The FCP Podcast

Richard welcomes back Dr Mai Elftise to the podcast to discuss Equity, Diversity, Inclusion & Belonging (EDIB) in General Practice. During the episode Mai defines EDIB , including the legislation and what this means in General Practice. We then discuss how EDIB can affect patient assessments and how to you may consider adapting your consultations. Thank you to Scott for your help and support as as well. Please feel free to leave comments and suggestions or content us via email or x. Richard Tennant - richard.tennant@nhs.net Mai Elftise - m.elftise@nhs.net Equality Act 2010 - Equality Act 2010 (legislation.gov.uk) Protected characteristics Age Disability Gender reassignment Marriage and civil partnership Race Religion or belief Sex Sexual orientation Unconscious bias Understanding different types of bias — Conscious inclusion - Equality, diversity and inclusion - About (hee.nhs.uk) The Weathering Hypothesis The weathering hypothesis as an explanation for racial disparities in health: a systematic review - ScienceDirect NHS Employers Equality, diversity and inclusion | NHS Employers Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk)

Richard is joined by regular MSK specialist - Ed Baker, FCP Physio and ambassador for the episode. During the episode Ed discus's the assessment of patients with possible shoulder pathology. This includes history taking, physical examination , investigations, red flags and referral. Ed then discus's cases in including subacromial impingement syndrome and frozen shoulder. As always thank you Scott for your help and support. Please feel free to leave comments and contact us about the show. Shoulder Pain NICE guidelines Shoulder pain | Health topics A to Z | CKS | NICE College of Paramedics Home (collegeofparamedics.co.uk) Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk) Limb Examination Day Limb Examination Day - 16 August 2024 - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk)

Richard welcomes back consultant cardiologist Professor Derek Connolly to the podcast. During the episode we discuss cases including patients presenting with leg swelling / orthopnea, and patients with palpitations. Derek give us he's specialist knowledge on how to assess's these patient presentations including history, red flags, investigations and referral. Please follow us on X @FCPParamedicpod and Derek @DrDerekConnolly As always special thank you to Scott for your help. British Society For Heart Failure British Society For Heart Failure (bsh.org.uk) Primary Care Cardiovascular Society Primary Care Cardiovascular Society (pccsuk.org) Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk) CHADVAS Score CHA₂DS₂-VASc Score for Atrial Fibrillation Stroke Risk (mdcalc.com) HAS-BLED Score HAS-BLED Score for Major Bleeding Risk (mdcalc.com)

Richard welcomes Professor Derek Connolly to the show who is a consultant cardiologist at Birmingham City Hospital. During the episode, Derek discus's how he assesses patients with possible cardiac pathology's. We discus, history taking , red flags, investigation and referrals. We then discus a case of a patient presenting with chest pain in general practice, which includes when to refer, what is involved in the rapid access to chest pain clinic and perinate history which could increase the likely of cardiac pathology. As always thank to Scott for your help and support. This podcast was brought to you with collaboration between Coventry and Warwickshire Training Hub, Primary Care Cardiovascular Society and the College of Paramedics. Follow Derek on X at @DrDerekConnolly Primary care Cardiovascular Society Primary Care Cardiovascular Society (pccsuk.org) Know your numbers Blood Pressure UK NICE guidelines - Chest Pain Chest pain | Health topics A to Z | CKS | NICE Ischaemia with Non-Obstructive Coronary Arteries INOKA Coronary artery spasm: What it is and the treatment options - BHF NONSTEMI Angiography research Comparison of Acute Versus Subacute Coronary Angiography in Patients With NON-ST-Elevation Myocardial Infarction (from the NONSTEMI Trial) - ScienceDirect Lipoprotein(a) Lipoprotein(a) and Major Adverse Cardiovascular Events in Patients With or Without Baseline Atherosclerotic Cardiovascular Disease | Journal of the American College of Cardiology (jacc.org) Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk) College of Paramedics Home (collegeofparamedics.co.uk)

Richard and is joined by guest presenter Sophie and Dr Mai Elftise to discuss respiratory assessment. During the episode we discus's the assessment of patient cases including wheezing, prolonged cough and sleep apnea. This includes history taking, red flags, investigations and referrals for these patient presentations. As always thank you Scott for your input. GINA guidelines Global Initiative for Asthma - Global Initiative for Asthma - GINA (ginasthma.org) Primary Care Respiratory Society Inspiring best practice in respiratory care | Primary Care Respiratory Society (pcrs-uk.org) Asthma Toolkit NHS RightCare » Asthma toolkit (england.nhs.uk) Rightbreathe RightBreathe Asthma NICE guidelines Asthma | Health topics A to Z | CKS | NICE NICE guidelines lung and pleural cancers Lung and pleural cancers - recognition and referral | Health topics A to Z | CKS | NICE Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk) College of Paramedics Home (collegeofparamedics.co.uk)

