Summer 2022 Department of Primary Care & Public Health Photo by Jackson Simmer on Unsplash Twitter logo by Alexander Shatov on Unsplash
SUMMER 2022 As a clinical department, we have a lot of interaction with the NHS in areas such as teaching, research and professional practice. I was therefore very pleased to see Professor Mala Rao lead work on the development of an induction programme for international medical graduates who are starting work in the NHS. The NHS remains short of staff in many key areas and this work will allow international graduates to understand the NHS better before they start their clinical roles. Congratulations to Dr Ravi Parekh and Dr Viral Thakerar on their Imperial College Teaching Awards. Finally, many thanks to everyone who helped with the Great Exhibition Road Festival 2022. I was very pleased to see the contribution from our department to the festival. Professor Azeem Majeed Head of Department of Primary Care and Public Health Imperial College London Follow Prof Majeed on Twitter We welcome feedback on the newsletter ARCHIVE PRIVACY NOTICE and are taking submissions for future issues. Email your news, events, achievements and stories to us. PCPH eMagazine Production Team [email protected] Designed and edited by Javier Gallego Editorial Assistant – Mehrosa Memood Subscribe Unsubscribe Copyright © 2022 Department of Primary Care & Public Health, Imperial College London
LONG TERM IMPLICATIONS OF COVID-19 IN PREGNANCY An article published in the BMJ by Allyah Abbas-Hanif, Neena Modi and Azeem Majeed, discusses the long-term implications of Covid-19 in pregnancy. Covid-19 in pregnancy we must pregnancy increases end the default the risk of severe exclusion of complications for pregnant women both mother and from the rigorous baby. The long-term regulated drug implications are development unknown, but process and emerging signals implement warn of substantial systematic, long public health term, population- threats. wide surveillance of infected and non- To counter high infected people. vaccine hesitancy in The full article can be read in the British Medical Journal. Photo by Alexander Krivitskiy on Unsplash
MONITORING DEATH RATES IN A GUIDE TO INDUCTION FOR IMGS IRELAND’S HOSPITALS RECRUITED TO THE NHS Congratulations to Professor Mala Alex Bottle Rao from PCPH for leading work to was asked develop an induction programme by for international medical graduates Ireland’s working in the NHS. Health The NIHR ARC NW London also Service provided support. Executive to lead a FREE ONLINE PUBLIC HEALTH review of COURSES FOR NHS STAFF Ireland’s LAUNCHED National Five new massive open online Hospital Audit of Mortality, a tool courses (MOOCs) are now available that allows staff to analyse their to help health and care staff patients’ deaths in public hospitals, improve their knowledge skills and including comparisons with the national average. His team’s review consisted of consultations with international experts, focus groups, user surveys, literature reviews and stakeholder consultations. The Board accepted his 12 recommendations, covering statistical methodology, better integration with the national sepsis and safety programmes, and the scope and format of public reporting of hospital performance on mortality, which remains of much public interest in Ireland as elsewhere.
understanding of public health Watch NewLocal podcast about the research. initiative - \"I'd like them for all my patients\": The community members The courses, offered through transforming a GP practice - New Imperial College London, have been Local devised and delivered virtually by Prof Helen Ward, Patient NIHR ARC Two of the CHWWs, Maureen and NWL Theme Lead, Public, Nahima (pictured), shared their Community Engagement and experience at the National Involvement, and Dr Thomas Association of Primary Care (NAPC) Woodcock, Deputy Theme Lead, annual meeting and dinner. Information and Intelligence. The initiative was showcased as an FIND OUT MORE example of best practice in the recently published Fuller report on COMMUNITY HEALTH AND the integration of Primary Care WELLBEING WORKERS CHANGING (page 8). It is a stocktake on THE FACE OF PRIMARY CARE integrated primary care, looking at what is working well and why, and The Community Health and how we can accelerate the Wellbeing Worker (CHWW) implementation of integrated Initiative, spearheaded by the primary care across systems. Innovation and Evaluation theme of the NIHR ARC in collaboration with primary care and local authority in Westminster, gained traction recently. Dr Sheila Neogi (GP Principal at Pimlico Health at the Marven which hosts the CHWWs) and Maureen Katusabe, one of the CHWWs, gave a well-received lightning talk at ‘Stronger Things – Community Power 2022’ event. This was organised by NewLocal Stronger Things 2022 - Community Power: The Movement Grows - New Local.
