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  • Emma and Nick discuss the debate that’s raging about the use of physician associates in the NHS after the BMA issued new guidance on the tasks PAs should and shouldn’t be doing and the RCGP updated its red lines on the use of PAs in general practice.


    They also talk again about the struggles GPs are facing finding work as the financial pressures in general practice continue to bite, as well as the results of a new BMA survey of GP registrars about their future career intentions.


    And they look at what happened at the Welsh LMCs conference recently where GPs called for the BMA to move towards industrial action by GPs in Wales - and also what’s going on in England as we head towards the end of the referendum on the GP contract there.


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


    Useful links

    Physician associates must never see undifferentiated patients, BMA safety advice warns

    RCGP expands 'red lines' on use of physician associates in general practice

    NHS promises clear safety advice for GPs on physician associate role

    Qualified GP driving for Uber amid chronic shortage of jobs

    Just two in five GP registrars plan to work in UK general practice, devastating poll reveals

    Welsh LMCs push for industrial action as ministers warned not to 'devalue general practice'


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  • Emma talks to BMA England GP committee chair Dr Katie Bramall-Stainer about the impact the GP contract for 2024/25 will have, the BMA’s referendum on the deal and what happens next.


    GPs in England are facing the third consecutive contract imposition and a deal that will deliver just a 1.9% uplift to funding in 2024/25. The BMA last week launched a referendum on the contract and we’re entering a crucial period for the profession that could see GPs head towards industrial action later this year.


    In this interview Dr Bramall-Stainer explains why she thinks the deal represents an ideological dismantling of NHS general practice, how it could harm practices and patients, and what happened during this year’s contract negotiations.


    She also talks about what she hopes the referendum will achieve and what happens next, how the BMA’s safe working guidance could help practices in the coming months and how working in partnership with patients could help convince ministers of the need for further investment in general practice ahead of the general election.


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


    Useful links

    GP concerns have been 'ignored' but referendum offers chance to speak up, says BMA

    BMA reveals forms of industrial action GPs could take this year

    What is in the GP contract for 2024/25?

    GP business model 'non-viable' under 2024/25 contract, warns BMA


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  • This week the GPonline team discusses the GP contract for England for 2024/25. 


    They look at how the contract deal will affect practice finances, as well as some of the other changes it will bring.


    They also talk about the human impact of underfunding in general practice, which has seen some unemployed locum GPs being forced to use food banks as well as and practices having to cut back services because of funding constraints.


    They also look at what happens next after the BMA launched its referendum on the deal this week and ask whether GPs in England are heading for industrial action and what that might look like.


    Our good news story is about plans for same-day access hubs in North West London being shelved.


    This episode was presented by GPonline editor Emma Bower, deputy editor Nick Bostcock and senior reporter Kimberley Hackett. It was produced by Czarina Deen.


    Useful links

    GPs asked to vote on 2024/25 contract as BMA launches yes/no referendum

    BMA reveals forms of industrial action GPs could take this year

    Unemployed locum GPs relying on food banks, BMA council member warns

    Outstanding practice forced to scale back services due to 'spiralling' costs

    What is in the GP contract for 2024/25?

    ICB backs down on same-day access plan after GP and patient outcry


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  • This week Emma speaks to Beccy Baird, senior fellow at health think tank the King’s Fund.


    Beccy is the lead author of a report the King’s Fund published in Feburary called Making care closer to home a reality – refocusing the system to primary and community care. The report looks at what needs to happen to ensure a greater share of NHS funding goes to primary care and community services and we build an NHS that is focused on communities rather than hospitals.


    The report says that the government's failure to invest in primary care ranks as one of the most significant and long-running failures of NHS policy over the past 30 years.


    In this interview Beccy explains why we need an NHS that is focused around primary care and community services and why, despite so many policies advocating this shift over the years, this has not happened. She also explains how she thinks we can make that move in future and what needs to happen at a national and local level to make it a reality.


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


    Useful links

    You can find the full King’s Fund report here.


    Register for or subscribe to GPonline here.