Richard welcomes Dr Mai Elftise to the podcast who is a GPwSI in respiratory medicine. During the episode we discuss the assessment of patients who present with protentional respiratory pathology. This includes history taking , red flags, investigations and referrals. We use Dr Mai's knowledge to introduce a case of a patient with possible COPD to assess and arrange appropriate investigations and referrals when needed. As always thank you to Scott for your help and support. Please follow us on X @FCPParamedicpodcast Primary Care Respiratory Society Inspiring best practice in respiratory care | Primary Care Respiratory Society (pcrs-uk.org) GOLD guidelines Global Initiative for Chronic Obstructive Lung Disease - Global Initiative for Chronic Obstructive Lung Disease - GOLD (goldcopd.org) NICE gudielines Chronic obstructive pulmonary disease | Health topics A to Z | CKS | NICE MRC Dyspnoea Scale MRC Dyspnoea Scale | Primary Care Respiratory Society (pcrs-uk.org) Spirometry Spirometry | Primary Care Respiratory Society (pcrs-uk.org) Spirometry Interpretation | Obstructive vs Restrictive | Geeky Medics Diagnosis - COPD | Diagnosis | Chronic obstructive pulmonary disease | CKS | NICE Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk) PCRS respiratory conference PCRS Respiratory Conference | Primary Care Respiratory Society (pcrs-uk.org)

Richard and Emma welcome back FCP ambassador and physio Ed Baker to discuss hip pain assessment. Ed discus's his assessments of patients that present in his clinics with hip pain. Ed discus's history taking , physical examination and potential pathology's of the hip joint. Ed, then discus's a case of hip osteoarthritis and how he applies his assessment skills to this case. As always thank to Scott and Martin for your help and support. Please follow us on X @FCPParamedicpod and leave comments and reviews. Red Flags Trauma Unexplained weight loss Neurological systems Age Fever IV drug use Steroids History Consideration for referral Walking aid Sleep Walking distance Hip Quadrant test Hip Quadrant Test | Clinical Physio (youtube.com) Great trochanter joint syndrome Greater trochanteric pain syndrome | Health topics A to Z | CKS | NICE Femoroaceabular impingement Diagnosis and management of femoroacetabular impingement | British Journal of General Practice (bjgp.org) Osteoarthritis of the hip Osteoarthritis (OA) of the hip | Hip pain | Versus Arthritis

Richard and Emma welcome back Ed Baker who is a FCP - MSK physio in general practice and a FCP ambassador at Coventry and Warwickshire Training Hub. During the episode we discuss the approach to patients that present with knee pain and how to carry out a effective knee assessment. Including, history taking, common examination findings and knee pathology. Ed discus's when we should be investigating knee pain and what investigations should requested. Ed then relates his assessment to discuss a case related to osteoarthritis presenting in general practice. Please feel free to rate the podcast and comment, follow us on twitter @FCPParamedicpod. As always thank you to Scott and Martin for you input on developing the podcast. Coventry and Warwickshire Training hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk) Physiopedia Physiopedia - universal access to rehabilitation knowledge (physio-pedia.com) Physiotutors Physiotutors | Online Learning for Physiotherapists Thessaly Test https://www.youtube.com/watch?time_continue=13&v=ebraZ4jM36A&embeds_referring_euri=https%3A%2F%2Fwww.bing.com%2F&embeds_referring_origin=https%3A%2F%2Fwww.bing.com&source_ve_path=Mjg2NjIsMjg2NjY&feature=emb_logo Anterior Drawers Test https://www.youtube.com/watch?time_continue=2&v=X2sDFK76xNo&embeds_referring_euri=https%3A%2F%2Fwww.bing.com%2F&embeds_referring_origin=https%3A%2F%2Fwww.bing.com&source_ve_path=Mjg2NjY&feature=emb_logo

