Primary Care Knowledge Boost

Doctors Lisa and Sara talk to Dr Tim Dalton, a GP in Wigan, and Chair of the Greater Manchester GP Provider Board. The focus of today’s episode is all about how general practice is funded. They cover how it is different from other NHS settings, the sources of income in general practice and the flow of money through the system, DES’, LES’ and QOF, the place of PCNs and Federations, as well as talking about different types of GP contracts and what these mean. To note: this was recorded in March 2024, just before the new contract details were released and so doesn't contain the specifics of the new contract. Useful resources:  The Kings Fund: GP funding and contract explained: https://www.kingsfund.org.uk/publications/gp-funding-and-contracts-explained NHS England: GP Contract: https://www.england.nhs.uk/long-read/gp-contract/ GPOnline Talking General Practice Podcast, Dr Katie Bramall-Stainer on the GP contract and the fight for a better deal: https://www.gponline.com/podcast-dr-katie-bramall-stainer-gp-contract-fight-better-deal/article/1865234 ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara are joined this week by Satty Boyes (Senior programme manager) and  Lorna Laflin (Previous Practice Manager who works with the GP Excellence team). They discuss a new platform in Greater Manchester for the non-clinical workforce within General Practice, which allows staff to explore progression pathways,  track their professional progress, and access learning opportunities all in one place.  Some quotes from those who have accessed the platform already:  “I think this is an absolutely wonderful tool and wish that there had been something like this available when I first started my career with the NHS. Easy to use and lots of really useful information. I would be really inclined to push some of my administration staff to enrol for the passport to develop their skill-set. A wonderful piece of work. Well done to the team for pulling this all together.”   “Useful for everyone to understand that career progression pathways ARE available if they wish to progress. Very useful to see standardised Job Descriptions and training pathways all in one place.” Useful resources:  Greater Manchester Non-Clinical Workforce Programme: https://gmprimarycare.org.uk/primary-care-passport/non-clinical-workforce-programme/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to Specialty Doctor Caitriona MacDermott about anticipatory prescribing for Palliative patients. An area where there has been much learning over the last several years, it is a good opportunity to get some teaching on why this is the case, the stages involved in recognition and addressing symptoms at the end of life, the need for regular reviews in terms of the potential for change and her advice on how she opens up conversations around future needs, death and symptom control.  You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  Greater Manchester Palliative Care Symptom Control Guidelines for Adults (2019): https://www.england.nhs.uk/north-west/wp-content/uploads/sites/48/2020/01/Palliative-Care-Pain-and-Symptom-Control-Guidelines.pdf NICE Guidelines related to caring for Adults at the End of Life: https://www.nice.org.uk/guidance/ng142 The Gosport Independent Panel Report: https://www.gosportpanel.independent.gov.uk/ RCGP End of life and palliative care toolkit: https://elearning.rcgp.org.uk/mod/book/tool/print/index.php?id=12529&chapterid=272 Compassion in Dying Information on Do Not Resuscitate Forms and CPR decisions for Patients: https://compassionindying.org.uk/how-we-can-help/do-not-resuscitate-dnr-forms-and-cpr-decisions/ British Journal of General Practice: The Liverpool Care Pathway for the dying, what went wrong? Knights D, Wood D, Barclay S (2013: 63): https://bjgp.org/content/63/615/509/tab-article-info ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

This is the third episode in our MSK mini-series. Doctors Lisa and Sara speak to Tom Smith and Charlotte Barker again, who are First Contact Practitioners in Wigan. The focus of this chat is shoulder pain - using a hypothetical case to discuss important history points, red flags, useful examination tips, differential diagnoses and further assessment options. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  Escape Pain: https://escape-pain.org/ Be Well Wigan: https://www.wigan.gov.uk/BeWell/index.aspx Versus Arthritis: https://versusarthritis.org/ Age UK: https://www.ageuk.org.uk/information-advice/health-wellbeing/conditions-illnesses/arthritis/ NICE CKS Guidelines for Knee Pain: https://cks.nice.org.uk/topics/knee-pain-assessment/ NICE Osteoarthritis Guideline (NG226): https://www.nice.org.uk/guidance/ng226 NHS Decision Making Tool for Knee Osteoarthritis: https://www.england.nhs.uk/publication/decision-support-tool-making-a-decision-about-knee-osteoarthritis/  Patient Exercise Options: https://www.nhs.uk/conditions/nhs-fitness-studio/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

