BJGP Interviews

Science Podcasts

Listen to BJGP Interviews for the latest updates on primary care and general practice research. Hear from researchers and clinicians who will update and guide you to the best practice. We all want to deliver better care to patients and improve health through better research and its translation into practice and policy. The BJGP is a leading international journal of primary care with the aim to serve the primary care community. Whether you are a general practitioner or a nurse, a researcher, we publish a full range of research studies from RCTs to the best qualitative literature on primary care. In addition, we publish editorials, articles on the clinical practice, and in-depth analysis of the topics that matter. We are inclusive and determined to serve the primary care community. BJGP Interviews brings all these articles to you through conversations with world-leading experts. The BJGP is the journal of the UK's Royal College of General Practitioners (RCGP). The RCGP grant full editorial independence to the BJGP and the views published in the BJGP do not necessarily represent those of the College. For all the latest research, editorials and clinical practice articles visit BJGP.org (https://www.bjgp.org). If you want all the podcast shownotes plus the latest comment and opinion on primary care and general practice then visit BJGP Life (https://www.bjgplife.com).

Location:

United Kingdom

Genres:

Science Podcasts

Description:

Listen to BJGP Interviews for the latest updates on primary care and general practice research. Hear from researchers and clinicians who will update and guide you to the best practice. We all want to deliver better care to patients and improve health through better research and its translation into practice and policy. The BJGP is a leading international journal of primary care with the aim to serve the primary care community. Whether you are a general practitioner or a nurse, a researcher, we publish a full range of research studies from RCTs to the best qualitative literature on primary care. In addition, we publish editorials, articles on the clinical practice, and in-depth analysis of the topics that matter. We are inclusive and determined to serve the primary care community. BJGP Interviews brings all these articles to you through conversations with world-leading experts. The BJGP is the journal of the UK's Royal College of General Practitioners (RCGP). The RCGP grant full editorial independence to the BJGP and the views published in the BJGP do not necessarily represent those of the College. For all the latest research, editorials and clinical practice articles visit BJGP.org (https://www.bjgp.org). If you want all the podcast shownotes plus the latest comment and opinion on primary care and general practice then visit BJGP Life (https://www.bjgplife.com).

Twitter:

@BJGPJournal

Language:

English

Website:

http://www.bjgplife.com/

Email:

journal@rcgp.org.uk

Episodes

How better funding and resources can help Primary Care Networks reduce health inequalities

4/30/2024

In this episode, we talk to Dr Lynsey Warwick-Giles, a Research Associate based within the Centre for Primary Care and Health Services Research at the University of Manchester. Title of paper: Can Primary Care Networks contribute to the national goal of reducing health inequalities? A mixed method study Available at: https://doi.org/10.3399/BJGP.2023.0258 Primary Care Networks are an important policy development in English primary care, with an additional contract supporting practices to work collaboratively. Policy makers intend that they will tackle local health inequalities. Our research suggests that there is potential for them to achieve this, but it will require: continued weighting of funding formulas to account for deprivation; redistribution of funds and other resources internally to support the most deprived practices; managerial support, particularly for PCNs with deprived populations; and realistic and achievable targets for PCN action.

Duration:00:15:58

The impact of continuity on mortality in four common and chronic diseases in general practice

4/23/2024

In this episode, we talk to Dr Sahar Pahlavanyali, a doctor and PhD candidate based at the Department of Global Public Health and Primary Care at the University of Bergen in Norway. Title of paper: Continuity and breaches in GP care and their associations with mortality for patients with chronic disease: an observational study using Norwegian registry data Available at: https://doi.org/10.3399/BJGP.2023.0211 There is a growing body of evidence on advantages of continuity, and a GP personal list is believed to be one of the positive measures to improve continuity, though not much researched. In a Norwegian setting with GP personal lists, we investigated the associations between GP continuity and mortality for patients with different chronic diseases. Our results showed that lower GP continuity was associated with increased risk of death, but the association was not significantly different for patients with the same RGP compared with those with different RGPs. This study suggests that high informational and management continuity provided by a GP personal list might lower and compensate for the adverse effects when changing GP.

