The British journal of general practice : the journal of the Royal College of General Practitioners
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The unadjusted gender pay gap in general practice is reported to be 33.5%. This reflects partly the differential rate at which women become partners, but evidence exploring gender differences in GPs' career progression is sparse. ⋯ There are some long-standing gendered barriers that continue to affect the career decisions of women GPs. The relative attractiveness of salaried, locum, or private roles in general practice appears to discourage both men and women from partnerships presently. Promoting positive workplace cultures through strong role models, improved flexibility in roles, and skills training could potentially encourage greater uptake.
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Identifying and responding to patients affected by domestic violence and abuse (DVA) is vital in primary care. There may have been a rise in the reporting of DVA cases during the COVID-19 pandemic and associated lockdown measures. Concurrently general practice adopted remote working that extended to training and education. IRIS (Identification and Referral to Improve Safety) is an example of an evidence-based UK healthcare training support and referral programme, focusing on DVA. IRIS transitioned to remote delivery during the pandemic. ⋯ The authors recommend a hybrid DVA training model for general practice, including remote information delivery alongside a structured face-to-face element. This has broader relevance for other specialist services providing training and education in primary care.
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The COVID-19 pandemic compelled clinicians to change access to primary health care as face-to-face consultations were a risk to patients and staff. Video consultations (VCs) were frequently substituted as a proxy for a clinical examination. ⋯ While video use overall was low, patients from lower socioeconomic backgrounds had less access to VCs with their GPs in the initial lockdown, which may have had negative impacts on health. The pandemic was an unprecedented event, and primary care rapidly pivoted to online care. However, to mitigate health inequalities, primary care must implement methods to cater for all patients and minimise the risk of digital health exclusion.
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Urinary incontinence (UI) impacts patients and society in many ways. There are good treatment options, but healthcare delivery and processes are often suboptimal. ⋯ Poor UI identification in primary care and a lack of patient guidance through the healthcare system hamper continence care provision.
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The NHS has limited human and financial resources, with particular pressures in primary care. The National Institute for Health and Care Excellence (NICE) makes decisions on which services can be commissioned within the NHS. Many women experiencing antenatal depression are not identified as such in routine care and so may not access support. Current NICE guidance does not recommend universal case-finding for antenatal depression; however, a programme targeted towards pregnant women with risk factors (for example, previous mental illness, traumatic life events) has not been considered. ⋯ Universal case-finding for antenatal depression is cost-saving and improves health compared with no case-finding. It should be considered by policymakers to improve the identification and support of women experiencing antenatal depression in primary and maternity care.