This is the second episode in our MSK mini-series. Doctors Lisa and Sara speak to Tom Smith and Charlotte Barker again, who are First Contact Practitioners in Wigan. The focus of this chat is shoulder pain - using a hypothetical case to discuss important history points, red flags, useful examination tips, differential diagnoses and further assessment options. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  British Elbow and Shoulder Society guidelines: https://bess.ac.uk/national-guidelines/ British Elbow and Shoulder Society pathways: https://bess.ac.uk/patient-care-pathways-and-guidelines/ ShoulderDoc: https://www.shoulderdoc.co.uk/ Patient Exercise Options: https://www.nhs.uk/conditions/nhs-fitness-studio/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

This is the first episode in a three part MSK mini-series, which aims to briefly capture important features in history, examination and further investigations of common joint presentations. Doctors Sara and Lisa speak to Tom Smith and Charlotte Barker who are First Contact Physiotherapists in Wigan. Back pain is the focus of this episode, with a fictional case used to chat through history, examination, red flags and further assessment of this very common primary care topic. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  Getting it right first time (GIRFT): https://gettingitrightfirsttime.co.uk/interactive-pathway-to-help-diagnose-and-treat-cauda-equina-syndrome-without-delay-is-now-live/ National Spine Network, National Back Pain and Radicular Pain Pathway: https://www.nationalspinenetwork.co.uk/National-Back-Pain-and-Radicular-Pain-Pathway  MACP cauda equina information cards: https://www.macpweb.org/learning-resources/cauda-equina-information-cards.aspx NICE guidelines for back pain and sciatica: https://www.nice.org.uk/guidance/ng59 International Framework for Red Flags for Potential Serious Spinal Pathologies - Finucane et al 2020: https://www.jospt.org/doi/epdf/10.2519/jospt.2020.9971 Patient Exercise Options: https://www.southtees.nhs.uk/services/back-pain/backtracks/my-backtracks-playlist/ Patient Exercise Options: https://www.nhs.uk/conditions/nhs-fitness-studio/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to Senior Pharmacist Sarah Hafeez about Polypharmacy. She explains the difference between inappropriate and appropriate polypharmacy before talking through some typical cases that illustrate several examples of common scenarios.  This leads to discussions on prioritising concerns, weaning/stopping medications, counselling patients on the effects of Opioids and Gabapentinoids and involving community teams aiming for successful reductions of addiction forming medications. Other gems include a discussion of the potential long term risks of Proton Pump Inhibitors and advice on weaning, remembering to consider anticholinergic burdens as well as handy resources for tackling Polypharmacy, Structured Medications Reviews and medication reductions. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  Greater Manchester Medicines Management Group: Inappropriate Polypharmacy Review and Treatment Optimisation: Resource Pack (from Dec 2022, accessed Dec 2023): https://gmmmg.nhs.uk/wp-content/uploads/2023/02/GMMMG-Polypharmacy-resource-pack-v3.0.pdf Scotland Polypharmacy Resources for Professionals and for Patients: https://www.polypharmacy.scot.nhs.uk/for-patients-and-carers/ Scottish Polypharmacy Guidance 2018: https://www.therapeutics.scot.nhs.uk/wp-content/uploads/2018/04/Polypharmacy-Guidance-2018.pdf Lewis T. Using the NO TEARS tool for medication review. BMJ. 2004 Aug 21;329(7463):434. doi: 10.1136/bmj.329.7463.434. PMID: 15321901; PMCID: PMC514207 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC514207/ Toolkit for General Practice in Supporting Older People Living with Frailty (includes a great Appendix of the STOPP/START criteria (2017): https://www.england.nhs.uk/wp-content/uploads/2017/03/toolkit-general-practice-frailty-1.pdf An example of an Anticholinergic Burdon Resource from West Essex CCG 2020: https://westessexccg.nhs.uk/your-health/medicines-optimisation-and-pharmacy/clinical-guidelines-and-prescribing-formularies/04-central-nervous-system/61-anticholinergic-side-effects-and-prescribing-guidance/file