The British journal of general practice : the journal of the Royal College of General Practitioners
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A majority of sex-workers (SWers) do not have a GP aware of their professional activity, which prevents appropriate support to this group. One of the reasons is fear of the doctors' judgment. ⋯ This study demonstrates that primary care doctors' knowledge of SW is limited, and that these limitations can lead to stigmatisation and suboptimal treatment. The following recommendations are to: draw up a list of doctors who can welcome SWers without being judgmental and make this list available to associations active in the field of SW; co-construct a training course, in partnership with SWers, aimed at GPs (it would include sections on the historical and legal context, the approach to harm reduction and substance abuse, PreP, PEP, and a communication guide); and teach courses on marginalised populations with specific health needs during the initial training of medical students.
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Suicide is a major public health issue and is the leading cause of death of men under the age of 50 in the UK. Patients are more likely to visit their GP in the month leading up to a suicide attempt, thus highlighting the key role GPs play in suicide prevention. ⋯ The challenges experienced by GPs when managing suicidal behaviour are well documented. More work is needed to explore what approaches GPs find effective in managing suicidal behaviour, especially in younger patients.
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A dementia care coordinator (DCC) service has recently been implemented across Kent and Medway Integrated Care Board (ICB). DCCs are provided at the primary care network (PCN) level and work closely with GP practice teams. The service is intended to help service users navigate the care system and provide proactive support to mitigate crisis points. However, the value of this service from key stakeholder perspectives is not yet known. ⋯ This evaluation describes preliminary findings from a recently implemented DCC service in Kent and Medway ICB. There is a crucial need to enhance the support of this workforce in order to ensure sustainability of this service. These findings will inform service development and future investment decisions.
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Total triage (TT) has the potential to achieve more equitable access to primary care, to improve the overall quality of care, and enhance health outcomes. TT has gained increasing attention from the public, policymakers, and academics. ⋯ TT can influence patient access, safety, and equity. The approach may also generate profoundly different working styles for general practice. This review adds to current debates surrounding patient access and TT, and consequences for staff/patients. The findings can be used to aid practices when navigating the new GP contract and the implementation of new TT approaches.
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Vulval lichen sclerosus (VLS) is a skin condition which causes pain, itching, anatomical changes, and increases vulval cancer risk by up to 22 times. VLS is treatable, with use of topical steroids allowing symptom resolution and complication prevention. Diagnostic delay and misdiagnosis of VLS is common. Previous studies found that women attribute this to poor interactions with and knowledge of clinicians. Most VLS is diagnosed in primary care. ⋯ This study illuminates the multiple barriers to diagnosis and treatment of VLS. The results confirm that clinicians share patient concerns that knowledge is poor, highlight the importance of developing clear diagnostic criteria, and will allow us to target training to those lacking in confidence.