WFME STANDARDS WORKSHOP BY HEALTH INSURANCE IN IRAQ GENERAL HEALTH COUNCIL FOR LIBYA The Republic of Iraq with a population of 45 million is planning The aim of this series of awareness to introduce a national health workshops is to increase awareness insurance system to cover all the of the World Federation Medical population. The health system in Education (WFME) accreditation Iraq is highly centralised with large standards, not only their relevance proportion of it delivered through and importance in today’s medical the private sector (40%). The private education, but more importantly, sector is not regulated, and the their in-depth content and how to public sector is not well financed translate those standards into and suffered immensely since 1980 meaningful actions to improve due to wars and civilian unrest. quality, as well as get accredited. The talk was held on a Zoom To introduce a national health meeting in May 2022 and broadcast insurance, as the recent Act (2021) on the GHC- Libya social media envisaged, the health system should pages. address many issues and prepare the ground for such a major step. The panel included experts from the Most of the ingredients are missing EMRO region and a member from Finance, Regulations, Service the WHOCC team, Celine Tabche, to Delivery, Workforce, Governance. discuss the 7th standard of the WFME which is Quality Assurance. The talk presented in Baghdad by Celine presented a general overview the WHO Collaborating Centre of the Quality Assurance of Higher Director, Prof Salman Rawaf, to Education in the UK and looked at health leaders and senior managers, the specifics of medical education provided a comprehensive plan to GMC standards. Emphasising the prepare the health system in Iraq new ‘value-added’ indicator that for this major undertaking. The will be a criterion for higher WHOCC Team will support the team education organisations in the next at the Health Insurance Authority few years, the role of research, and and Ministry of Health in this the continuous monitoring and complex project. evaluation of the schools that encourages innovation and renewal. Watch the recording on YouTube
GENEVA TRIP opposed to only 30 selected due to logistical limitations) to the The WHO Collaborating Centre fascinating and very current talks attended a Virtual Geneva trip in with real specialists in the field of June this year. This student trip has public and global health. This year marked its 12th anniversary and the topics covered: due to the pandemic has been delivered virtually for the past 2 Global health inequity, Migration, years. With restrictions being lifted, NCD prevention, Food Security, the centre hopes that the WHO Workforce Resilience, Lessons from headquarters will resume physical COVID-19, and a career advising visits in time for the next year’s session. cohort. Nevertheless, the online format presents its own advantage: access for all the students (as AFRICA EXCON CONFERENCE In June Prof Salman Rawaf delivered a talk at the Africa EXCon Conference in Cairo, Egypt. The main mission of the conference was: Positioning Africa as the continental hub for Health innovation and trade; The objectives were: • Refocusing the minds of health and pharma business to Africa's investment potential • Ensuring equitable access of health technology to Africa • Thrive the health and pharma business in Africa • Incubate health innovation and trade in Africa LATEST NEW PUBLICATIONS FROM THE WHO COLLABORATING CENTRE: • Amati, F., McCann, L. and Spector, T., 2022. The gut microbiome, health and personalised nutrition. Trends in Urology & amp; Men’s Health, 13(3), pp.22-25. • Rawaf S, Tabche C. Public Health Workforce Development Through Virtually Interactive Training Courses. Public Health Rev. 2022;43. doi:10.3389/phrs.2022.1604657 • Castelpietra G, Knudsen AKS, Agardh EE, et al., 2022, The burden of mental disorders, substance use disorders and self-harm among young people in Europe, 1990-2019: Findings from the Global Burden of Disease Study 2019., Lancet Reg Health Eur, Vol:16 • Haagsma JA, Charalampous P, Ariani F, et al., 2022, The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study, Archives of Public Health, Vol:80, ISSN:0778-7367
TRAILBLAZING IDEAS AND UNIQUE EXPERIENCES FROM SCIENCE AND THE ARTS ON SHOW AS GREAT EXHIBITION ROAD FESTIVAL TRANSFORMS SOUTH KENSINGTON.