Canadian Resource for Deprescribing including reducing medications and some patient information leaflets: https://deprescribing.org/ Resource for help reducing and stopping medications: https://medstopper.com/ Me and My Medicines Resource for Patients to look through their medications before reviews or for information: https://meandmymedicines.org.uk/ Anticholinergic Medications and Risks of Dementia Cochrane Editorial with Reports in Link (Sept 2021): https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.ED000154/full Anticholinergic drugs and risk of dementia: Time for action? British Pharmacological Society. Bell B et al Jun 2021 (9:3). Accessed 15/1/2024:  https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1002/prp2.793 Cognitive Effects of Anticholinergic Load in Women with Overactive Bladder. Clin Interv Aging. 2020; 15: 1493–1503: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457731/ Greater Manchester Medicines Management Group: Management of Overactive Bladder Including a simple Bladder Diary before and after stopping Medications (Jun 2019): https://gmmmg.nhs.uk/wp-content/uploads/2021/08/Management-of-OAB-in-adults-v3-0-approved-Aug-2019.pdf ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara speak with Dr Anne Connolly, a GP with a special in Gynaecology, trained hysteroscopist, and founding member of the Primary Care Women's Health Forum, where she just stepped down as chair in 2023. They speak about the importance of raising awareness about women’s health problems such as heavy menstrual bleeding, how underappreciated it can be, and the impact it can have on women’s lives. They then use cases to illustrate the assessment and management of heavy menstrual bleeding, making sure to touch on risk factors, concerning features and differentials. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  Who pays this doctor: https://www.whopaysthisdoctor.org/ Primary care women’s health forum: https://pcwhf.co.uk/# NICE NG88 Heavy Menstrual Bleeding Guidelines (May 2021): https://www.nice.org.uk/guidance/ng88 NICE guidelines for Red Flags for Gynaecological Cancers (Updated Dec 2021): https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#gynaecological-cancers Cancer Research UK: https://www.cancerresearchuk.org/about-cancer/ Jo’s Trust for Cervical Cancer: https://www.jostrust.org.uk/ The Eve Appeal: UK Charity funding research and raising awareness of the five gynaecological cancers – womb, ovarian, cervical, vulval and vaginal: https://eveappeal.org.uk/ Go Girls: UK Charity Supporting Women with gynaecological cancers: https://www.gogirlssupport.org/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa talk to Dr Mahindra Chincholkar, a consultant anaesthetist and Clinical Director Manchester and Salford Pain Centre. They take a detailed dive into the concept of pain and chronic pain, and then Mahindra explains his stepwise approach to assessing and managing chronic pain through the use of an anonymous case.  Greater Manchester healthcare professionals have collaborated to design the Greater Manchester Pain Management Resources Hub that gathers helpful tools and resources in one place. The Hub brings together a variety of useful resources including guidance to support effective consultations, patient self-management information to share, clinician aids and tools, shared learning and education, how to use data to understand the local population, and information to access related services across the conurbation. “Pain Killers” do not stop pain, they mask it, and prolonged use can lead to lasting harm including addiction. Healthcare professionals can use the new NHS Greater Manchester Pain Management Resources Hub to support their patients to safely reduce opioids and identify alternatives. Take a look and explore more here: Greater Manchester Pain Management Resources Hub You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  Case report about nail in the boot (original article inaccessible): Fisher et al BMJ 1995 Permission to Move Book: https://www.permissiontomove.com/books Tame the Beast: https://www.tamethebeast.org/#tame-the-beast Flippin’ Pain: https://flippinpain.co.uk/ British Pain Society: https://www.britishpainsociety.org/ Faculty of Pain Medicine: https://fpm.ac.uk/ The Pain Toolkit: https://www.paintoolkit.org/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa discuss the podcast episodes over the year. We talk about our longer term learning points, how the year has gone and what's to come. ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa talk to Dr Sadaat Ahmed about Frailty. We discuss definitions, frailty syndromes, frailty scores and the need to take care with these. We talk through a case to showcase how recognising frailty and managing the controllable areas can make a big difference to patients' lives and slow or even sometimes reverse frailty.  You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  British Geriatrics Society Fit For Frailty Guidelines: https://www.bgs.org.uk/resources/resource-series/fit-for-frailty British Geriatrics Society Comprehensive Geriatrics Assessment Primary Care Toolkit: https://www.bgs.org.uk/resources/resource-series/comprehensive-geriatric-assessment-toolkit-for-primary-care-practitioners National Osteoporosis Guidelines Group: https://www.nogg.org.uk/ British Geriatrics Society Frailty eLearning Hub: https://www.bgs.org.uk/elearning-0 The dangers of diagnosing frailty based on automatically calculated electronic Frailty Scores: https://www.england.nhs.uk/wp-content/uploads/2017/04/gms-contract-batch-coding-statement.pdf RCGP Internal and External Resources around Frailty: https://www.rcgp.org.uk/your-career/gp-extended-roles/Useful-resources-for-frailty ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

The importance of addressing climate change and sustainability is gaining more traction across the NHS. In order to find out more about the situation, and what can be done within Primary Care, Doctors Sara and Lisa talk to Dr David McKelvey who is a GP from Salford and NHS Greater Manchester Integrated Care Clinical Lead in Sustainability in Primary Care. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  Greater Manchester Primary Care Provider Board - Sustainability in general practice: https://gmpcb.org.uk/sustainability/sustainability-in-general-practice/ Greater Manchester Medicines Management Group - Three steps for Greener Respiratory Care: https://gmmmg.nhs.uk/wp-content/uploads/2022/08/Greener-inhaler-poster-Staff-FINAL.pdf Patient decision aid on asthma inhalers and climate change (Aug 2022): https://www.nice.org.uk/guidance/ng80/resources/inhalers-for-asthma-patient-decision-aid-pdf-6727144573 The GP Excellence Podcast - How can you support sustainability in General Practice? https://omny.fm/shows/gp-excellence-podcast/how-can-you-support-sustainability-in-general-prac Royal College of General Practice Climate change and sustainability resources page: https://www.rcgp.org.uk/representing-you/policy-areas/sustainable-development Royal College of General Practice Net Zero Hub: https://elearning.rcgp.org.uk/course/view.php?id=650 10 Step Plan for Primary Care Sustainability in GM https://gmpcb.org.uk/sustainability/sustainability-10-step-plan/ Planetary Boundaries – an up-to-date interview between Kevin Anderson and Johan Rockstrom.  https://www.youtube.com/watch?v=lLq8e73-FAw The 2023 state of the climate report - Entering uncharted territory: https://academic.oup.com/bioscience/advance-article/doi/10.1093/biosci/biad080/7319571 NHS Green Plan – a video about what’s happening. https://youtu.be/Nap2p4EeUQo Greater Manchester Greener Practice Group: https://www.greenerpractice.co.uk/join-our-network/local-groups/greater-manchester/ Take the jump – steps individuals can do: https://takethejump.org/ Open Prescribing Green NHS: https://openprescribing.net/icb/QOP/measures/?tags=greenernhs Health for Extinction Rebellion: https://healthforxr.com/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa talk to a GP involved in Primary Care Research Dr Imran Ghafoor and Ewa Grzegorska, a Research Support Facilitator from the National Health and Clinical Research Institute about Research in Primary Care. We talk through Dr Ghafoor’s journey into being part of Primary Care Research, what embarking on Research Projects in Primary Care might look like, from the straightforward to the more involved, and some of the practicalities and financial considerations.  