Richard and Emma welcome back Dr David Palmer, who is a GPwSI in mental health. During the the podcast we discuss patient presentations including substance abuse, psychosis and post natal depression. David give us his incite into mental health assessments including history taking , investigations and appropriate referrals. As always special thank you to Scott and Martin for your support in the podcast and for David for giving up his time to record the episode. Please rate and subscribe to the podcast, we are also on twitter @FCPparamedicpod Psychosis NICE guidelines Psychosis and schizophrenia | Health topics A to Z | CKS | NICE Postnatal depression NICE guidelines Depression - antenatal and postnatal | Health topics A to Z | CKS | NICE Alcohol abuse NICE guideline Alcohol - problem drinking | Health topics A to Z | CKS | NICE Edinburgh scoring tool EDPS_text_added.pdf (stanford.edu) Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk) College of Paramedics Home (collegeofparamedics.co.uk)

Emma's back and we are discussing mental health assessment with Dr David Palmer, who is a GP with a keen interest in mental health. During the episode we discuss the importance of mental health assessment, David give his guidance of how he approach's mental health assessment. We they apply his knowledge to two cases including depression and anxiety. Thank you to Martin and Scott for you help as always. Please feel free to rate the podcast and follow us on @FCPParamedicpod on twitter. Basic Human needs Maslow's Hierarchy of Needs (simplypsychology.org) PHQ9 PHQ-9 Depression Test Questionnaire | Patient GAD7 GAD7 Anxiety Test Questionnaire | Patient Depression Depression | Health topics A to Z | CKS | NICE Anxiety Generalized anxiety disorder | Health topics A to Z | CKS | NICE Talking therapies NHS talking therapies - NHS (www.nhs.uk)

Richard welcomes back Dr David Lupini who is a GP partner and GPwSI in dermatology. During the episode we discuss the assessment of skin lesions. Dr Lupini discus's how he started to assess skin lesions in primary care without the use of a dermatoscope. We apply the assessment to 3 cases including melanoma , squamous cell carcinoma and basal cell carcinoma. Within the cases we discuss red flags in skin lesions and the correct referral pathway for these patients. Please feel free to leave us comments and rate the podcast. We are on twitter @FCPParamedicpod. As always special thanks to Scott and Martin for your help and Dr Lupini for giving up your time to record the episode. Skin Lesion Assessment Dermoscopic assessment (pcds.org.uk) Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk) College of Paramedic - Primary and Urgent Care Primary and Urgent Care (collegeofparamedics.co.uk) Melanoma Melanoma (pcds.org.uk) Squamous Cell Carcinoma Squamous cell carcinoma (pcds.org.uk) Basal Cell Carcinoma Basal cell carcinoma (pcds.org.uk) Actinic Keratosis Actinic (solar) keratosis (pcds.org.uk) Bowen disease Bowen's disease (pcds.org.uk) Gateway C - Skin Cancer Early Diagnosis New course: Skin Cancer – Early Diagnosis - GatewayC Fitzpatrick Skin Type Skin phototype (Fitzpatrick skin type) | DermNet (dermnetnz.org)

Richard welcomes Jo Taylor a personalised care ambassador and Katie Chuter a heath and well being coach. Within the episode we look to celebrate the new role within heath care which is health and wellbeing coaching. During the episode we discuss where heath and wellbeing coaching came from, who is a heath and wellbeing coach and what does the training involved. We look to identify what the expected benefits for the patient, the service and what the future looks like in health and well being coaching. The aim of heath and wellbeing coaching awareness is to - •Raise awareness of the opportunities and benefits of health coaching by highlighting how it can increase people’s capability to self-manage major conditions. •Highlight how health coaching can support people to make more informed and conscious choices that prevent the escalation of illness and improve health outcomes. •Showcase how health coaches’ unique expertise can bring about positive changes for individuals and the health and care system, such as reducing demand on services and the need for clinical interventions. •Showcase good practice and the impact of health coaching across the NHS in primary, secondary and community care. ·Highlight that health and care professionals from any specialism can learn to take a health coaching approach, with the right training. Please follow us on twitter @FCPparamedicpod As always special thanks to Scott and Martin for your support. Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk) Personalised Care Institute personalisedcareinstitute.org.uk NHS Futures platfrom FutureNHS Collaboration Platform - FutureNHS Collaboration Platform