Sir Mo Farah at the Great Exhibition Road Festival
Ground-breaking theory and practice across science and the arts formed the backdrop for the Great Exhibition Road Festival 2022: Trailblazers, which saw over 38,000 visitors journey to South Kensington for the weekend-long festival. Imperial College London partnered with the Science Museum, Natural History Museum, V&A and Royal College of Music, as well as the Goethe- Institut, Royal College of Art, Royal Parks and the Royal Geographical Society to co-ordinate and deliver a unique programme of events. Olympian Sir Mo Farah (pictured Left) even dropped by the festival to encourage visitors to ‘exercise their mind.’ Talks, workshops, performances and activities saw audiences inspired by innovation in medicine, art, technology, design, chemistry and more, from cutting-edge virtual reality experiences to insight into forgotten histories, untold stories and scientific breakthroughs. As in previous years, the full programme drew on the vast wealth of expertise from the College, museums and cultural institutions who collaborated to deliver it. ENGAGING COMMUNITIES IN HEALTHCARE The Undergraduate Primary Care highlighted the importance of a Education team participated in this diverse and inclusive healthcare year’s festival. It was a fantastic workforce that is reflective of the event, and through their stall, the communities they work with. team interacted with many Children discussed how important members of the public across the healthcare professionals are in age spectrum. Children entered a supporting us to keep healthy and competition by drawing their ideal were not shy in being creative- healthcare professional with the some healthcare professionals even help of resident artist Anh Cao. had superpowers! Some also added the personal qualities that they thought Alongside this, adults at the festival healthcare professionals should were asked “What does good health have. By the end of the weekend mean to you?” which revealed a children had produced a vibrant, variety of priorities from “no aches diverse collage of drawings. It and pains” and “being able to do
what you want to do” through to They are constantly developing their “non-judgemental and equal care.” community-engaged primary care The team will use the themes curriculum. If you have any emerging from this to inform initiatives or ideas to discuss, get in development of their touch with Community undergraduate primary care Collaboration Lead Stephanie courses, supporting students’ Powell. Plus, if you want to know understanding of community the winners of the competition – priorities and holistic healthcare. follow them on @icgpteaching on Twitter! CONNECTING WITH THE COMMUNITY AT THE PEOPLE’S RESEARCH CAFÉ As part of the Great Exhibition Road had interesting discussions around Festival, researchers were invited to the possible future implications of engage with the community during her research. the “People’s Research Café\". Kim Foley, a research associate with the Reflecting on the day, Kim said, Child Health Unit and part of ARC “This was a fantastic event. In a two NWL hosted a table at this event to hour ‘cafe shift’, I shared my discuss plans for her next research research project ideas with project with public visitors. Her café members of the public during 5 table was co-hosted with a public rounds of discussions, each with 2-3 contributor, who had a critical role participants. This was an incredible in helping ensure conversations amount of public engagement in a flowed between researchers and short period of time! Their views the members of the public. are helping me to better refine the plans for my next research study, Kim briefly discussed her research and through our discussions, I was plans which will involve using able to refine my thinking and electronic healthcare records to better communicate the importance look at the impact of covid-19 on and relevance of my work to the child health. She heard from public. I would highly recommend members of the public about what this event to other researchers in matters most to them in relation to future!” her proposed plans and listened to their views on the importance of Kim is on Twitter and has tweeted her research question. Together about her experience at the with the public contributor, they People’s Research Café. Follow her to stay involved with her work!
Primary Care Education team Kim Foley and Kabelo Murray from ARC NWL at the People’s Research Café
By 4th Year Medical Students Ailin Anto & Arunima Basu Photo by Jackson Simmer on Unsplash Twitter logo by Alexander Shatov on Unsplash
Social media has become an integral part of our daily lives, with the average user spending approximately 2.5 hours on it daily (Statista). Many key organisations such as the government and research groups have indicated the detrimental effects that social media has on mental health, however, there are currently little resources within healthcare that addresses or acknowledges this impact.
