps with episodes linked so that Abdominal pain that became gallstones that ended in a Lap Cholecystectomy should be grouped together. That MI (heart attack) should be obvious so should that Duodenal ulcer even if it was 10 years ago. In practice they are a mess with all sorts of things showing that shouldn’t, significance all over the place and despite a few OCD GPs attempts with the plethora of people involved in care its very easy to get into a mess. Now you could argue that the system shouldn’t let you do this.. that’s another post… the question for today is how do we tidy them up?
Remember the GP record - forms the basis of the shared record that all other users use. The record goes off to insurance companies and Pensions agencies and Benefits - often in a right mess.
For most it only takes 5 mins to tidy them up but with 10000 pts and a 5% turnover a year most people haven’t the time.. But its a simple rule based system - had an MI? That’s a past significant problem. Got 27 diagnoses of asthma - combine them into one and give the starting date etc.. isn’t this rich for RPA to sort?
The problem who pays? The GP?? well good luck with that one - we are struggling with electricity bills and yes while it may make my life easier a lot of the benefits are to others? So would the insurance companies pay? That’s the way iGPR works… should the regulators build it into the requirements for an EPR? probably… Should shared records teams care about the quality of the data going into their Lakes - I think so… an RPA company isn’t going to build this without someone paying for it.
However given patients are about to be given full access to their records - could we ask them to do it?? on their own records? or even more radical could we crowd source it? are there mad individuals that would sit and tidy up others records for something to do? or some sort of reward? could it be built into some form of I’m not a robot widget.. though of course a robot would be good at it…
High quality easy to read notes summaries benefit everyone - why aren’t we pursuing them?
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@hollyhealth are offering 6 months free of digital health and mental well being coaching to NHS staff. https://lnkd.in/e5payg2Q“
“(disclaimer ive not tried it - and im not on commission just passing on the info in case you find it useful - any feedback welcome)
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This report out today. Thoughts/comments later… but first read seems to support traditional partner based general practice.. interestingly the conclusion recognises there is a Crisis in general practice…“
“#generalpractice
My wife Dr Carolyn Paul (right) who co-leads our joint cross practice clinical trials team with me gets some pleasant publicity for getting the first patient in the north west on a new study we are doing!
Supporting GPs in winter document is out - headlines are“
“1. can use ARoles money on GP assistants and IT support”
“2. some IIF indicators removed and money put into support pot”
“3. some indicators made easier”
“4. some efforts being made to reduce training/paperwork to free up clinical time.”
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“ICBs are being asked “
“1 to look at cloud based telephony for all”
“2 to look at what BI tools are being used to assess demand access and capacity”
“3 to look at spreading successful process automation and working at scale initiatives to reduce admin burden”
“4 there is talk of some capital money for investment in estates”
“and a push to make sure Ext Access is going ahead.”
“5 a push to make sure the IT hardware is sufficient to deliver..”
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“There is a push to make sure GP websites have the right info on them.”
“there is a push to make sure appointment systems are efficient”
“there is a push to make sure BP@home and LTC remote monitoring schemes are up and running”
“and a push to make sure people know of pharmacy schemes that might reduce burden”
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“Some push to have SPLW and CCs get involved in High Frequency attenders.”
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“My opinion - most of these make sense and hopefully should be happening but little is new - we have been doing most of these for months now. reducing the IIF indicators might reduce workload a little but its a bit late and a bit of nothing really. Dont see much of this really sorting winter.. “
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“#primarycarenetworks
My PCN had a great session with Ben Hampshire from Edenbridge APEX - given the DH are going to publish GP appt data - he’s helped us see the practice’s in my PCN GPAD coding is not great.. completely undercounting what we are doing. Having sorted it - Using Apex allowed me to show near live data on activity in primary care to our local acute trust yesterday demo’ing that its not just them that are busy!
GPs/PCNs are going to be allowed to employ digital leads under Aroles funding. Details are sketchy but rumour is 8a level which is fairly senior and not sure some smaller PCNs will want/need this but it might drive an expansion of IT expertise in primary care not along side it…. thoughts comments??? #primarycarenetworks
Does anyone know if any of the GP apps (or indeed the NHS app) list all upcoming appointments (no matter how booked) AND allow people to cancel them?“
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“I know some surgeries don’t turn on online appt booking or only allow a few appts to be booked on line.. and I’m not saying this is right or wrong. However Id like the app to list any upcoming appointments a patient may have whether booked online or phone or in person AND allow them to cancel it - so that it was removed from the appointment system and was available to book (even if not online)”
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“Hope this makes sense?”
