All things General Practice! Join doctors Sara and Lisa as they interview specialists from around Greater Manchester with the aim of improving the confidence and knowledge of local primary care clinicians. The podcast has been made possible due to the support of Wigan CCG and GP Excellence in Greater Manchester.
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Now that the Greater Manchester Enabling Safe Certification of Death in the Community service is being stood down, we take the opportunity to talk through the new legislation (from the Coronavirus Act 2020) and how this applies in practice. Dr Aamna Khan (GP and Clinical Lead for the Enabling Safe Certification of Death in the community service) and Dr Viren Mehta (GP partner, clinical director of his PCN and clinical director for Stockport CCG) take us through this important subject. They discu...
At the moment with increased isolation, anxiety and loneliness, social prescribing has become more important than ever. Sara and Lisa speak to GP Dr Jaweeda Idoo (clinical champion for personalised care in Greater Manchester) and Sophie Glinka (social prescribing lead for people and communities in Greater Manchester) about the role of social prescribing during COVID-19 and indeed in general. They talk about some case studies where social prescribing has been invaluable to the care and support of...
Staff risk assessments in primary care during COVID-19 are generating many questions such as; Which tool? How should they be carried out? What are the advantages and disadvantages of doing them? How does Vitamin D fit in? What does this mean for practice? GPs Sara and Lisa talk to Greater Manchester based GP Dr Jaweeda Idoo and Practice manager Gina Bird about their experiences of staff risk assessments in general practice at the moment. ____ Useful resources: BMJ Covid-19: Known risk factors fa...
Recorded in January 2020, this is the long awaited second part of Lisa and Sara’s conversation with Professor Anthony Jones and Consultant Physiotherapist William Gregory from Salford Royal Foundation Trust. In Part 1 we covered diagnosis and in Part 2 we look at management of fibromyalgia including: The role of targeted CBT and physiotherapy Groups for patient education and support The role of medications Where secondary care fits in Research in the area The place alternative therapies occupy f...
With so much changing in how we work in general practice at the moment, assessing and investigating patients for suspected cancer symptoms can be a challenge. To help talk us through the current situation, Lisa and Sara speak to: Dr Sarah Taylor: GP in Fallowfield and Cancer Research UK Cancer Diagnosis Lead for Greater Manchester Dr Viren Mehta: GP in Cheadle, Clinical Director at Stockport CCG and Clinical Director at his PCN We discuss: Thoughts around how to assess patients with suspected ca...
Yesterday was international nurses day and so we wanted to highlight the great work that is being done by our community nurses during COVID-19. Our guests are: Lesley Royle-Pryor: Primary and Community Nurse Lead for Greater Manchester Health and Social Care Partnership Moira Ogunsakin: Greater Manchester Training Hub Lead Nurse, Lead Nurse for Practice Renewal for Salford Primary Care Together and Practice Nurse in Salford Dr Joanna Bircher: GP Partner in Tameside and Glossop and Clinical Direc...
Lisa and Sara talk to doctors involved in primary care research to give an overview of what developments are happening in COVID-19 research in the community at the moment. Our guests are: Professor Philip Evans - GP, Associate Professor of General Practice at The University of Exeter, National Speciality Lead for Primary Care at NIHR, Cluster Lead at Clinical Research Network National Speciality Hub Dr Sheila McCorkindale - GP, Local Clinical Research Speciality Lead at NIHR Clinical Research Ne...
Lisa and Sara take a short break from full recording this week. They give an update on what to hopefully expect from episodes over the next few weeks as well as sharing a couple of useful links and information from listeners. Useful resources: Bereavement helpline number: 0800 2600 400 Centre for Evidence Based Medicine, Oxford: https://www.cebm.net/ NHS England Time for Care: https://www.england.nhs.uk/gp/gpfv/redesign/gpdp/releasing-time/ ____ We really want to make these episodes relevant and...
There have been a lot of questions within primary care regarding shielding and vulnerable patients. Sara and Lisa speak to Dr Joanna Bircher and Dr Viren Mehta about the confusion and get their thoughts on the subject. In the episode we cover: Demystifying all of the terminology and putting it into simpler terms. What has been asked of primary care with regards to these lists of patients, tips on how to complete these tasks and where to look for help. How to support extremely vulnerable/shielded...
