The British journal of general practice : the journal of the Royal College of General Practitioners
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Many patients receive routine medications for long-term conditions (LTCs). Doctors typically issue repeat prescriptions in one to three month durations, but England currently has no national guidance on the optimal duration. ⋯ One month prescription durations are common for patients taking medicines routinely for long term conditions, particularly in dispensing practices. Electronic health record configurations offer an opportunity to implement and evaluate new policies on repeat prescription duration in England.
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Clinical guidance recommends promoting physical activity during general practice consultations. The frequency and content of physical activity discussions in UK general practice are poorly understood. ⋯ Physical activity advice, following national guidance, was potentially relevant to more than half of GP consultations; GPs delivered advice of varying depth in a third of these consultations. Future work should explore ways of delivering physical activity advice effectively, efficiently, and equitably within the constraints of general practice.
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The challenges of recruiting and retaining rural GPs are well described. UK data suggest high levels of burnout, characterised by detachment, exhaustion, and cynicism, plays a role in GP turnover. The contrast is engagement with work. There is limited evidence examining the relationship between work engagement and recruitment and retention in rural areas. ⋯ Our data suggest that factors associated with engagement and burnout can contribute to rural GPs' migration decisions. We highlight four areas that could promote desirable work environments by mitigating burnout and promoting engagement at work.
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General practice faces pressures because of increased demand and a shortage of GPs. Paramedics in general practice (PGPs) increasingly contribute to managing minor illnesses, conducting home visits, and providing urgent consultations. ⋯ Well-designed training and supervision are needed to ensure PGPs have the right knowledge and can clearly convey healthcare plans to patients. While PGPs may reduce GP workload pressure, they do not necessarily reduce NHS costs.
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The introduction of remote and digital forms of working in UK general practice has driven the development of new routines and working styles. ⋯ The digitalisation of working routines in UK general practice poses a unique challenge to the workforce, risking technostress, workplace suffering, and increased relational strain within and between teams. To embed the benefits of digitalisation, we must first improve practice teams' readiness for change, which includes strengthening practices' relational structures that provide support during periods of adaptation. Practices must be empowered to determine a locally appropriate configuration of digital tools and given the resources and time to adapt working routines.