Duration:00:13:02

The challenges and impacts of the Additional Roles Reimbursement Scheme (ARRS) in general practice

4/16/2024

In this episode, we talk to Dr Zoe Anchors, a Research Fellow based at the Centre for Health and Clinical Research at the University of the West of England. Title of paper: A qualitative investigation of the Additional Roles Reimbursement Scheme in primary care’ Available at: https://doi.org/10.3399/BJGP.2023.0433 The government has delivered on its commitment of recruiting 26,000 more primary care professionals through the ARRS in order to reduce patient waiting lists, widen the range of healthcare services and meet the needs of local populations. This qualitative analysis supports the positive impact of these additional roles in broadening the healthcare available to patients, and finds similar challenges (i.e., lack of career progression and supervision; lack of understanding of role descriptions and scope creep; problematic roadmaps; and poor integration) to implementation previously identified. However, our data reveals the scheme’s inflexibility and lack of available workforce particularly impacted Primary Care Networks in deprived areas resulting in the potential exacerbation of health inequalities, with the needs of populations not necessarily being met. More flexibility needs to be provided about who and what is funded under the scheme, with particular focus in areas of higher deprivation.

Duration:00:17:06

Improving access to general practice for people with multiple disadvantage

4/9/2024

In this episode, we talk to Dr Lucy Potter, a GP and a doctoral research fellow based at the Centre for Academic Primary Care at the University of Bristol. Title of paper: Improving access to general practice for and with people with severe and multiple disadvantage Available at: https://doi.org/10.3399/BJGP.2023.0244 This study builds on previous work showing that continuity of care, being able to develop a trusting relationship and being proactive are of particular importance in providing care to highly people with SMD(3-7). This work describes co-designed strategies including prioritising patients on an inclusion patient list with more flexible access, continuity from a care coordinator and micro-team, and an information sharing tool, in addition to rich contextual information on how to shift ways of working to achieve this. These co-designed strategies are practical examples of proportionate universalism in general practice, where resources are prioritised to those most in need. They could be adapted and piloted in other practices and areas and may also offer promise in improving inclusion of other marginalised groups. Investing in this focused way of working may improve healthcare accessibility, health equity and staff wellbeing.

Duration:00:15:17

BJGP Easter break

4/2/2024

We are taking a break from the BJGP podcast this week for Easter, but we’ll be back on 9 April 2024.

Duration:00:00:39

Addressing child weight issues in the consultation – what could we be doing better in general practice?

3/26/2024

In this episode, we talk to Professor Miranda Pallan, a public health doctor who is Professor of Child and Adolescent Public Health at the University of Birmingham. Title of paper: Supporting healthcare professionals to address child weight with parents: a qualitative study Available at: https://doi.org/10.3399/BJGP.2023.0238 Healthcare professionals (HCPs) working in primary care and community settings are known to experience barriers in discussing child excess weight with parents. We conducted a qualitative study with General Practitioners, Primary Care Nurses and School Nurses to further explore these barriers and identify facilitating factors to inform recommendations for actions to support HCPs in addressing child weight with parents. Structural changes within primary/community care, joined up systems and data sharing across agencies, and development of HCP knowledge and skills through core training and continuing professional development will enable HCPs to discuss child weight and provide advice to parents.

Duration:00:16:31

The shift to online consultations – what is the patient perspective?

3/19/2024

In this episode, we talk to Dr Susan Moschogianis, a Research Associate based at the Health Services Research and Primary Care team at the University of Manchester. Title of paper: Patient experiences of an online consultation system: qualitative study in primary care post-COVID-19 Available at: https://doi.org/10.3399/BJGP.2023.0076 Online consultation systems (OCSs) have been rolled out rapidly, but little is known about patients’ experiences using them. We undertook the largest ever reported qualitative study of patient experiences using an OCS. Our findings provide insight into why some patients prefer in-person consultations, and why others prefer to use OCSs. Patients’ experiences of using OCSs can be influenced by how they are designed, how GP practices use them, and characteristics of the patient and request they use them for.

Duration:00:15:52

How can we provide better care for older patients with multiple disadvantage?

3/12/2024

In this episode, we talk to Laiba Hussain, a THIS Institute Research Fellow and PhD Candidate at the Nuffield Department of Primary Care Health Sciences at the University of Oxford. Title of paper: Developing user personas to capture intersecting dimensions of disadvantage in marginalised older patients: a qualitative study Available at: https://doi.org/10.3399/BJGP.2023.0412 Equity is an important core value in primary care, but meeting the needs of patients who are multiply disadvantaged is increasingly difficult as services become more digitised. User personas (fictional cases based on empirical data which draw together and illustrate the multiple intersecting elements of disadvantage) could help practices better plan for the needs of disadvantaged groups.

Duration:00:15:30

How can we better manage patients after a hospital admission for asthma?