The increased use of social media has been shown to impact anxiety, especially amongst university students, who are deemed to be a vulnerable population by many researchers due to their unique challenges and struggles. The Government and Royal Society of Public Health has acknowledged this to be a prominent issue for young people. Despite this, there are very limited tools in healthcare which incorporate social media as a contributor to mental health. One such tool is the HEADSS screening tool used amongst paediatric patients, where problematic SM use is screened for. Our iBSc project aimed to investigate if the impact of social media usage on mental health, specifically in university students, should be addressed in primary care. In order to explore how students (n=27) and GPs (n=7) primary care could address the to explore the barriers and impact of social media on facilitators to addressing social anxiety, key barriers and media induced anxiety in facilitators to addressing this primary care. These were problem need to be identified. subsequently organised into We conducted a qualitative GP, Student Patient and study using semi-structured Organisational factors (Figure interviews with university 1, Figure 2). Figure 1
Photo by Collins Lesulie on Unsplash
Photo by James Dryden on Unsplash
Figure 2 The barriers and facilitators are highlighted organisational colour coded to indicate which factors that could facilitate ones were mentioned by the change include training on the GPs, the students and by both topic, top-down influence, and (highlighted in the key). initiatives from official organisations such as RCGP as Barriers included perceived lack well as better support provided of GP awareness and in the community. Student knowledge of social media; Patient facilitators include high generational gap was student awareness and student highlighted as a possible reason education. for this. Some GPs upheld a cautious attitude towards This study highlights the enquiring about social media complexities associated with during consultations due to addressing social media’s perceived intrusiveness and impact on anxiety amongst low priority. Organisational university students within factors included system primary care. However, pressures constraining time, through utilising our findings funding, and existing we have created resources to demanding workload. Student help increase awareness of the Patient barriers included lack of matter and equip GPs with trustworthy resources and tools to tackle this issue. We resistant student attitudes. developed a potential Facilitators include GPs open framework of questions to attitudes to discussing social assess a patients’ social media media in consultations. GPs experience.
(CALM – Figure 3). that primary care faces with mental health and understand The tool aims to capture the that the system cannot take on impact that social media has on the whole weight of this the student’s anxiety levels and burden, so government and forms a basic framework for social media action is further discussion. We also desperately needed. created a short video in Meanwhile, we hope that with collaboration with students and these tools we can make the GPs, showing young peoples’ initial steps to equip primary and GPs’ views regarding social care to address this problem. media as well as how the CALM framework can be utilised. We acknowledge the vivid reality Contributors: Ailin Anto Arunima Basu Rania Selim Jahed Zaman Rafey Asif Haadi Salam Dylan Kanapathipillai
Photo (cropped) by Tony Liao on Unsplash
STAFF SUCCESSES “The best part of working with students for me has been in seeing the students flourish as they progress through the curriculum, but also as they graduate and become junior doctors”
The Imperial President’s Awards in Excellence 2022 took place at the South Kensington Campus on Monday 27 June. The ICGP Teaching and MEdIC team were delighted to be the recipients of a number of nominations and awards including the President’s Medal for Excellence for Teaching Innovation to Dr Ravi Parekh and the Award for Excellence in Teaching to Dr Viral Thakerar. Ravi (pictured left) co-founded and now with students forming meaningful co-leads Imperial’s Medical Education relationships with patients, staff and their Innovation & Research Centre. He uses peers. educational research to both improve existing teaching as well as launching new In the nomination form for this award, a initiatives. Ravi has designed and led student stated: “Dr Parekh embodies innovative longitudinal courses for everything students value at Imperial, the medical students based in the community. drive for educational innovation and These courses involve medical students excellence, and compassion and respect spending a longer time immersed within a for the many students privileged to have clinical team as part of their curriculum, worked alongside him.”