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  • This week the GPonline team looks at the visa challenges facing international medical graduate (IMG) GPs in training and how this could drive them out of the NHS.


    They also talk about the difficulties locum GPs in England are facing finding work, why this is happening, and how it is affecting rates of pay following a recent survey carried out by GPonline and our sister site GP Business.


    And they discuss appointment data and patient data for the whole of 2023 and how general practice fared over those 12 months.


    This week’s good news story is about how a practice has used patient feedback and effective communication about the work they are doing to deliver a massive fall in complaints.


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


    Useful links

    NHS risks losing thousands of new GPs because of visa sponsor shortfall

    IMG doctors lift the lid on why a generation of GPs may slip away from the NHS

    How GP practices can become skilled worker visa sponsors

    More than half of locum GPs in England are struggling to find work

    GP locum rates fall slightly in England but rise in rest of UK

    Practices delivered 'an extra month and a half' of appointments last year


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  • Emma speaks to GP and author Dr Ellen Welch about her latest book Why Can’t I See My GP? which was published this month.


    The book looks at the current state of general practice, why we have reached this point, and puts forward ideas on what needs to be done to address the problems. Along with her own views the book includes personal accounts from GPs and others about their experiences.


    In this interview Ellen discusses the process of writing the book and why she chose this topic, what she learned during the process of writing it and what she thinks needs to happen to address the current crisis facing general practice.


    The Doctors Association UK is sending a copy of the book to every MP to raise the alarm about the state of primary care and Ellen also talks about what she hopes this will achieve.


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


    Useful links

    ●     Why Can’t I See My GP (Amazon link)

    ●     Viewpoint: Patients and GPs are unhappy with access to general practice, what's the solution? (from GPonline)


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  • Last week the BMA rejected a contract offer for practices in England that would deliver a 1.9% uplift in funding. In this episode of Talking General Practice the GPonline team looks at what we know about the deal that’s currently on the table.


    They discuss what a 1.9% funding uplift would mean for practices, what the BMA, grassroots GPs and Labour think about the deal, and what happens next – including whether industrial action could be on the cards.


    In other news, they look at what’s going on with regulation of physician’s associates and the ongoing debate about their use in the NHS. And this week’s good news is about Northern Ireland.


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


    Useful links

    What do we know about the 2024/25 GP contract offer?

    'Insulting' 1.9% uplift threatens £50,000 black hole per average practice

    Labour says 1.9% GP contract offer ‘devaluing general practice'

    Dr Katie Bramall-Stainer: It's time to stop ignoring reality - GPs need more funding

    Most doctors say working with physician associates has increased workload

    Lords set for full debate on physician associates after pressure from doctors


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  • Robyn Clark is a managing partner in a practice in Gloucestershire and a founder and director of the Institute of General Practice Management.


    On this episode of Talking General Practice she talks to Emma about the challenges facing practice managers in the current climate, what needs to be done to cut bureaucracy in general practice – including how the QOF needs to change – and what practice managers are hoping to see from the next GP contract.


    Robyn also explains the current financial pressures facing GP practices, and discusses what NHS England and GP partners should be doing to support managers and recognise the vital role they play.


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


    Useful links

    Institute of General Practice Management


    From GPonline

    Viewpoint: Investment in practice managers is a step towards saving general practice

    Accreditation for practice managers


    Find out more about our website GP Business and how to subscribe here.



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  • In this week’s podcast the team discusses GP funding after analysis by the Liberal Democrats showed a real-terms fall in practice funding during the past four years. Meanwhile, government figures have also shown that the share of NHS funding going to primary care has fallen to an eight-year low.


    They also talk about problems at the primary care interface - the interface between practices and other parts of the NHS, including hospitals, community services and mental health services – and how it is wasting millions of GP appointments every year.


    And they look at the latest on measles and MMR vaccine uptake after the UK Health Security Agency last week declared a national incident because of rising cases of measles.


    Our good news story this week is about the Friends and Family Test.


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


    Useful links

    ●     Which ICB areas have seen the largest drops in real-terms GP funding?

