The British journal of general practice : the journal of the Royal College of General Practitioners
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Clinical guidance recommends promoting physical activity during general practice consultations. The frequency and content of physical activity discussions in UK general practice are poorly understood. ⋯ Physical activity advice, following national guidance, was potentially relevant to more than half of GP consultations; GPs delivered advice of varying depth in a third of these consultations. Future work should explore ways of delivering physical activity advice effectively, efficiently, and equitably within the constraints of general practice.
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The challenges of recruiting and retaining rural GPs are well described. UK data suggest high levels of burnout, characterised by detachment, exhaustion, and cynicism, plays a role in GP turnover. The contrast is engagement with work. There is limited evidence examining the relationship between work engagement and recruitment and retention in rural areas. ⋯ Our data suggest that factors associated with engagement and burnout can contribute to rural GPs' migration decisions. We highlight four areas that could promote desirable work environments by mitigating burnout and promoting engagement at work.
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The Additional Roles Reimbursement Scheme (ARRS) was introduced in England in 2019 to alleviate workforce pressures in general practice by funding additional staff such as clinical pharmacists, paramedics, first-contact physiotherapists, and from 1 October 2024 the scheme funds recently qualified GPs. However, the employment and deployment models of ARRS staff present ongoing complexities and challenges that require further exploration. ⋯ This study provides novel insights into the complexities of different employment and deployment models of ARRS staff. These findings will be invaluable for creating a sustainable GP practice workforce and informing future workforce strategies as the scheme expands to include recently qualified GPs.
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Workload is probably the biggest challenge facing general practice and little is known about any modifiable factors. For GPs, both continuity and locum status are associated with differences in outcomes. ⋯ The differences in outcomes were associated more with having continuity than with GP locum status. Seeing a GP with whom the patient had continuity of care was associated with reduced workload within the practice and in hospital.
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Over the past decade, the number of clinical pharmacists working within multidisciplinary teams in English general practices has expanded. ⋯ This analysis is limited by practice-level data but supports the hypothesis that clinical pharmacist implementation results in improvements in prescribing quality.