Reflecting on the award, Ravi said: “I feel honoured and humbled in winning the President's Medal for Teaching Innovation, I feel it is an award for our whole team, which reflects the quality and impact of our work in the Medical Education Innovation & Research Centre (MEdIC). I am very lucky to be surrounded by an incredibly talented and inspirational team, who have supported me through my educational journey. The MEdIC team believe passionately in the power that education has in helping to address societal problems, in particular, related to health & social inequalities. We have seen the impact our students can have when working in partnership with communities for transformational learning, as well as the ability to contribute through meaningful service to the priorities of the local community.” Viral (pictured opposite) is the Course Lead for the Phase 1a and b MBBS Patients, Communities and Healthcare (PCH) module. Viral’s commitment to inclusive medical education and person-centred clinical care has driven his outstanding work in education. He has applied his expert knowledge in development of comprehensive, person-centred care and digital health, innovative teaching materials for tutors working with the undergraduate primary and students to support learning about care team to develop PCH into a cutting- holistic healthcare, working edge course at the forefront of these collaboratively with under-represented fields, transforming the experience for students and community members to Imperial students, faculty and wider local ensure inclusivity. communities. This has included We are also proud to announce that one of our students won the President’s Award for Student Societal Engagement – Hamza Iklaq, 4th Year Medical Student “Hamza has dedicated himself to our widening access programme, WATCCH for the last 4 years, inspiring so many students and local school pupils interested in healthcare with his personal story and infectious enthusiasm. This award is so well deserved!” Dr Nina Dutta, GP Course Lead The ICGP Teaching/Undergraduate Primary Care team have won 13 President’s Awards in Excellence since 2016.
“I was truly humbled when I was awarded the President’s Awards for Excellence in Teaching. I’ve had multiple roles in the department, each of which has challenged me to develop myself in new directions. This award really speaks volumes about the encouragement and inspiration I’ve had from the department over the years. In particular I’d like to thank Sonia, Arti, Ravi, Nina, Neepa, Sian, Vanessa, Nadine, Michael, Tom, Steve, Jenna, Renee, Neha, Bhakti and Beth. There are countless others too. You’ve all supported me in terms of academic/professional development but also in terms of personal growth/wellbeing”
Instigating attitudes towards the routine pr
Pre-exposure prophylaxis (PrEP) is an antiretroviral medication that can be used to prevent being infected with HIV. The antiretroviral therapy is highly effective when taken as prescribed and reduces the risk of getting HIV from sex with people who are already living with HIV by more than 90%. provision of HIV PrEP in community pharmacy
Multiple studies confirmed the efficacy of PrEP in reducing HIV acquisition in men who have sex with men (MSM), heterosexual couples (where one partner is HIV positive), and in people who inject drugs, all of whom are considered in the high-risk group of patients. Knowledge of PrEP among UK gay & advice on sexual health, and bisexual men is among the highest in community pharmacy could be the Europe, but a small but appreciable ideal setting for individuals to learn number of users reported a knowledge more about PrEP and to access it if gap among healthcare providers, needed - but this area remains largely including negative judgements. understudied. A key question emerges: Greater awareness among health what are the barriers to the routine professionals is needed to ensure provision of HIV PrEP in community these experiences do not undermine pharmacy? access or adherence to PrEP. Additionally, knowledge remains low in Working in collaboration with the at-risk groups who may not actively Terrence Higgin Trust, the London identify as MSM, and other segments Pharmaceutical Committee (Marsha of society including ethnic minorities Alter and Shivali Lakhani) and Anne and in particular the Somali sub- Sullivan (Imperial), the Self-Care population who appear to be the most Academic Research Unit is conducting underserved as only a very small an eSurvey and interview-based study proportion use PrEP. To address this, to investigate barriers and drivers for the UK Health Secretary Matt Hancock the routine provision of PrEP in announced in 2020 that PrEP would be community pharmacy. The aim of the made available free on the NHS to study is to surface assumptions from those at high risk of HIV infection. The members of the public (including rollout of PrEP in England has begun in ethnic minority groups) and sexual health services, but it is still not community pharmacy staff regarding accessible from general practice or the need and sustainable plans for the community pharmacy. provision of PrEP via a community pharmacy route. Pharmacists have an important front- line role in providing information and You can learn more about the study, and consider participating in the anonymous eSurvey by following the relevant link below: • Survey link if you are a member of the community • Survey link if you are pharmacy staff
Reflections and highlights of a year as Clinical Teaching Fellows in Lifestyle Medicine and Prevention (LMAP)
Over this Academic Year we have had the pleasure of working as part of the Undergraduate Public Health Education team as Clinical Teaching Fellows. As junior doctors, this role has been extremely rewarding and has afforded us the opportunity to develop as educators, build connections with incredible colleagues and open our eyes to the breadth of population health opportunities in our future clinical practice.