3/5/2024

In this episode, we talk to Dr Shamil Haroon, Associate Clinical Professor and Honorary Consultant in Public Health Medicine at the University of Birmingham, and Dr Prasad Nagakumar, a Paediatric Respiratory Consultant. Title of paper: Post-hospitalisation asthma management in primary care: a retrospective cohort study Available at: https://doi.org/10.3399/BJGP.2023.0214 Asthma is a common cause of hospital admissions and clinical guidelines recommend that hospitalised patients are followed up in primary care. Little research has been done on 3 evaluating post-hospitalisation asthma management in primary care. We found that 40% of hospitalised patients did not receive asthma management in primary care following hospital discharge, particularly among patients from black ethnic minority groups. Primary and secondary care services should develop systems for ensuring the timely follow-up of asthma patients after hospital discharge and address the observed health inequities.

Duration:00:14:00

Joining the dots – how do patients and clinicians experience continuity in extended access clinics?

2/27/2024

In this episode, we talk to Patrick Burch, a GP and a THIS Institute PhD fellow at the Centre for Primary Care and Health Services Research at the University of Manchester. Title of paper: An observational study of how clinicians, patients and the health care system create the experience of joined up, continuous primary care in the absence of relational continuity DOI: https://doi.org/10.3399/BJGP.2023.0208 The way that many modern healthcare systems are designed increasingly relies on the assumption that, in the absence of relational continuity, any competent clinician can deliver joined up, continuous care if they have access to clinical notes. This study of a primary care environment, where patients are usually seen by a clinician they have not seen before, demonstrates multiple connected patient, clinician, and system factors that appear important for a patient to experience joined up, continuous care. Considering these factors in the design of primary care systems may have the potential to improve experience for patients.

Duration:00:15:59

What prescription medicines patients share and why

2/20/2024

In this episode, we talk to Dr Shoba Dawson, a Senior Research Fellow within the School of Medicine and Population Health at the University of Sheffield . Title of paper: Understanding non-recreational prescription medication sharing behaviours: A systematic review Available at: https://doi.org/10.3399/BJGP.2023.0189 Sharing of prescription medicines for non-recreational purposes is a form of inappropriate medication use and such practices can cause delays in seeking medical care, masking the symptoms and severity of disease and could potentially result in the progression of the health condition. The reasons why people engage in medication sharing, how they assess the potential risks and benefits of these practices, and the factors which influence these behaviours are poorly understood. This systematic review shows that prescription medication sharing for non-recreational purposes is common with analgesics and antibiotics being the most commonly shared medications. Data on the prevalence and predictors of these behaviours are however limited. This review highlights that prescription medication sharing for non-recreational purposes is a potentially important medicines safety issue and significant public health concern which merits healthcare provider intervention, public awareness efforts and further research.

Duration:00:11:53

Signals before a diagnosis of bipolar disorder and opportunities for earlier diagnosis by GPs

2/13/2024

In this episode, we talk to Dr Cathy Morgan, a Research Fellow within the NIHR Greater Manchester Patient Safety Research Collaboration at the University of Manchester, and Professor Carolyn Chew-Graham, GP and Professor of General Practice Research at Keele University. Title of paper: Identifying prior signals of bipolar disorder using primary care electronic health records Available at: https://doi.org/10.3399/BJGP.2022.0286 Delayed diagnosis and treatment of BD of between 6-10 years leads to adverse patient outcomes. No published studies examine the timings of early signals of BD in a primary care setting and/or use electronic health records. Routinely collected data identified early signals of undiagnosed BD: previous depressive episodes, sleep disturbance, substance misuse, those receiving 3 or more different psychotropic medication classes in a year, escalating self-harm, twice as many face-to face consultations and missing scheduled appointments. Awareness of collective early signals can be used to prompt consideration of BD and offer timelier referral for specialist assessment of a BD diagnosis and initiation of appropriate treatment.

Duration:00:15:06

BJGP’s top 10 most read papers of 2023

2/6/2024

Joining me today are the Editor in Chief of the BJGP and my two fellow associate editors, Sam Merriel and Tom Round. This week we’re taking the time to reflect back on some of the most read research here at the BJGP, looking at the top 10 papers of 2023. BJGP Top 10 research This collection of Top 10 research most read and published in 2023 brings together high-profile primary care research and clinical innovation. Listen to the accompanying podcast in which BJGP Editors discuss the Top 10: 10. Cancer risk and fatigue Read the research here: https://doi.org/10.3399/BJGP.2022.0371 9. Antibiotics for LRTIs Read the research here: https://doi.org/10.3399/BJGP.2022.0239 8. Why do GPs do blood tests? Read the research here: https://doi.org/10.3399/BJGP.2023.0191 7. What motivates GPs' work? Read the research here:https://doi.org/10.3399/BJGP.2022.0563 6. Opioids, antibiotics, and GP burnout Read the research here:https://doi.org/10.3399/BJGP.2022.0394 5. Non-drug interventions in mental health Read the research here:

Duration:00:32:11

Satisfaction with remote consultations and why education matters

1/30/2024

In this episode, we talk to Professor Kate Brain, who is a Professor of Health Psychology, within the School of Medicine at Cardiff University. Title of paper: Satisfaction with remote consultations in primary care during COVID-19: a population survey of UK adults Available at: https://doi.org/10.3399/BJGP.2023.0092 Remote consultations became more widespread during the COVID-19 pandemic and continue to date. However, patterns of association between demographic characteristics and satisfaction with GP remote consultations during the pandemic were unclear. People with higher levels of educational qualification were found to have greater levels of satisfaction with remote GP consultations. Those with lower educational levels may benefit from further support with remote consultations.