You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  If you want to contact the research Team from today Directly: Researchsupport.CRNGM@NIHR.ac.uk or  I.gafoor1@NHS.net National Institute of Health and Care Research: https://www.nihr.ac.uk/ Clinicians wanting to Train up in Research Initial Training Module Good Clinical Practice (through National Institute for Health and Care Research): https://www.nihr.ac.uk/health-and-care-professionals/learning-and-support/good-clinical-practice.htm Implementation of inclisiran in UK primary care for patients with atherosclerotic cardiovascular disease (ASCVD) or ASCVD-risk equivalents: rationale and design of VICTORION-Spirit, a pragmatic phase IIIb, randomised controlled study: https://www.ijclinicaltrials.com/index.php/ijct/article/view/672 Safety and Efficacy of Dexpramipexole in Eosinophilic Asthma (EXHALE): A randomized controlled trial (mentioned and not published yet): https://pubmed.ncbi.nlm.nih.gov/37277072/ National Institute of Health and Care Research List of Possible Studies of Interest: https://bepartofresearch.nihr.ac.uk/results/search-results Some Primary Care professionals may also want to be a participant in research (which in itself is a nice way to see what it's all about). The best way to do this is to go to https://www.researchforthefuture.org/  ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

To find out more about how Dentistry works in England, Doctors Lisa and Sara talk to Greater Manchester Workforce Lead for Dentistry Mukhtar Ahmad. We cover how Dental Services are set up and funded in England and some current challenges. We move on to specific questions about how General Practice and Dentistry can help each other. Themes include; information sharing, Bisphosphonates, Chemotherapy, Radiotherapy and Diabetes.  You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  BMA Advice and Support Patients presenting with dental problems (Sept 2020): https://www.bma.org.uk/advice-and-support/gp-practices/gp-service-provision/patients-presenting-with-dental-problems?fbclid=IwAR1-rLLfHumLXMZSXxnb8UF_4acvgbTTcPYmvSQHa8VX18fM0Yn-8fCBoAk Scottish Dental Resources for Professionals: https://www.scottishdental.org/professionals/ Scottish Dental Clinical Effectiveness Programme. Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs (March 2022): https://www.sdcep.org.uk/published-guidance/anticoagulants-and-antiplatelets/ NHS Choices: Find A Dentist: https://www.nhs.uk/service-search/find-a-dentist Baby Teeth Do Matter: https://babyteethdomatter.org/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to Senior Eating Disorder Practitioners Vicky McGee and Rachelle Davies to get their advice on consulting with children and young people who present with features of an Eating Disorder. We take the theoretical case of 14-year-old Suzie, who presents to the Practice alongside her Mum with mood symptoms, reduced eating and weight loss. We use this to guide the discussion around consulting with children and young people and assessing for an Eating Disorder. We talk about Red Flags during acute assessment and follow up. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  Medical Emergencies in Eating Disorders: Guidance on Recognition and Management (Updated July 2023 - Traffic Light System Starts p31): https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr233-medical-emergencies-in-eating-disorders-(meed)-guidance.pdf?sfvrsn=2d327483_52 NICE Guidelines Eating disorders: recognition and treatment  (Dec 2020): https://www.nice.org.uk/guidance/ng69/resources/eating-disorders-recognition-and-treatment-pdf-1837582159813 Royal College of General Practice Eating Disorders eLearning: https://elearning.rcgp.org.uk/enrol/index.php?id=173 Children and young people with suspected eating disorders: Guidelines for primary care professionals (Greater Manchester Focus): https://hub.gmintegratedcare.org.uk/mental-health/children-and-young-people-with-suspected-eating-disorders-guidelines-for-primary-care-professionals/ Eva Musby, a resource for Parents and Clinicians around Anorexia Nervosa: https://anorexiafamily.com/ Maudsley Model in Eating Disorder Treatment: https://www.eatingdisorderhope.com/blog/maudsley-model-eating-disorder Guidelines Summary for Primary Care: Management of Eating Disorders (lists specific types): https://www.medscape.co.uk/viewarticle/eating-disorders-2022a10019oa FEAST (Families Empowered And Supporting Treatment for Eating Disorders) Resources for Families: https://www.feast-ed.org/ Beat Eating Disorders: https://www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa talk to GPs and Workforce Leads Dr Nikesh Vallabh and Dr Richard Bircher. They wanted to talk to us today to discuss a practical approach to some of the workforce issues we are all facing. This episode will be particularly useful for GP Partners, Practice Managers and anyone interested in workforce issues in General Practice. The clicking into the episode will bring up a large list of resources for people to check out as well.  