Articles: england.
-
Many patients receive routine medications for long-term conditions (LTCs). Doctors typically issue repeat prescriptions in one to three month durations, but England currently has no national guidance on the optimal duration. ⋯ One month prescription durations are common for patients taking medicines routinely for long term conditions, particularly in dispensing practices. Electronic health record configurations offer an opportunity to implement and evaluate new policies on repeat prescription duration in England.
-
Following the 2019 NHS Long Term Plan, link workers have been employed across primary care in England to deliver social prescribing. ⋯ Social prescribing was introduced into primary care to promote greater attention to the full range of factors affecting patients' health and wellbeing, beyond biomedicine. For that to happen, our analysis highlights the need for a whole-system approach to defining, delivering, and maintaining this new part of practice.
-
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.
-
Birth cohort screening has been implemented in some countries to identify the potentially 'missed population' of people with undiagnosed chronic hepatitis C virus (HCV) who may not be found through targeted approaches. ⋯ Wide-scale screening could be delivered and identify people infected with HCV, however, most of these individuals could have been detected through lower-cost targeted screening. The yield and cost per case found in patients were substantially worse than model estimates and targeted screening studies. Birth cohort screening should not be rolled out in primary care in England.
-
The age-standardised rate of cervical cancer is 8.5 per 100,000 in England, double the WHO "elimination" goal of 4.0 per 100,000, despite England being close to the target coverage for both HPV vaccination and cervical screening. Our aim was to see whether trends in mortality and incidence rates suggest that England is on the path to elimination. ⋯ Raising the age of starting screening from 20 to 25 transiently increased incidence and mortality in women born 1984-1990. Vaccination may enable the NHS to reach its target for cervical cancer incidence of 4.0 per 100,000 by 2040. Whether the switch from cytology to primary HPV testing in 2019 will reduce rates among unvaccinated women born before 1991 is not yet clear.