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“#GPIT #primarycare #nhsapp
I’ve heard a rumour that GP apps that SMS patients may be soon able to send messages to patients via the NHS app (and presumably save sms costs? - this would be a huge win if so? anyone know the details? is it open to all?
Anyone know of an accredited laboratory that does Lipoprotein(a) tests ideally in the newer nmol/ml units? Preferably one that will accept batch frozen samples from us - we are doing a research study and need a load doing and the lab we are speaking to is being very slow…
Did you know that our free to use How2.training website not only has videos on using EMIS web and other IT systems used in general practice it also has videos to help practice managers such as this one on using CQRS - We would love to hear what else would be of use! - get in touch!“
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“https://lnkd.in/e3YZYMkJ”
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“We are also putting a lot of our content on YouTube to make it even easier to access.”
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“#CQRS #GP #practicemanager #practicemanagement
The current tax rules mean that some doctors (hospital docs as well as GPs) basically cant work any extra hours as they end up taking home less money if they do! Given the huge waiting lists and backlogs in the system this is crazy and counter productive. This isn’t about doctors earning more - this is about people having less access to health care because the workforce is currently penalised for working harder!“
“Please sign!”
“#doctors #healthcare #tax #NHS”
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“https://lnkd.in/exxm3htk
We have just done a quick video of the new e-sign function in EMIS web for Fit notes and how to send it electronically to patients saving everyone time.“
“The video is one of our free to use training collection of videos on www.how2.training aimed at improving the use of primary care IT systems. #training #gptraining #gp #primarycareIT #emis #accurx
Miriam and Vicki from Libera Partners have done a couple of great OD sessions for us in SMASH PCN. Miriam really gets PCNs and the NHS and provided great advice to me as CD. She’s also an active member of the PHCSG of the BCS and has been around primary care IT for quite some time - she gives a lot of good advice on IT strategy and is an expert on passing CQC inspections.“
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“If you are a PCN CD or manager highly recommend you speak to them!”
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“#nhs #pcn #generalpractice #clinicaldirector #primarycare
Anyone know if #Alivecor have an API? I love their new 6L device (my GP federation bought about 100 of the old ones for local GPs but the 6L is much better!) and use it all the time in my surgery room - but their basic app is not really aimed at doctors. Its for members of the public. It defaults to the ECG being you (I dont want some being sent to my Apple Health) although there is a guest mode.. it has no features. They have a all singing cloud platform that is too much and too American and aimed at onboarding large numbers of patients who buy the device. I just want to get the reading I take in my room into the notes with ideally the appropriate Snomed codes. “
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“Need a simple app that reads the ECG - lets you input the patient details and then ideally upload it into my clinical system (or send it to docman - which I think is possible with an email)”
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“Any app developers interested? If there is an API cant believe its a difficult one… Im sure Alivecor users would pay a fee for an app that did this simply and efficiently. “
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“#medicalapp #ecg
Further to a previous post we have now updated our advice on the new GP contract and in particular the PCN DES - to include up to date information from April 22.“
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“#primarycarenetworks #PCN #generalpractice #primarycare
This is a case study and explanation of how Howbeck Healthcare is helping 10 PCNs deliver the Enhanced Access component of the PCN ES. We use a practice based model that aims to keep as much of the money at practice level as possible and minimise the overheads. Happy to answer questions.
From an IT point of view we utilise EMIS enterprise consultations and we monitor all the activity with Apex from Edenbridge.
Is it right that Vaccine targets in QOF are not on a scale and there is no way to exempt a person who refuses to be vaccinated? 1st MMR target is 95% - we have over 90% done but only 1/18 points as the indicator does not allow us to exclude those with informed dissent or other valid reasons. We have taken on a load of Afghan refugees and registered them fully and providing all health care to them but we stand to loose £30K income because they didn’t have mmr in their country in the right time scale! - thats a nurse we might have to sack… is this fair?