You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  NHS Long term Workforce Plan (June 2023):  ttps://www.england.nhs.uk/long-read/accessible-nhs-long-term-workforce-plan/ National offers to support GPs, including information on Returning to General Practice, GP retainer Scheme, International GP recruitment and the GP Fellowship Scheme: https://www.england.nhs.uk/gp/the-best-place-to-work/ Greater Manchester Primary Care Provider Board: New Access Models with Worked Examples: https://gmpcb.org.uk/general-practice/new-access-models/ GM Primary Care Provider Board website with links to case studies for new models of care to improve access: https://gmpcb.org.uk/general-practice/new-access-models/ Our Previous Episode ‘Changing Access Models in General Practice’: https://www.podbean.com/ew/pb-nw7rc-13ca7c0 NHS England GP Fellowship Programme: https://www.england.nhs.uk/gp/the-best-place-to-work/gp-fellowship-programme/ Health Education England GP Fellowship Programme: https://www.hee.nhs.uk/our-work/gp-fellowships Health Education England North West Professional and Educational Development Course (for GPs): https://nwpgmd.nhs.uk/professional-education-and-development-course-ped Greater Manchester Training Hub (access to lots of different training opportunities for General Practice Staff as well as Coaching and Mentorship Courses): https://gmthub.co.uk/ GP careers: Becoming a GP trainer: Article on GP Online (Jan 2022): https://www.gponline.com/gp-careers-becoming-gp-trainer/article/1424835 Health Education England General practice educator, assessor, coach or mentor: https://www.hee.nhs.uk/our-work/primary-care/general-practice-educator-assessor-coach-or-mentor GPs Return to Practice: https://www.england.nhs.uk/gp/the-best-place-to-work/returning-to-practice/#:~:text=A%20national%20support%20team%20means,educational%20needs%20of%20each%20GP National GP Retention Scheme: https://www.england.nhs.uk/gp/the-best-place-to-work/retaining-the-current-medical-workforce/retained-doctors/ Health Education England Apprentices in primary care - success in practice! https://www.hee.nhs.uk/sites/default/files/documents/Apprentices%20in%20primary%20care%20Mar%202017_0.pdf Gov.uk Education Hub Blog: NHS doctor apprenticeships: Everything you need to know (June 2023): https://educationhub.blog.gov.uk/2023/06/30/nhs-doctor-apprenticeships-everything-you-need-to-know/ Greater Manchester Primary Care Careers: https://gmprimarycarecareers.org.uk/ (Direct link to page with infographic for GPs Career paths): https://gmprimarycarecareers.org.uk/generalpractice/careers/general-practitioner/ Information on becoming a learning environment: https://gmthub.co.uk/placements/health-professions-in-social-care/becoming-an-accredited-learning-environment ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback ___ This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to Dr Aseem Mishra to discuss changes in the guidelines for Hypertension. The discussion includes advice on how to get the most accurate diagnosis and measurements for blood pressures, the importance of counselling patients well, and advice on medications. We started with a poem from Aseem focusing around why this is such an important topic. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  NICE Clinical Knowledge Summaries (updated March 2023): https://cks.nice.org.uk/topics/hypertension/ NICE Visual Summary of Hypertension Diagnosis and Management (Aug 2019): https://www.nice.org.uk/guidance/ng136/resources/visual-summary-pdf-6899919517 European Society of Hypertension Guidelines: https://www.eshonline.org/guidelines/2023-guidelines/ Greater Manchester Medicines Management Group (GMMMG) Hypertension Toolkit (Sept 2023): https://gmmmg.nhs.uk/wp-content/uploads/2023/09/GM-Hypertension-Pathway-V9.2-Final.pdf Antonios T116 Antihypertensive drug concordance in patients with apparent resistant hypertension: a tertiary hypertension referral centre experience Heart 2019;105:A97 https://heart.bmj.com/content/105/Suppl_6/A97.1 Blood Pressure UK (good resources including patient booklets: https://www.bloodpressureuk.org/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback ___ This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk with Consultant Psychiatrist Dr Mark Spurrell about a framework that can be applied to the care of complex patients with multiple problems or difficulties. It is particularly useful at times where we feel stuck, we are struggling to help or move forward and care may be fragmented with lots of care professionals feeling similarly. The idea is to use a value based approach using the whole team to breathe new life into the scenario, create positivity and momentum and build on this to help generate better outcomes for patients that are tailored to their values.  