A current concern for primary care clinicians is how to manage end of life care in the context of the COVID-19 pandemic. Lisa and Sara are joined by Dr Liam Hosie, Dr Adam Firth and Dr Viren Mehta who have sifted through the key information and guidelines that are available on this topic. We talk about: Advanced care planning Common symptoms for patients with COVID-19 at the end of life Discuss 5 guidelines (including NICE, RCGP, Hospice UK) relevant to this topic and some take home messages Ant...
Lisa and Sara are joined by GPs Dr Viren Mehta and Dr Joanna Bircher who summarise new guidelines and evidence relevant in primary care this week. Covered this episode: Clinically recognised natural courses of COVID-19 infection Remotely assessing and risk stratifying COVID-19 patients Learning points from the updated standard operating procedures from NHS England Salient points from the new NICE guidelines on managing pneumonia in adults in the community Briefly touch on the updated PHE guidanc...
In this, our second of the COVID-19 specific episodes, GPs Lisa and Sara are joined electronically by Dr Dan Bunstone (GP and Clinical Director of Warrington CCG and Chief Medical Officer at Push Doctor) and Dr Joanna Bircher (GP partner, clinical director for GPExcellence and Pandemic Lead for her PCN). We discuss: Advantages of telephone and video consultations including how to use the golden minute, picking up cues on video consults and when they might be most useful. Safety points around con...
We have decided to take a break from our normal release schedule to do a special, weekly series about the COVID-19 situation which is unfolding. Our hope is that we can provide some useful and practical information for everyone within primary care during this difficult time. In this first episode we talk to Dr Joanna Bircher (GP partner, clinical director for GPExcellence and Pandemic Lead for her PCN) and Dr Viren Mehta (GP partner, clinical director of his PCN and clinical director for Stockpo...
In this week’s episode Lisa and Sara speak to Professor Anthony Jones and Consultant Physiotherapist William Gregory from Salford Royal Foundation Trust to learn more about Fibromyalgia. In part 1 we cover what the condition involves, the central sensitisation theory, useful examination tips and differentials to consider. We also talk about simple ways of explaining a diagnosis of Fibromyalgia to your patients. In part 2 (which will be released in 2 weeks), we break down management options as we...
Bronchiectasis can sometimes be overlooked amongst the other, more common lung conditions such as COPD. Because of this, it can be difficult for primary care clinicians to be fully aware of how to comprehensively diagnose and manage patients who have this condition. Lisa and Sara talk to respiratory consultant Dr Ashish about bronchiectasis. We learn exactly what this condition is, what the risk factors are for developing it, and when we should be suspicious of it as a cause. We also talk throug...
Interstitial lung disease (ILD) can be difficult to identify in primary care and unfortunately for some patients, currently carries a poor prognosis; the median survival for those with idiopathic pulmonary fibrosis is only 3–3.5 years ( https://www.england.nhs.uk/wp-content/uploads/2018/08/Interstitial-lung-disease-service-adult.pdf ). Lisa and Sara talk to respiratory consultant Dr Ashish about this condition. We learn about when to be suspicious about a diagnosis of ILD, who is at risk and the...
Worldwide, sepsis kills more people than cancer ( https://www.bbc.co.uk/news/health-51138859 ). In 2050 it is predicted antibiotic resistance will kill more than cancer ( http://bsac.org.uk/securing-new-drugs-for-future-generations/ ). What a difficult balance! Lisa and Sara opportunistically talk to Trafford GP Dr Anya Leaver about antibiotic prescribing in Greater Manchester. We discuss the issues, recent changes in local guidelines, helpful tips to improve prescribing practice, great resource...
Lisa and Sara talk to several different primary care professionals about portfolio working. Dr Anya Leaver, Dr Hussain Gandhi, Practice Nurse Alyson Rimmer, Dr Nikesh Vallabh, and Dr Saira Zaman share with us their journey into Primary Care, how they got involved in their different roles outside of clinical work, what it means to them and advice for those out there wanting to explore adding variety to their working week. ____ Useful resources: eGP Learning (made by Dr Gandhi): https://egplearnin...
Lisa and Sara talk to GPwSI, Dr Rachel Hilton about Urticaria (aka hives/wheals). She talks us through the pathophysiology, causes, potential triggers, history, examination and management of this sometimes difficult area. ____ Useful resources: Skin Support Website (urticaria page): http://skinsupport.org.uk/conditions-details/urticaria-and-angioedema British Association of Dermatologists (urticaria leaflet): http://www.bad.org.uk/for-the-public/patient-information-leaflets/urticaria-and-angioed...
