The British journal of general practice : the journal of the Royal College of General Practitioners
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In the UK, chronic kidney disease (CKD) is a prevalent, silent and strong predictor of cardiovascular disease. Identification of CKD is poor in primary care, particularly in minority ethnic and socio-economically deprived groups. ⋯ Remote ACR testing presents an opportunity to diagnose early CKD but there is still inequity in who completes testing. Engagement with stakeholders is needed to explore innovative ways to implement remote ACR testing to achieve equitable CKD screening.
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Measures are needed to address recruitment and retention problems in general practice. A good team climate (relational processes of team working) can mitigate the effects of pressured work environments, but little is known about it in British general practice. ⋯ Team climate could be used to improve morale and patient experience. Micro teams might be beneficial in larger practices.
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We frequently fail to meaningfully incorporate patient voice in the development of health services, in particular the voices of those who are most disadvantaged. ⋯ Partnership working between GPs, the third sector, and other organisations is vital. This can allow GPs to benefit from the expertise of those with relevant lived experience in tackling health inequalities.
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Mesothelioma is a terminal disease that is linked to asbestos exposure. Continuity is difficult for GPs, and other healthcare professionals (HCPs), to provide within the current NHS primary care system, but is highly valued by people with mesothelioma. ⋯ Patients perceive their continuity needs to be unmet by the inflexible primary care system, which needs to adapt to a society in which people receive increasingly novel treatments and live longer with complex healthcare needs. A societal perspective shift is required to understand that an MDT now shares responsibility for care, rather than an individual family doctor. Policy documents continue to focus on access, and still do not advocate strongly enough for continuity, despite unequivocal evidence demonstrating its worth.
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Primary care is a challenging and evolving specialty. We are increasingly dealing with patients who present with complex multi-morbidities and varied constellations of symptoms that we need to masterly unravel with limited time and resources. Yet, how many times have we said or heard 'just a GP.' ⋯ General practice is on a knife edge. Real, meaningful changes are needed to avoid a mass exodus of GPs for pastures new. Perhaps changing our title to reflect our expertise in family medicine could be one of many essential measures to improve public and professional perceptions.