GPs in deprived areas tell me this is a common thing for them - that they constantly suffer because their population doesn’t attend for these things. They work harder to achieve and fail to be rewarded than more affluent areas - is this how we reduce health inequalities? Perhaps its just easier to not bother at all for anyone is that right?
We urgently need the ability to exclude those that either have informed dissent or just refuse to engage despite trying (most other indicators have this).
Here is a briefing document Howbeck Healthcare prepared for the PCNs and practices that we work with - for them to discuss this year end pending the new contracts and regulations - fine details to come.
Feel free to share! Any questions get in touch.
Our main message is the line between PCN and practice is blurring and practices need to take PCNs and the contracts seriously
(a lot still seem to be disengaged.) Read the briefing document here.
Here are 10 ideas on how to make clinical trials easier to do in primary care in the UK. (some of these are based on some mentioned in an interview my research nurse heard on the radio with one of the Oxford Prof’s who worked on the covid vaccine - apologies don’t have link) but we have expanded the list.
keep the protocol as simple as possible and only do things that are routinely done in primary care. (while I’m lucky enough to have 2 massively experienced research nurses not every practice has)
base the inclusion / exclusion criteria on data/codes routinely kept/measured in primary care
provide tools to help find and manage recruitment
base numbers and power calcs on real numbers from real results from searches based on the above already collected codes and values already measured
only measure things that are routinely measured in primary care so routine primary care staff can do the work and routine visits help add to the data
stop doing everything fasting as it massively limits when a patient can be seen
use local labs as deliveries and pickups from couriers are a nightmare
look at how more visits can be done virtually
look at how IP can be kept at more than one location as this limits multi practice recruitment or consider IP delivery by post or other source
for the right study think about pre approving SMS/social media messages as we use these media a lot.
and finally get GPs involved at an early stage to advise!
This is a really nice report pulled from Apex (from Edenbridge) for our local GP Federation on practice activity over the last two years. (we are also looking to do it for the 2 places we cover) #primarycare #GPappointments
from april - patients can see all of their notes including free text. what if you need to redact something? weve created some training videos!“
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“remember how2 is free to use for nhs staff. just register and browse.
An interesting article about how ARRS or Aroles staff are going in general practice.“
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“My reading of the report: Not going as well as it could be.. Problems with culture, with purpose, with contracts, with estates, with perhaps not enough of the most useful groups being available, with perhaps some of the staff being more junior and needing more education/support than was hoped.”
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“In my PCN.. we have devolved most Aroles budgets to practices and encouraged practices to employ the staff directly to their needs rather than impose a one size fits all solution. I think we have welcomed the investment, certainly its added to the skill mix but we certainly recognise some of the issues in the report.”
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“https://lnkd.in/eg_Rs7eB”
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“#generalpractice
The future of general practice has been published…. and it might be quite different from what we have now…“
“https://lnkd.in/eJ3RVDdx”
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“However document isnt saying anything massively new. Move to salaried/at scale general practice - which might be quite controversial. Embracing Digital - NHS gateway and NHS App to be a major route into NHS - not sure how this affects existing App makers? - possibly changing the data laws to promote data sharing and research. Virtual doctors in hard to recruit areas (already doing this..) “
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“#generalpractice
One of my contacts is asking does anyone know of any online/electronic solutions to DMARD monitoring? At the moment locally patients have hand hold records. “
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“The ideal solution would ideally be integrated with EMIS or similar, auto-populating for blood results, visible to patients/primary care/specialist, and allow for localisation of reference ranges and alerts for patient as to when to contact a clinician.”
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“thoughts?
Some quite depressing GP workforce figures out today. There are now just 0.45 fully qualified GPs per 1,000 patients in England – down from 0.52 in 2015. For the GPs that remain, this means increasing numbers of patients to take care of. The average number of patients each GP is responsible for has increased by around 300 – or 16% - since 2015. “
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“Despite there being 1,516 fewer fully qualified FTE GPs today than there were in 2015, each practice has on average 2,222 more patients than in 2015. With over one in 10 (16%) of respondents to a BMA survey saying they plan to leave the NHS altogether after the pandemic, this figure is expected to rise.”
