The British journal of general practice : the journal of the Royal College of General Practitioners
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In the summer of 2021, after 18 months of the COVID-19 pandemic, there were still no clear evidence-based interventions for COVID-19 infection in the community. Recruiting large numbers at pace was a challenge to urgently generate the evidence needed to inform care within the pandemic. ⋯ Large-scale, at-pace recruitment supported by the English CRN and equivalent networks across the UK, is achievable in a pandemic situation, producing potentially game-changing results of national and international importance.
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Children with pre-symptomatic type 1 diabetes can be identified through testing for circulating islet autoantibodies. Identifying children at risk reduces the rates of diabetic ketoacidosis at presentation and allows participation in clinical trials for type 1 diabetes prevention. ⋯ Social media has been an effective route to recruitment. Community outreach to schools and general practices will be implemented as this study evolves, to explore optimal recruitment modalities and acceptability.
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The NHS App was launched as a 'front door' to digitally enabled health services, offering a range of services including appointment booking and ordering prescriptions. The extent of App use and its impacts on digital inclusion is under-explored. ⋯ There is high uptake of the NHS App but there are differences in adoption rates among different population groups and issues of relevance and accessibility, that warrant further work.
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The NHS has limited human and financial resources, with particular pressures in primary care. The National Institute for Health and Care Excellence (NICE) makes decisions on which services can be commissioned within the NHS. Many women experiencing antenatal depression are not identified as such in routine care and so may not access support. Current NICE guidance does not recommend universal case-finding for antenatal depression; however, a programme targeted towards pregnant women with risk factors (for example, previous mental illness, traumatic life events) has not been considered. ⋯ Universal case-finding for antenatal depression is cost-saving and improves health compared with no case-finding. It should be considered by policymakers to improve the identification and support of women experiencing antenatal depression in primary and maternity care.
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The COVID-19 pandemic compelled clinicians to change access to primary health care as face-to-face consultations were a risk to patients and staff. Video consultations (VCs) were frequently substituted as a proxy for a clinical examination. ⋯ While video use overall was low, patients from lower socioeconomic backgrounds had less access to VCs with their GPs in the initial lockdown, which may have had negative impacts on health. The pandemic was an unprecedented event, and primary care rapidly pivoted to online care. However, to mitigate health inequalities, primary care must implement methods to cater for all patients and minimise the risk of digital health exclusion.