    ●     RCGP warning as primary care share of NHS funding hits eight-year low

    ●     Solving NHS 'interface' chaos could save 6m GP appointments a year

    ●     NHS England launches catch-up MMR campaign amid rising measles cases

    ●     GPs told to wear PPE when seeing suspected measles cases



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  • Talking General Practice speaks to former BMA chair Dr Chaand Nagpaul about the extent of the problem of racism in the medical profession and what we can do to address this.


    Dr Nagpaul is a London GP, a former chair of the BMA GP committee, and in 2017 he became the first person from an ethnic minority to chair the British Medical Association - a post he held until 2022.


    While he was chair the BMA set up a national forum for racial and ethnic equality - the first time it had such a group. It also conducted a landmark survey in 2022 to establish the scale of the issue of racism across the medical profession and how it affects doctors’ wellbeing and their careers.


    In this conversation Dr Nagpaul explains some of the key findings from that survey and what he believes the NHS and the medical profession need to do to tackle racism. He also talks about the impact racism has on doctors and how it affects patient care, how we can address differential attainment in medical exams and disparities in GMC referrals, as well as the importance of having more leaders in medicine from different ethnic groups.


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


    Useful links

    BMA FREE (forum for racial and ethnic equality)

    BMA racism in medicine survey

    BMA - delivering racial equality in medicine


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  • In our regular news review Emma and Nick discuss a practice in Surrey that is set to make three salaried GPs redundant, and what this tells us about changes in primary care


    They also talk about the GP workforce, in particular the falling number of GP partners and the impact this might have, and NHS England’s decision to scrap two key GP retention schemes.


    Our good news story this week highlights those GPs and others from the world of primary care who received New Year Honours.


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


    Useful links


    ●     Practice makes salaried GPs redundant as model shifts to additional roles

    ●     GP partners' income down 20% in a year, BMA poll reveals

    ●     Small increase in GP workforce during past year but partners still falling

    ●     Which ICB areas have the biggest shortages of GP partners?

    ●     RCGP condemns 'disappointing' decision to scrap GP retention schemes

    ●     GPs recognised in New Year Honours


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  • In this bonus episode Talking General Practice speaks to Dr Helen Evans-Howells, about how GPs can manage infants presenting with the signs of cow’s milk allergy.

    Alongside working as a GP and an allergy specialist, Helen also runs the peanut immunotherapy clinic in Southampton Children’s Hospital and is chair of the charity Anaphylaxis UK’s Clinical and Scientific Panel.


    In this episode Helen explains the key symptoms of milk allergy, the different types of formula that can be used, and when infants may need a referral. She also talks about when to do a rechallenge and reintroduce cow’s milk and how to advise parents on weaning.


    Using insights from her own experience Helen has lots of practical advice for GPs and other healthcare professionals on managing the allergy and how they can best support parents.


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


    This podcast is sponsored by Reckitt/Mead Johnson Nutrition.

     

    About Reckitt

    At Reckitt we exist to protect, heal and nurture in the relentless pursuit of a cleaner and healthier world. This purpose drives everything we do as a company – inspiring us to improve people’s lives, through better hygiene, health and nutrition.  Every day we are fighting to make access to the highest quality hygiene, wellness and nourishment a right and not a privilege.


    Useful links


    The MIMS Learning Cows Milk Allergy in Practice webinar series is here. The 2022 series provides 3 hours of CPD and covers:

    ●     When is an allergy not an allergy? How to make the history matter - presented by GP and allergy specialist Dr Helen Evans-Howells

    ●     Why is my baby still crying? A GP’s guide to common infant feeding conditions - presented by specialist paediatric dietitian Bianca Parau

    ●     When, why, how? Demystifying hypoallergenic formulas, presented by specialist paediatric dietitian in allergy Andrea Moreno

    In addition the 2023 series of webinars is also available on demand via the link above.

    Helen mentioned the following guidance in this conversation:

    ●     The Milk Allergy in Primary Care (MAP) Guideline 2019

    ●     BSACI cow’s milk allergy guidance

    RKT-M-44442, January 2024

    RKT-M-44445, January 2024



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  • Happy new year!