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“General practice appointment bookings reached record highs over the winter of 2021 with GPs seeing more patients than ever abeit some on the phone/video.”
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“See the report: https://lnkd.in/euJXcjpd”
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“Other data shows the average age of a patient seen has gone up, the number of times a patient presents a year has gone up and the complexity of what is wrong with them is going up.
an interesting new feature that I plan on trying out at my surgery - love the idea of being able to sms someone a link that only lets them book into the type of clinic I want them to but still gives them choice and frees up my reception team! lets hope its as good as it sounds… ill let you know!
My research team at Ashfields Primary Care Centre, Sandbach have been working with a couple of companies to provide them with human biological samples for testing their assays and new products against in vitro. We helped in the ethics submission (all work is regulated and approved) and helped in writing the Patient info leaflets. We recruit volunteers and consent them and obtain the samples processing them and sorting transportation to your labs as needed - we have centrifuge, -20 and -80 freezers etc. We have obtained venous blood, skin biopsies and mucus membrane swabs but other samples may be possible either from random patients or specific patient groups. If you are a company interested in obtaining human tissue samples get in touch - DM or email me.“
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“#research
The other night I did my first online parents evening. I had 10 minute slots with teachers. It was great I sat at work - my wife sat at her work - no rushing home to get to the school - what was interesting was it hade a countdown and built in clock and we got 10 mins with the teacher and not a second more - it closed the window at the 10 minute mark… Now my GP appointments are 10 minutes and would it be awful of me to want this features in our video consultation software??
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This is amazing news - and really proud to be involved even in a small way as one of the clinical advisory team to PocDoc - has the potential to change chronic disease management in primary care
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A post on my practice Facebook page the other day about Tinnitus got almost 2000 views and developed a conversation between patients on useful resources and self help solutions. During the early stages of our vaccination programme some posts were getting over 10000 views. Social media is a great way of communicating with your patients. #selfhelp #socialmedia #facebook
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Some of you will know that we run How2.training as a not for profit GP IT training platform. We have over 1500 active users with more joining all the time. We cover an every increasing range of GP IT software - not just EMIS Web but Docman, Edenbridge Apex, Ardens Searches, iGPR etc..“
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“Registration and use is free for NHS users.”
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“We have just created a YouTube channel to showcase some of the videos and to demo what kind of content is on there.”
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“Have a look at our new channel https://lnkd.in/exVcwKF2”
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“We would love some feedback - should we put all our content on YouTube? For the moment please register on the main How2 site as you get extra functionality - including customised playlists, CPD certificates and ability to record notes etc.”
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“#primarycarenetworks #GPIT
Next frustration… Multiple copies of the same patient letter. Sometimes I get a photocopy delivered by hand or posted to me, or the patient sends their copy of a letter. Sometimes these come in over a period of days and they all end up in my inbox needing to be read and/or actioned. Worse if they arrive on days when I’m not in, someone else has to action them - at least I might remember I’ve seen it before. So three doctors reading and actioning the same letter!
Why can’t each letter produced by a Trust have a UUID on it that IDs it and my document software recognizes this and says… oh you’ve had this before??
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Frustration no 2453: Admittedly I do a lot less home visits than previously - partly due to the fact that we now directly employ some ANPs to do them, but it always puzzles me why GPs can’t carry and personally dispense a range of medications for home visits.
A house bound patients rings for a visit - they wait to be seen - someone comes out - examines them - diagnoses them and issues a prescription - at this point is the problem. How do they get the prescription? Ok if they have someone with them who can travel to a chemist but that’s not always the case, often you ask can any neighbours/friends/relatives get it for you. Some chemists deliver - but not all the same day, quite often I ring a chemist and beg them and sometimes we have to ask another chemist to the usual chemist the patient uses as they don’t always use the one that delivers same day. But sometimes it’s late in the day or no one will deliver same day. So despite being ill, despite being the most vulnerable, they wait for treatment. Often its antibiotics or a very small range of prescriptions.
Why cant I carry some or have a visit box and dispense them?
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On the whole I find video consultations add little value over a phone call in most cases. However they might be really useful if I (as the consulting doctor) received (with permission) other information along side the video image.