Richard welcomes FCP ambassador and MSK physio Ed Baker to the podcast . During the episode we discuss the assessment of patients with lower back pain, including red flags , pertinent history taking and investigations in general practice. We apply this knowledge in some cases, including a patient with mechanical back pain and inflammatory spondyloarthropathy. Please follow us on twitter @FCPParamedicpod As always special thank you Scott and Martin for your help. Versus Arthritis Back pain | Causes, exercises, treatments | Versus Arthritis Examination of the spine | Versus Arthritis Patient info Back and Spine Pain | Causes and Treatment | Patient Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk) NICE guidelines Sciatica (lumbar radiculopathy) | Health topics A to Z | CKS | NICE Babinski sign The Babinski Sign or Reflex | Upper Motor Neuron Lesion - YouTube Clonus Clonus - YouTube Straight leg raise Straight Leg Raise or Lasègue's Test for Lumbar Radiculopathy - YouTube Human leukocyte antigen B27 (HLA-B27) HLA-B27 (labtestsonline.org.uk) Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk)

Richard and Emma welcome back Dr Heidi Kerr who is a GPwSI in Women's Health. Within the episode Dr Heidi Kerr discus's the assessment of Women who present with pelvic pain and vaginal bleeding. Dr Heidi Kerr has given up her free time, please feel free to give feedback, I know I enjoyed the episode and learnt lots I will use in my practice. As always thank you to Martin and Scott for your input. Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk) VHK Education VHK Education – Delivering bespoke education in women’s health Gynaecological cancers - recognition and referral Gynaecological cancers - recognition and referral | Health topics A to Z | CKS | NICE Dr Heidi Kerr's 5 C's - PV bleeding Conception - what are they taking? Compliance - how are they taking the medication? Chlamydia (STI's) Cervix Cancer Consider drug history Primary Care Women's Heath forum Home - Primary Care Women's Health Forum (pcwhf.co.uk) Mittelschmerz Mittelschmerz - Symptoms and causes - Mayo Clinic

Richard and Emma welcome Dr Heidi Kerr who is a GPwSI in Women's Health to the podcast. Within the episode Dr Kerr discus's her approach to patient assessments in women's health. We then discuss common general practice presentations including breast pains and vaginal discharge. Please feel free to leave comments and follow us on twitter @FCPParamedicpod. As always special thank you to Martin and Scott for your input on the podcast. If you wish to contact Dr Heidi Kerr about training in Women’s Heath please contact - vhkwomenshealthclinic@gmail.com. VHK Education VHK Education – Delivering bespoke education in women’s health Breast cancer reconition https://cks.nice.org.uk/topics/breast-cancer-recognition-referral/diagnosis/symptoms-suggestive-of-breast-cancer/ NHS Breast Cancer screening program https://www.nhs.uk/conditions/breast-screening-mammogram/when-youll-be-invited-and-who-should-go/ Breast cancer managing FH https://cks.nice.org.uk/topics/breast-cancer-managing-fh/ Dr Kerr’s funnel questions for sexual history When did you last have sexual intercourse? Was it a new or regular partner? Was it a male or female? What sort of sexual intercourse? Was protection used? Coventry and Warwickshire Training hub https://www.cwtraininghub.co.uk/

Richard and Emma welcome back Dr David Lupini who is a GPwSI in Dermatology. Within the episode we discuss a range of common Dermatology cases in General Practice and use his expertise to ensure an affective patient assessment. Within the episode Dr Lupini discus's cases include systemic rash, pruritus and acne. Please feel free to leave comments and follow us on twitter @FCPParamedicpod. Dr Lupini kindly gave up his own time for these podcasts, please join Richard and Emma thanking him for sharing his knowledge and experience. As always special thanks to Martin and Scott for your input. Some further reading and resources :- The Primary Care Dermatology Society The Primary Care Dermatology Society | UK (pcds.org.uk) British Association of Dermatologists Home Page - British Association of Dermatologists (bad.org.uk) Dermnet DermNet | Dermatology Resource (dermnetnz.org) Pruritus Itch (pruritus) without a rash (pcds.org.uk) Acne Acne vulgaris (pcds.org.uk) Acne vulgaris | Health topics A to Z | CKS | NICE Morbilliform Rash Morbilliform drug reaction (maculopapular drug eruption) | DermNet (dermnetnz.org) Urticaria Urticaria | Health topics A to Z | CKS | NICE Urticaria and angioedema (pcds.org.uk) Yellow Card Reporting Yellow Card | Making medicines and medical devices safer (mhra.gov.uk)