    This week Emma is talking to GP partner Dr Tommy Perkins and specialist medical accountant Andy Pow from Medics Money, about the financial year ahead for general practice.


    Tommy and Andy talk about the current financial pressures GP practices are under, how GP partner income has changed, and the sort of uplift practices might need from this year’s GP contract to help address the shortfalls they’ve experienced in recent years.

    They also offer lots of useful advice on how practices can start the new year on a sound financial footing, explain what upcoming tax changes will mean for all GPs, and the importance of better financial training for GPs as general practice becomes increasingly complex.

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


    Useful links

    GP Business

    Our website GP Business provides practical advice for GP partners and practice managers to help them run their business more effectively. More details here.

     


    From Medics Money

    Medics Money GP partnership course

    Medics Money GP registrar Business for GPs course

    Medics Money podcast

    Find a good accountant for doctors (from Medics Money)

    Find a good independent financial adviser for doctors (from Medics Money)


     



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  • This week we’re bringing you some highlights from our top interviews of 2023 - and we’ve had some really fantastic guests this year.


    In this episode you’ll hear from BMA GP committee for England chair Dr Katie Bramall-Stainer, Royal College of GPs chair Professor Kamila Hawthorne, NHS England director for health inequalities Professor Bola Owolabi, RCGP Wales chair Dr Rowena Christmas and all-round general practice expert and fellow podcast host Ben Gowland.


    And between them they’ll be talking about GP contract negotiations, continuity of care, what we can do to retain more GPs, influencing politicians in the run up to next year’s general election, the difference healthcare professionals can make on health inequalities, and the future of primary care networks.


    Thanks to everyone who’s taken part in Talking General Practice during 2023 - and happy new year to all of our listeners!


    Don’t forget you can listen to the full versions of all these interviews - and interviews with lots of other brilliant people from the world of primary care by searching in our podcast feed or on our website at GPonline.com/podcast


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  • This week Emma and Nick look at what happens next for the quality and outcomes framework after the government launched its consultation on the future of incentive payments in general practice. They talk about what the consultation is asking and whether this could mean the end of the QOF?


    And they discuss an ageing GP workforce and what it means for the stability of GP practices in some parts of England.


    They also look ahead to next year and some of the key news stories that are likely to be important in 2024.


    Our good news story this week is about a Christmas delivery to a practice in Shropshire.


    Merry Christmas to all of our listeners.


    Useful links

    Government QOF consultation asks if continuity and access should be incentivised

    Hundreds of practices on the brink as half their GPs are over retirement age

    Which ICBs have most GP practices at risk from an ageing workforce?

    Patient safety fears as one in three practice nurses near retirement

    GP practice staff moved to tears as patients deliver Christmas tree gift

     



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  • This week Emma speaks to Dr Sylvia Kama-Kieghe, a GP from Sheffield who is vice chair of the RCGP South Yorkshire and North Trent Faculty and a chair of the RCGP Northern Faculties International Medical Graduate steering group.


    They talk about the challenges that international medical graduates - or IMG - GPs face and what the NHS and general practice can do to support them.


    Around half of the doctors who enter GP training each year are now IMGs, which means they received their initial medical qualification outside the UK.


    Sylvia herself qualified as a doctor in Nigeria. In this episode she talks about her own move to the UK in 2004, and some of the difficulties IMG doctors face in the UK, including racism, long-standing problems related to visas and the challenges of practising medicine in a completely different country and culture.


    She also explains why the RCGP Northern Faculties IMG steering group was set up and what it is hoping to achieve, and offers some practical advice on how practices can best support IMG doctors. It was produced by Czarina Deen


    Useful links

    IMG group on the RCGP members’ forum

    E-learning for health’s guide to induction for IMG doctors

    RCGP overseas doctors guide

    BMA guide on becoming a tier 2 sponsor for GP practices

    NHS guide for IMG doctors


    Most regions of Health Education England will have information for IMG doctors working in their area , including:

    Yorkshire and the Humber - you can find the IMG guidebook that Sylvia mentioned in the podcast here

    East of England

    London

    North West

    South West


    Information from Health Education Scotland

    Information from Health Education and Improvement Wales


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  • This week Emma and Nick look at what we know about what the BMA in England might be looking to achieve in contract negotiations, how the current deal that’s on the table for consultants could affect talks, and whether continuity should be a contractual requirement.