There are perhaps two parts to this:
Live data from the video stream - I’ve seen several apps that can detect physical parameters like heart rate/temp from the video image. These would be cool and I’ve mentioned them before. I suspect the developers of this tech need to license it to others for its mainstream use.
Equally useful would be information perhaps gleaned from the users phone prior to the call. Some demographic e.g. up to date contact details, emergency contact details, allergies, location and any recent readings from attached devices e.g. BP machines blood glucose pulse ox etc. If all users attached medical devices recorded their data into Healthkit or its android equivalent - why cant Healthkit send me some of that data as “metadata” along side the video image? or perhaps just send it on direct request. Perhaps even better might be the ability to send a questionnaire or similar to be filled in prior to the call.
Any thoughts on if this is possible? At the moment we seem to send a link that opens up in a browser - could data be sent that I could receive? I think it would really push the sales of devices that write to something like Healthkit if the data was sharable - of course, a commenter will no doubt tell me this already exists!
Even the ability to ping a patient and receive back some of the data stored in their Health app - to be filled in their records might be useful.
How annoying just spent half an hour trying to get a pivot table to give sensible information in #excel for Mac - and not understanding why it isnt.. and it turns out that despite having a menu item called discrete count - it doesn’t work and gives the same answer as count (it shouldn’t) according to some forums its a well know missing feature.. but its not documented - why cant it pop up with a message saying this doesn’t work rather than just giving the wrong answer and confusing the hell out of me!!!
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Is it time to setup a national vaccination service?
I read yesterday that we might need to give multivalent covid-19 vaccines for some time perhaps along side flu jabs but perhaps on a more than once a year basis and to more than just the traditional flu cohort. Anyone that wants GPs to go back to some sense of normality can’t expect GPs to be doing this every 3-6 months. Flu jabs take up months of GP time each year. Covid-19 jabs seriously disrupt practice. If we need the NHS and primary care to get back to normal we need a separate well run service from proper premises with proper facilities and not staffed by people doing overtime and reliant on unpaid volunteers.
Time to start planning/designing/building now?
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Anyone else fed up of The BBC news app (and others) over alerting?“
“It seems to go off all the time for some fairly boring news. Can I suggest 2 ideas for improvement?”
“They introduce a scale 1-10 of news worthiness. I might subscribe to 1 - War - the Zombie apocalypse - death of a monarch..etc. some might subscribe to 10 - and get Z list celeb opens shop or PM resigns.. “
“Alternatively could they introduce a feedback button - did you think this was alert worthy? NO…. could they or could an AI bot on their behalf learn which news items are worth alterting for and which not…
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Ok - my GP federation in South Cheshire is looking to ‘hire’ a BI/Data analyst/visualisation expert to work with us. Preferably on a contractor basis - someone who has some time free but isn’t looking for full time.. experience of NHS data sources and public health data sources would be useful, experience of working with primary care data - extracting/manipulating and clearly presenting and cross linking to some of the other data sets again really useful. happy to do this virtually - so location isn’t really an issue. get in touch - if interested - neil dot Paul at nhs dot net
This is so cool - link it to your smartphone and it gets called as you collapse - there is already an app that when activated alerts any first responders in your area to come help you - link the 2 together…. and they have the kit to help you when they get there. (interestingly the app mentioned shows the nearest portable defibrillator but this saves having to go get it!)
In the book Good Omens there is a brilliant scene where the demon character Crowley moves some road cones and changes the layout of the m25 into a symbol that promotes devil worship and all the commuters going round it add to the power. I wonder if EMIS is doing something similar? How often does it crash? how often does it go wrong or slow or hang… Today - several what’s app groups im on - some local some regional one national are full of GPs saying - “why is emis so slow?” there must be hundreds swearing and adding to the devils power again today. “
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“Given I was on a NHS E call last night where they basically said the next 2 weeks are going to be hell - do we really need an IT system that slows us down all the time? causes us to run late…. With all the IT startups around at the moment - how about a lean mean browser based way of viewing records and entering data that runs quickly and speedily? or is it time to switch?
I’m seeing a lot of rashes post Covid and post Covid vaccination - here is a useful website I’ve come across from the British Assoc of Dermatologists: www.covidskinsigns.com“
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“#covid