A highlight has been incorporating the who support people with lived experience patient voice into much of our of exclusion to take part in education and Undergraduate material. As ‘fresh eyes’ research. This entire project has been co- reviewing this material, we were able to produced with Lived Experience Experts identify this as an area for development and three volunteer Phase 1B medical within the LMAP content. This work students (Avani Kaura, Misan Kakayor and began through working with patients to Reshaba Pushparatnam) to ensure its develop videos where they shared their relevance to all parties. lived experience of screening within the Phase 1C guided online learning. This Alongside our talented colleagues at the content promoted deep reflection from Digital Media Lab, we are now in the our students, who gained an process of editing the docuseries on the appreciation for why screening may be a experiences of socially excluded groups in frightening experience for people and healthcare. The first of these videos is due identified steps they can take, as future for release in July. We will incorporate doctors, to address this. these materials across our undergraduate teaching and aim to make these materials As our confidence as educators grew, we open access so they can be used across began to seek out further opportunities to the college and beyond. Further to this, in enhance the module further. As you may June 2022, we ran a complementary recall from the previous newsletter, we lecture to Phase 1A medical students with were awarded a grant from the Equality, a Lived Experience Expert on how Diversity and Inclusion (EDI) seed fund to Homelessness impacts access to incorporate the lived experience of social healthcare. As part of this, our medical exclusion into the LMAP content, through students (Avani and Misan) delivered a a live lecture and video content. We ‘near-peer’ microteach on the benefits of partnered with Expert Focus, a company co-production. “I have already learned so much from the Lived Experience Project! My eyes have been opened to the complicated reality and time-consuming nature of co- production. Students’ feedback from the live lecture, however, illustrates how important, relevant and advantageous learning from experts by experience is - ultimately highlighting a net benefit to medical education” - Avani Kaura, Phase 1B medical student and project volunteer This project brought huge learning for us hope that we have enhanced the learning as teaching fellows – both in overseeing a experience of undergraduate medical complex project with multiple students and through these videos, left a stakeholders and the value of student lasting impression on the medical involvement in the developing of teaching curriculum. Hopefully this will catalyse the material. initiation of similar projects across the Faculty of Medicine and contribute to the It has been an enriching and fulfilling year development of medical graduates who - though time has flown! This role has are equipped and inspired to champion supported our professional development, health equity. both as clinicians and educators. We also
Filming days with the Digital Media Lab and Expert Focus “I think screening can be quite a daunting and worrying experience especially if the patient has family members affected by the condition. The test itself can also be annoying and difficult for the patient and so it's important to be kind, understanding and compassionate to make the experience as positive as possible” “[I] realise that what seems like a simple test to a medical professional may be a life-changing event for the patient. So, think about how the patient is feeling and how they might respond, and empathise with them. Take time to listen and answer questions where possible” – Phase 1C medical students reflecting on Patient Stories of Screening
Photo by Artem Bryzgalov on Unsplash THE GUT MICROBIOME, HEALTH AND PERSONALISED NUTRITION
The importance of the gut microbiome in health and disease is now well established. Thanks to improved metagenomic sequencing capabilities we have a growing understanding of which strains are beneficial for good health and which strains are associated with poor health outcomes and communicate this with individuals. Gut microbiome modulation has been possible with dietary changes in the lab and in clinical studies, with improved results for mental health conditions, fertility and even cancer treatment. This article published in Trends in Urology & Men’s Health, by Federica Amati, with Professor Tim Spector and a brilliant medical student, Lucy McCann, provides a snapshot overview of the exciting progress made to date and what the future holds for personalized nutrition to harness the modulatory power of the gut microbiome for health.