The idea is originally for the MDT approach of Mental Health work but it has been interesting to discuss the approach for General Practice Patients.  You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  Spurrell M, Potts L, Shaw A. Framing Value Based Healthcare in Practice: Introducing the Complex Case and Recovery Management Framework (The CCaRM). Int J Integr Care. 2023 Jan 9;23(1):1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9838237/ Dr Mark Spurrell Website with resources: www.mark-spurrell.com Shared Decision Making Summary guide NHS England and NHS Improvement Feb 2019: https://www.england.nhs.uk/wp-content/uploads/2019/01/shared-decision-making-summary-guide-v1.pdf Royal College of GPs 2016: Collaborative Care and Support Planning: Ready to be a reality https://elearning.rcgp.org.uk/pluginfile.php/174399/mod_book/chapter/576/RCGP-CCSP-Ready-to-be-a-Reality.pdf The Good Lives Model, a strengths-based approach to offender rehabilitation that can be used in other areas: https://www.goodlivesmodel.com/ Recovery Star The Outcomes Star for mental health and well-being: https://www.outcomesstar.org.uk/using-the-star/see-the-stars/recovery-star-4/ NHS Examples of survey tools for use in supported self-management: https://www.england.nhs.uk/personalisedcare/supported-self-management/health-system-support-framework-for-supported-self-management/examples-of-survey-tools-for-use-in-supported-self-management/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback ___ This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to Optometrist Dharmesh Patel to get an understanding of Optometry as part of the Primary Care Team. We discuss how the service is set up, what can be done at the Opticians, different types of patient access and how GP practices can link in with services. We discuss the Community Urgent Eye Care Service (CUES), Minor Eye Conditions Service (MECS) and Community Eye Care Service (CECS). We take a few examples of cases to illustrate options for accessing services in Greater Manchester. Check out the links in the resources section for more about these services.  You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  Generic Introduction to Optometry and Opticians in the UK for Patients: https://www.nhs.uk/nhs-services/opticians/visiting-an-optician/ Criteria for Free NHS eye checks: https://www.nhs.uk/nhs-services/opticians/free-nhs-eye-tests-and-optical-vouchers/ Easy Eyecare Pathway Pathway to support patients with Disabilities and Autism: https://www.gov.uk/government/publications/eye-care-and-people-with-learning-disabilities/eye-care-case-study-community-eye-care-pathway Primary Eyecare Services including finding nearest practices with Community Urgent Eye Care Service (CUES), Minor Eye Conditions Service (MECS) or Community Eye Care Service (CECS): https://primaryeyecare.co.uk/find-a-practice/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback ___ This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to GP Dr Charlotte Bădescu about Ovarian Cancer. We focus on the important learning points about cardinal and other features of presentations to better understand this cancer as an abdominal cancer with symptoms that can and do often present much earlier than the diagnosis is often picked up. She talks us through the value of CA125 tests and the reasons not to be overly reliant on them, though they can be a useful tool in the tool box. The usefulness of ultrasound scans, both pelvic and transvaginal, as well as clinician continuity is discussed.  We go through 2 hypothetical cases based on real examples as well as Charlotte’s own diagnosis. An excellent episode for picking up great learning points to avoid missing this diagnosis in your own patients.  You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources:  NICE Guidelines: Suspected Cancer, Recognition and Referral (Dec 2021): https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#gynaecological-cancers NICE guidelines on Ovarian Cancer (Published April 2011): https://www.nice.org.uk/guidance/cg122 GP network & resources: https://targetovariancancer.org.uk/health-professionals/GPs Nurses network & resources: https://targetovariancancer.org.uk/health-professionals/nurses Patient resources: https://targetovariancancer.org.uk/support-for-you Shine Cancer Support: https://shinecancersupport.org/ ForteenFish Free Ovarian Cancer Webinar (you will need to log-on and search Ovarian Cancer): https://www.fourteenfish.com/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback ___ This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.