Duration:00:13:41

A paradox of access and how we can address the increasing demand in general practice

1/23/2024

In this episode, we talk to Dr Jennifer Voorhees, who is a GP in Tameside and an NIHR Academic Clinical Lecturer based at the University of Manchester. Title of paper: A paradox of access problems in general practice: a qualitative participatory case study Available at: https://doi.org/10.3399/BJGP.2023.0276 Access to general practice is an important topic, yet research and policies addressing access often take a simplistic definition, resulting in a lack of understanding of the complexities of longstanding interrelated problems. This research explains a paradox of access problems, in which the focus and attention on the increasing demand on general practice both creates and obscures another problem of unmet need. This is done through reactive rules and policies to manage demand, which largely undermine continuity in favour of speed of access, and generate work that takes up capacity of staff and patients. Clinicians can look at their current ways of working and identify ways to reverse the paradox in order to address hidden unmet needs and the resulting health inequalities in the population.

Duration:00:15:44

Providing proactive and holistic palliative care in general practice – exploring the patient perspective

1/16/2024

In this episode, we talk to Isabel Leach, who is a final year medical student at the University of Sheffield. Title of paper: Understanding patient views and experiences of the IDENTIfication of PALLiative care needs (IDENTI-Pall): a qualitative interview study Available at: https://doi.org/10.3399/BJGP.2023.0071 Understanding into patient views and experiences of identification of palliative care needs is lacking. This study suggests an individualised and compassionate approach is required, with key components including open conversations about palliative care and the sharing of prognostic uncertainty. Proactive palliative care intervention by primary healthcare professionals following identification of need is valued by patients and requires further attention in research, policy, and practice.

Duration:00:12:09

Coeliac disease and its diagnosis in primary care – what is the patient experience?

1/9/2024

In this episode, we talk to Dr Alice Harper, an NIHR Academic Clinical Fellow based at the Centre for Academic Primary Care at the University of Bristol. Title of paper: Understanding the patient experience of coeliac disease diagnosis: a qualitative interview study Available at: https://doi.org/10.3399/BJGP.2023.0299 Previous qualitative studies on coeliac disease (CD) focus on patient experience after diagnosis. This study found patients experience uncertainty during the pathway to CD diagnosis, particularly pre-diagnosis and during investigations. Endoscopy was thought to be necessary for diagnostic confidence and conviction in a lifelong gluten free diet. As the diagnostic pathway evolves, consideration must be given to reducing patient uncertainty.

Duration:00:14:31

Christmas break

12/19/2023

A quick note to say we're taking a break over Christmas but we'll be back with another BJGP Interview on 9 January 2024.

Duration:00:01:01

The BJGP Christmas stocking filler podcast

12/19/2023

In this Christmas edition of the BJGP podcast we discuss Christmas stocking filler books. We're joined by Ben Hoban, Nada Khan, Euan Lawson and Andrew Papanikitas and talk through four books for the holiday season.

Duration:00:45:54

Investigating the signals in primary care prescribing before a diagnosis of bladder or renal cancer

12/12/2023

In this episode, we talk to Dr Garth Funston, who is a Clinical Senior Lecturer in Primary Care Cancer Research within the Wolfson Institute of Population Health at Queen Mary University of London. Title of paper: Pre-diagnostic prescription patterns in bladder and renal cancer: a longitudinal linked data study Available at: https://doi.org/10.3399/BJGP.2023.0122 Previous studies have demonstrated that prescription rates for certain medications increase many months before the diagnosis of some cancers. Determining whether prescribing for common urological clinical features increases in patients with renal and bladder cancer could help us identify opportunities for more timely diagnosis. We found that prescription rates for UTI medications increased 9 months before bladder and renal cancer diagnosis, with an even earlier increase occurring before bladder cancer diagnosis in women (11 months). This indicates that there is a window of opportunity in which investigation and referral could lead to earlier cancer detection in some patients presenting to their GP with features of UTI.

Duration:00:11:29