International Paramedics Day will be held on 8th July 2023 to build a better understanding of the breadth and depth of work carried out by paramedics around the world. Paramedicine and the Paramedic, is relatively young profession but it is growing rapidly with a very wide range of paramedic roles being carried out in different fields and we want to showcase this diversity in 2023. . Richard presents a special episode for International Paramedic Day 2023, which I based around #whatwedo. Within the episode we showcase the work that Paramedics are undertaking in General Practice and within leadership roles. Guests include Sam Holmes from Coventry and Warwickshire GP Alliance, she is a lead Paramedic and works clinically, Sophie Delay from Leamington South and North PCN, who works as a advanced clinical practitioner, a ambulance paramedic and helps support her practices new staff and Helen Beaumont-Waters, who is the head of clinical development for the College of Paramedics. As always special thank you to Martin and Scott for your help and support developing the episode. Please feel free to contact us and follow on twitter at @FCPParamedicpod HOME | International Paramedics Day Display event - Primary Care and Prescribing Conference (collegeofparamedics.co.uk) Diploma in Primary and Urgent Care (collegeofparamedics.co.uk)

Richard and Emma welcome Dr David Lupini who is a GPwSI in Dermatology. Dr Lupini discus's his approach to patient presenting with skin complaints. Dr Lupini then applies his assessment to a single site rash. He discus's potential differential diagnosis and clinical reasoning in the assessment of skin presentation. Please feel free to leave comments and follow us on twitter @FCPParamedicpod. Dr Lupini kindly gave up his own time for these podcasts, please join Richard and Emma thanking him for sharing his knowledge and experience. As always special thanks to Martin and Scott for your input. The Primary Care Dermatology Society The Primary Care Dermatology Society | UK (pcds.org.uk) British Association of Dermatologists Home Page - British Association of Dermatologists (bad.org.uk) Dermnet DermNet | Dermatology Resource (dermnetnz.org)

Richard and Emma welcome back Dr Ian Allwood who is a GPwSI in gastroenterology. We would highly recommend listening to episode one where Ian discus's his process to assess abdominal pain. Dr Ian Allwood discus's gastroenterology patient presentations which include perinate history taken, appropriate examination and investigations. The cases include :- Change in bowel habit, Nausea / vomiting and rectal bleeding. Please follow us on twitter for updates @FCPParamedicpod Always great to here comments about the episodes. Our guests give up their time to record these episodes so please feel free to leave feedback on the episode. As always special thanks to Martin and Scott for your assistance. Primary Care Society for Gastroenterology PCSG – The Primary Care Society for Gastroenterology Ingest podcast - from the PCSG Ingest Podcasts – PCSG Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk) College of Paramedics Primary and Urgent Care (collegeofparamedics.co.uk) Rome Criteria Rome IV Diagnostic Criteria for Irritable Bowel Syndrome (IBS) - MDCalc NICE DG30 for Quantitative Faecal Immunochemical Test Overview | Quantitative faecal immunochemical tests to guide referral for colorectal cancer in primary care | Guidance | NICE NG12 Guideline for suspecting cancer Recommendations organised by site of cancer | Suspected cancer: recognition and referral | Guidance | NICE Offer testing with quantitative faecal immunochemical tests NICE diagnostics guidance on quantitative faecal immunochemical tests to guide referral for colorectal cancer in primary care Recommends to assess for colorectal cancer in adults without rectal bleeding who: orororor Joint guideline from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG) Faecal immunochemical testing (FIT) in patients with signs or symptoms of suspected colorectal cancer (CRC): a joint guideline from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG) | Gut (bmj.com) Patient advice for FIT fit_symptomatic_patient_leaflet_feb2022.pdf (cancerresearchuk.org)

Richard and Emma welcome Dr Ian Allwood who is a experienced GP with a specialist interest in gastroenterology. Dr Ian Allwood discusses the assessment of patient's presenting with gastroenterology complaints including a overview of taking abdominal pain history, epigastric pain and distension. Please follow us on twitter for updates @FCPParamedicpod Always great to here comments about the episodes. Our guests give up their time to record these episodes so please feel free to leave feedback on the episode. As always special thanks to Martin and Scott for your assistance. Primary Care Society for Gastroenterology PCSG – The Primary Care Society for Gastroenterology Ingest podcast - from the PCSG Ingest Podcasts – PCSG Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub (cwtraininghub.co.uk) College of Paramedics Primary and Urgent Care (collegeofparamedics.co.uk) Abnormal Liver Fuction Guidelines on the management of abnormal liver blood tests - The British Society of Gastroenterology (bsg.org.uk)