Lisa and Sara talk to GPwSI, Dr Rachel Hilton about Generalised Itching. She talks us through how to approach a patient presenting with generalised itching, the common and important causes, useful investigations and the management that we can try in primary care for these patients. ____ Useful resources: BATHE Study, BMJ 2018: https://www.bmj.com/content/361/bmj.k1332 Skin Support Website (pruritus page): http://skinsupport.org.uk/conditions-details/pruritus British Association of Dermatologists...
Lisa and Sara talk to Dr Rebecca Baron from Health Education England about Resilience. This is part two of a two-part series about Resilience. In this episode we continue the theme of exploring resources available to healthcare professionals around resilience; books and research that have advanced the field. Rebecca gives us her learning points from these. ____ Resources mentioned in the episode: • When “resilience” becomes a dirty word - BMJ article by David Oliver July 2017 https://www.bmj.com...
Lisa and Sara talk to Dr Rebecca Baron from Health Education England about Resilience. This is part one of a two part series about Resilience. In this episode we talk about what Resilience is and how it started as a concept in general and in healthcare. We also hear about the neuroscience behind Resilience and Rebecca goes through some resources that she has found particularly helpful herself. ____ Resources mentioned in the episode: BMJ article by David Oliver - When “resilience” becomes a dirt...
Lisa and Sara talk to Consultant Haematologist Dr Chris Gregory about Immunoglobulins. The subject is approached from the point of view of primary care clinicians ordering immunoglobulin blood tests. We get Dr Gregory's opinion on when it is useful to order an immunoglobulins blood test and go through the possible meaning of all the different types of results. We discuss raised immunoglobulin tests and the difference between monoclonal and polyclonal rises. We discuss the diagnosis of MGUS (mono...
Lisa and Sara talk to Consultant Haematologist Dr Chris Gregory about B12 and folate deficiency. In this episode we talk about B12 and folate deficiency; How to investigate further and manage these results as well as touching on other causes of macrocytosis including haemolytic anaemia. ____ Useful resources: British Society for Haematology guidelines 'Diagnosis of B12 and Folate Deficiency': click here ( https://b-s-h.org.uk/guidelines/guidelines/diagnosis-of-b12-and-folate-deficiency/) ____ Ha...
Lisa and Sara talk to Consultant Haematologist Dr Chris Gregory about anaemia and iron deficiency. In this episode we talk generally about anaemia, how to interpret full blood count results and iron deficiency anaemia. ____ Useful resources: Blood Journal article 'So you know how to treat iron deficiency anemia': click here http://www.bloodjournal.org/content/126/17/1971?sso-checked=true ____ Have feedback or suggestions? You can help us know how we are doing with our 5 minute survey: click here...
Lisa and Sara talk to GP Dr Gatenby about contraception. In this episode we talk about when contraception becomes effective when starting or swapping contraception types, quick starting pills, post-natal/breast feeding considerations for contraception as well as contraception around peri-menopause. ____ Useful resources: FSRH up to date guidance for all contraception matters: click here Stockley's interactions checker (requires subscription): click here ____ Have feedback or suggestions? You can...
Dr. Jacqueline Gatenby discusses the critical importance of contraception, its impact on women's health, and an overview of various methods, both hormonal and non-hormonal. The episode delves into innovative combined pill regimes, differences in pill preparations and associated VTE risks, and strategies for managing common side effects. It also thoroughly covers expected and unscheduled bleeding patterns across all hormonal contraception types, offering guidance on investigation when concerns arise and practical management strategies for non-worrying bleeding.
Dr. Karthik, a consultant cardiologist, joins the podcast to discuss palpitations and atrial fibrillation. The episode covers comprehensive guidance on defining palpitations, conducting initial assessments, interpreting ECG findings, and managing AF in primary care. Key discussions include when to refer patients, the role of beta blockers, and the benefits and considerations of various anticoagulation options like NOACs versus warfarin.
Lisa and Sara talk to Consultant Cardiologist Dr Karthikeyan about cardiac causes for blackouts. ____ Resources mentioned in the episode: - GMC guidance on reporting driving concerns: click here - DVLA fitness to drive guidance: click here ____ Have feedback or suggestions? You can help us know how we are doing with our 5 minute survey: click here ____ This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not b...
Lisa and Sara talk to Consultant Cardiologist Dr Arya about Heart failure. Have feedback or suggestions? You can help us know how we are doing with our 5 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C ------------------------- This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The infor...