IMPACT OF COVID-19 ON PRIMARY CARE CONTACTS WITH CHILDREN AND YOUNG PEOPLE IN ENGLAND During the COVID-19 pandemic, health systems shifted towards treating COVID-19 infection in adults and minimising use of health services for other patients, including children and young people, who were less susceptible to severe COVID-19. On 5 March 2020, the NHS recommended remote triaging before any face- to-face contact to reduce infection risk. The UK Government announced a nationwide lockdown from 23 March 2020, and the public was advised to stay at home to limit transmission of COVID-19 and avoid strain on health resources. General practitioners (GPs) were asked to prioritise consultations for urgent and serious conditions, and suspend routine appointments for planned or preventive care.
During March 2020, the number of consultations in primary care decreased by a third, from about 6 million consultations to 4.2 million consultations a week. Face-to-face appointments were drastically reduced, while telephone appointments more than doubled. Children’s access to primary care is highly sensitive to health system shocks. Before this study, the specific impact of the COVID-19 pandemic response on children and young people’s access to primary care was largely unknown. This study examined the impact of the first COVID-19 lockdown on total face-to-face and remote contacts with children and young people aged 0 to 24. A longitudinal trends analysis was urinary tract infections or epilepsy conducted using electronic health remained relatively high as there records from GP practices in was a large shift from face-to-face England from the Clinical Practice to remote. Research Datalink database. The number of total, remote and face- As part of this work, an online to-face GP contacts during the first forum was held with a small group UK lockdown (March to June 2020) of parents and carers to learn about was compared with the mean their experiences of accessing contacts for comparable weeks healthcare services for their from 2015 to 2019. children during the first UK lockdown. Their reflections helped The first COVID-19 lockdown in interpreting the results from the reduced children and young electronic health record data and people’s contacts with GPs by 41%. assisted in revising some of the However, more than a two-fold main messages and implications in increase in remote contacts the drafted peer-reviewed mitigated an 88% fall in face-to-face publication. For more reflections contacts. Children aged 1-14 years about involving parents/carers in had greater falls in overall contacts this research, please see: Involving with GPs compared with infants and parents and carers in research those aged 15-24 years. There were about children’s healthcare large falls in contacts with GPs for experiences during covid-19 - respiratory illnesses, which is Patient Experience Research Centre partially explained by children (imperial.ac.uk) getting fewer viral infections. In contrast, contacts for potentially As primary care adapts to a post- more serious conditions such as pandemic model, this study may offer some insights into the balance
between remote and face-to-face assessments. This may be explained appointments for children and by a lower incidence of respiratory young people. However more illnesses because of fewer social research is needed to determine the contacts; changing healthcare- optimal combination between face- seeking behaviour; or a combination to-face and remote contacts, and it of both. The large shift to remote is important to consider the contacts mitigated total falls in preferences of children and families contacts for some age groups and in the plans for primary care reform. for common non-transmissible conditions. Importantly, despite the In conclusion, during the first U.K challenges of the pandemic, these covid-19 lockdown, children and findings indicate that GPs largely young people’s contact with GPs continued to provide accessible fell, particularly for face-to-face acute care for children and young people. This work is published in the British Journal of General Practice For more information, please listen to the BJGP interviews podcast: Episode 075: Primary care contacts with children and young people in the first Covid lockdown or review the video summary: Impact of COVID-19 on young people's contacts with GPs - YouTube
By Azeem Majeed Photo by Florian Klauer on Unsplash
One of the causes of increased workload in general practice are the many requests that doctors get for letters from patients or from external organisations. It’s now so common that doctors have coined a term for it: GANFYD – Get A Note From Your Doctor. It seems that large sections of society can’t function without these ‘letters from doctors’. Instead of using common sense or employing their own clinical advisers, external organisations make repeated requests to NHS doctors for letters which are not at all needed. Often the worst offenders come from the public sector – e.g. universities who seem to look upon NHS general practice as a source of free occupational health advice for their students. Universities never – of course – offer to pay for this advice they get from NHS GPs. Instead, university requests will come with a mealy-mouthed statement that any fee is the responsibility of the student. Like doctors are going to impose heavy fees on impoverished students who already have large debts and are who are often living in poverty. Local government and schools are other frequent offenders, requesting letters for issues they could easily resolve themselves using some common sense. And perhaps surprisingly, the NHS is also a frequent offender (you would think that NHS Trusts would know better). What’s the solution? I have concluded that to address the GANFYD problem, we need to remember the adage “money talks while bullshit walks”. But don’t charge patients. Change NHS regulations so the (suitably large fee) is the responsibility of the organisation making the request. The NHS is under great pressure and we urgently need to do everything we can to reduce unnecessary work in the NHS so that NHS staff can focus on clinical work.