    They also discuss Labour’s plan for neighbourhood health centres and what the party might want them to achieve.


    Our good news story this week is about a British GP's success Down Under.


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


    Useful links

    What questions is the BMA asking GPs to shape its vision for general practice?

    Next GP contract 'must signal hope', GP committee chair warns

    Government must match consultants' pay offer in new contract for GPs

    Labour plans neighbourhood walk-in GP centres open seven days a week

    New contract that enforces continuity would make GPs and patients safer, says watchdog

    GP conquers 'Everest of competitive mullet growing'



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  • Emma talks to GPs Dr Beckie Akroyd and Dr Catherine Bell about neurodiversity in the medical profession and what general practice can do to better support doctors and other staff who are neurodivergent.


    Beckie is the GP Lead for Autistic Doctors International, a support and advocacy organisation, and until recently Catherine was an Equality, Diversity and Inclusion Fellow for Derbyshire’s GP Task Force focusing on supporting neurodivergent staff working in general practice.


    Beckie and Catherine talk about their own experiences of being neurodivergent, the challenges neurodivergent doctors can face, including stigma, and why it is important that we frame neurodiversity positively and focus on what people can do rather than what they can’t.


    Beckie and Catherine also have lots of practical tips for practices on how they can support neurodivergent staff and advice for anyone listening who may be neurodivergent about how to approach conversations with your employer and places to get additional support.


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


    Useful links

    Autistic Doctors International

    Access to Work support

    Society of Occupational Medicine: Evaluating and supporting neurodifferences at work

    Catherine’s article on neurodiversity in the general practice workforce - available for RCGP members

    Acas - Neurodiversity at work

    Beckie and Catherine’s full Linktree with links to all the resources they recommended during their talk at the RCGP conference.


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  • Emma and Nick look at the current state of the GP workforce and changes over the past year. We’ve just undertaken a major update of GPonline’s GP Workforce Tracker, which we launched a year ago, and Nick talks through some of the key findings from that work.


    They talk about the uplift to the minimum wage that is due to happen in April and what this will mean for practice, and discuss GP premises, in particular some of the problems relating to funding reaching practices when there are housing developments in their area.


    And, following the recent cabinet reshuffle, they look at the arrival of a new secretary of state at the Department of Health and Social Care and what this could mean in the months ahead.


    Our good news story is about NHS England’s pledge to eliminate cervical cancer by 2040.


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


    Useful links


    GPonline’s GP Workforce Tracker

    Where in England are patients per GP rising fastest?

    GPs fear practice closures as minimum wage hike threatens major rise in costs

    Chancellor to investigate delays in GP premises funding from housing development

    Who is new health and social care secretary Victoria Atkins?

    NHS England sets target to eliminate cervical cancer



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  • Emma speaks to Dr Sarah Taylor and Dr Rebecca Leon, who are GPs with a special interest in cancer, about early cancer diagnosis.


    Both Sarah and Rebecca have portfolio careers and one of their roles is as GP leads at GatewayC, an organisation backed by the NHS in England and Wales and leading cancer charities that is aiming to boost early cancer diagnosis. As part of this work they host the GPs Talk Cancer podcast.


    In this conversation Sarah and Rebecca explain how the pandemic and the current backlog of care have impacted on cancer diagnosis and treatment, whether the NHS can hit ambitious targets on early cancer diagnosis, and what recent changes to national targets mean.


    We also talk about inequalities in early cancer diagnosis, new tests to detect cancer early, and the importance of screening. Rebecca and Sarah also have some practical advice based on their own experiences and conversations with experts that can help GPs ensure they don’t miss a cancer diagnosis.


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


    Useful links


    ●     GatewayC

    ●     GPs Talk Cancer podcast

    ●     The NHS Galleri trial


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