The British journal of general practice : the journal of the Royal College of General Practitioners
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Following the COVID-19 pandemic, the NHS is facing increasing pressures because of growing patient demand and hospital backlogs. With the number of GPs declining, the average number of patients per GP has increased. There are reports of hospital trusts and GP practices introducing doctors' assistants (DAs) to help with clinical and administrative tasks, which has reduced the workload of doctors. As the authors are not aware of any DAs working with GPs locally, Maylands Healthcare (14 000 patients) has introduced this new workforce model by assigning a DA to each clinician's worklist. ⋯ This study demonstrates that the introduction of DAs has helped to manage the administrative workload in primary care, improving efficiency, patient care, and safety.
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Postural hypotension (PH), the drop in blood pressure (BP) on standing, is associated with falls, all-cause mortality and cognitive decline. PH diagnostic criteria require lying-to-standing BP measurements. PH Prevalence in older adults is 20%, however, it is infrequently recorded in primary care records, suggesting PH testing and/or recording is under-utilised in this setting. ⋯ Interim findings suggest that most PH assessments in primary care do not meet current guideline criteria. Full findings from this survey are expected to inform and influence future national guidelines.
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Sleep disturbance (SD) is common among people living with dementia (PLwD) or mild cognitive impairment (MCI). It has a significant impact on the wellbeing of PLwD and caregivers, and makes care at home more difficult. Within primary care, assessment and management of SD for this population is complex and challenging. ⋯ Increasing awareness, knowledge, and confidence in diagnosis and assessment of SD is needed. Primary care-specific assessment tools may help. Long-term medication use is the default option in absence of pragmatic and effective non-pharmacological interventions that can be easily incorporated into routine general practice.
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People with diabetes who do not attend their annual review appointments often have poorer glycaemic control and increased complication rates. A postal kit for self-collection of blood tests, urine samples, and anthropometric data may facilitate remote annual reviews and improve uptake. ⋯ Postal kits for annual reviews were well-received by people living with diabetes. Designed well, they have the potential to overcome far more than just the physical barriers to annual review attendance.