The British journal of general practice : the journal of the Royal College of General Practitioners
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Missed GP appointments have considerable time and cost implications for healthcare services. ⋯ Findings from this review have potential implications for targeted interventions to address missed appointments in primary care. This is the first step for clinicians to be able to target interventions to reduce the rate of missed appointments.
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Group consultations are a relatively new concept in UK primary care and are a suggested solution to current workload pressures in general practice. Little is known about the experience of implementing and delivering this approach from staff and organisational perspectives. ⋯ General practice clinicians enjoyed group consultations, yet significant work is required to initiate and sustain the approach. An implementation plan considering leadership, roles and responsibilities, and wider organisational support is required at the outset. Further research or evaluation is needed to measure process outcomes.
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Gestational diabetes mellitus (GDM) is an important risk factor for developing type 2 diabetes mellitus (T2DM) later in life. Postpartum screening provides an opportunity for early detection and management of T2DM, but uptake is poor. ⋯ Barriers to diabetes screening were identified at both system and individual levels. At the system level, clarification of responsibility for testing among healthcare professionals and better systems for recall are needed. These could be achieved through registers, improved clinical protocols, and automatic flagging and prompts within electronic medical records. At the individual level, clinicians should be supported to prioritise the importance of screening within consultations and better educational resources made available for women. Making it more convenient for women to attend may also facilitate screening.
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Bariatric surgery is the most effective treatment for severe obesity. However, without recommended follow-up it has long-term risks. ⋯ This study suggests that patients who have bariatric surgery are not receiving the recommended nutritional monitoring after discharge from specialist care. GPs and patients should be supported to engage with follow-up care. Future research should aim to understand the reasons underpinning these findings.
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The complexity of general practice consultations may be increasing and varies in different settings. A measure of complexity is required to test these hypotheses. ⋯ The present consultation complexity measure has face and construct validity. It may be useful for research, management and policy, and for informing decisions about the range of resources needed in different practices.