The British journal of general practice : the journal of the Royal College of General Practitioners
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Guidelines suggest that GPs should intervene on patients' weight, but to do so GPs must first recognise that a patient may have a weight problem and weigh them. ⋯ This sample of predominantly trainee GPs perceived overweight and obese weights as being of lower BMI and weight status than they actually are, and this was associated with a lower intention of discussing weight management with a potential patient. This was found to be true for trainee and fully qualified GPs who participated in the study. Healthcare professionals should not rely on visual judgements when identifying patients who may benefit from weight management treatment.
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The 2012 Health and Social Care Act in England replaced primary care trusts with clinical commissioning groups (CCGs) as the main purchasing organisations. These new organisations are GP-led, and it was claimed that this increased clinical input would significantly improve commissioning practice. ⋯ GPs have been involved in commissioning in many ways since fundholding in the 1990s, and claims such as these are not new. The key question is whether these new organisations better support and enable the effective use of this knowledge. Furthermore, emphasis on experiential knowledge brings with it concerns about representativeness and the extent to which other voices are heard. Finally, the implicit privileging of GPs' personal knowledge ahead of systematic public health intelligence also requires exploration.
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Case management may be a feasible solution to the problem of service fragmentation for people with dementia. ⋯ Further investigation is required before case management for people with dementia and their carers can be implemented in primary care.