Articles: primary-care.
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As cancer incidence increases and survival improves, the number of people living with a cancer diagnosis is increasing. People living with cancer have 50% more contact with GPs 15 months after diagnosis than a population of similar age, sex and locality; 70% have another long-term condition. ⋯ Local understanding of the cancer prevalent population is needed, with a concerted effort to interpret large discrepancies between QOF and NCRAS registers, which may arise from differences in coding practice. Ensuring patients are identified in primary care is a first key step to managing cancer as a long-term condition.
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The General Practice Forward View (GPFV) outlined how the government plans to attain a strengthened model of general practice. A key component of this proposal is an expansion of the workforce by employing a varied range of practitioners, in other words 'skill mix'. A significant proportion of this investment focuses on increasing the number of 'new' roles such as clinical pharmacists, physiotherapists, physician associates, and paramedics. ⋯ A negative correlation between advanced nurse FTE and GP FTE is potentially suggestive of substitution between roles, deliberate or otherwise. For example, practices may employ 'new' roles if they are unable to recruit GPs or they may recruit staff to free up GP time. Further work is needed to confirm these findings and to explore the reasons behind practice employment decisions.
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Older adults are the fastest growing subset of the population and residency training in the basic concepts of care to the older adult is limited. We created a 1-day interactive training program, Advanced Geriatric Evaluation Skills (AGES), to upskill first-year primary care residents in the care of older adults. ⋯ The development of an AGES program provided a structured geriatric didactic curriculum for primary care residents. The course was well received by the residents, was reported to be relevant and timely, and resulted in increased knowledge in the care of older adults in the outpatient setting.
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Screening for and addressing food insecurity in primary care may improve associated comorbidities. The purpose of this study was to explore patient attitudes regarding screening for food insecurity and to elicit patient preferences for intervention in a primary care setting. ⋯ Screening for food insecurity is not yet standard practice, partly due to concerns over potentially alienating patients with the screening questions. Based on our surveyed patient population and their indicated preferences, screening and providing resource referrals for food insecurity is not likely to damage the clinician-patient relationship.
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Primary care behavioral health (PCBH) is a service delivery model of integrated care linked to a wide variety of positive patient and system outcomes. However, considerable challenges with provider training and attrition exist. While training for nonphysician behavioral scientists is well established, little is known about how to train physicians to work efficiently within integrated teams. ⋯ While behavioral health content was well represented in family medicine residency curriculum, the depth and integration of content was inconsistent. More intentional and integrated curriculum accompanied faculty development and integration of behavioral health faculty. Future research should evaluate if faculty development programs and faculty status of behavioral scientists results in different educational or health care outcomes.