EVALUATING A LOCAL HEALTH FUNDING PROGRAMME
Photo by Vince Lee on Unsplash NIHR ARC NWL have been working with Imperial Health Charity to evaluate the impact and learn lessons from an innovative new £350,000 health and wellbeing funding initiative.
TRANSFORMING HEALTH AND WELLBEING In the first year, the ‘Compassion projects as part of the Communities’ programme has Compassionate Communities started transforming the health and programme. wellbeing of people in Northwest London most affected by the hidden Over the last 12 months, these impacts of the COVID-19 pandemic. grants have enabled a range of charities, community organisations Working in partnership with and local groups to break down Imperial College Healthcare NHS barriers and help those most in Trust, Imperial Health Charity need access vital care and support. awarded funding to support 20 local Each of the projects we’ve supported has addressed a major health problem deepened by the impact of COVID-19, including: · MENTAL HEALTH AND WELLBEING · FOOD POVERTY AND OBESITY · LANGUAGE BARRIERS AND MISINFORMATION
Image by 愚木混株 Cdd20 from Pixabay
MAKING AN IMPACT and organised more than 350 training events and workshops. So far, the funding has benefited around 5,000 of the most \"It was as if I emerged vulnerable people in Northwest from chrysalis, regaining London. Across a range of different my previous confidence\" projects, community champions have referred nearly 2,000 people Mandy*, Grow Well to appropriate healthcare services, participant delivered over 1,200 food parcels to those experiencing food poverty One of the groups that benefited from Compassionate Communities was the Hammersmith Community Gardens Association, which used its grant to support local people struggling with mental health challenges through therapeutic gardening and cooking courses. The Grow Well in 2021 initiative helped participants spend time closer to nature by sowing seeds, propagating herbs and growing fruit and vegetables. “The biggest step forward was going along to Grow Well”, said Mandy*, who had been living in isolation for over two years before attending the sessions.
“It was as if I emerged from a chrysalis, slowly but surely regaining my previous confidence. It’s been like a big, secure steppingstone to getting me out and about – being involved and feeling comfortable again talking to new people.” PROVIDING EXPERT EVALUATION We are evaluating how the Laura Lennox, our Lead of Health Compassionate Communities Improvement and Improvement programme has made a difference Science, said: over the last 12 months. Initial findings showed the programme “While much of the work is still had helped connect people to under way, the projects are making appropriate services, improve their excellent progress in improving mental and physical health and help mental and physical health, building them build skills, as well as community skills and knowledge, facilitating social cohesion and and enriching social engagement”. developing relationships in the local community. 'FAR-REACHING EFFECTS' Dr Bob Klaber, Director of Strategy, Research and Innovation at Imperial College Healthcare NHS Trust, said: “The pandemic has had far-reaching effects – not only in our hospitals but also in our local communities. Working together with Imperial Health Charity, we’ve been able to have a transformative impact on the health and wellbeing of the most vulnerable people by building strong relationships with local organisations who really understand the needs of their communities.” Ian Lush, Chief Executive of Imperial Health Charity, said: “We’re delighted to see Compassionate Communities making such a big impact – and we hope this initiative is just the beginning as we work to strengthen links with our local community partners and create more opportunities to collaborate in the future.” Discover more about the extraordinary projects supported on the Compassionate Communities webpage.
Photo by Robert Ruggiero on Unsplash
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