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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Chronic kidney disease (CKD) is prevalent in the UK, associated with significant mortality and morbidity, and disproportionately affects minority ethnic groups. The most common causes for CKD are diabetes and hypertension. An estimated glomerular function (eGFR) blood test and an albumin creatinine ratio (uACR) urine test can be used to assess the level of CKD and predict the risk of adverse outcomes such as cardiovascular disease, end stage renal failure, and death. However, UK National CKD audit data suggest that only 30% of those with hypertension have a recorded uACR. Our quality improvement project working with community stakeholders and Healthy.io digital enterprise will evaluate the feasibility of uACR self-testing in the community. ⋯ Improving equity in uACR testing through quality improvement tools can deliver a sustainable project for improving patient renal care. Leveraging innovative methods provides the potential for effective, equitable, and efficient services.
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Restrictions due to the COVID-19 pandemic resulted in a sudden shift to a predominantly remote consulting model in primary care from March 2020. Little evidence exists examining the experience of remote consulting for people living with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) or fibromyalgia, with the current literature focusing on the challenges faced by clinicians and people living with these conditions. Clinical guidance highlights the importance of building therapeutic relationships and personalising care, but it is unclear how this translates into a remote or virtual consulting space. ⋯ Remote consulting has presented new challenges for primary care, and it is important to identify which groups of patients are most suited. This study explores the views from a group of patients that are associated with some complexity, and complements the literature that explores the ability to deliver relationship-based care when consulting digitally/remotely. Recommendations from the findings will be created for use by patients and clinicians alike.
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Mesothelioma is a terminal disease linked to asbestos exposure, often with a poor prognosis. Palliative care can be valuable at all stages of the disease trajectory. GPs have a key role in supporting such patients. Continuity is difficult to provide within the current NHS primary care system but is highly valued by patients with mesothelioma. ⋯ More research is needed to understand the experiences of continuity in primary care among people with mesothelioma. Specifically, there is an evidence gap regarding understanding their ability to achieve their desired level of continuity within primary care.
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Randomized Controlled Trial
Experiences of urine collection devices during suspected urinary tract infections: a qualitative study in primary care.
Up to 30% of urine samples from women with suspected urinary tract infection (UTI) are contaminated and need to be repeated, burdening health services and delaying antibiotic prescription. To prevent contamination, midstream urine (MSU) sampling, which can be difficult to achieve, is recommended. Urine collection devices (UCDs) that automatically capture MSU have been proposed as a solution. There are few studies exploring women's experiences of using such devices. ⋯ Most women agreed there was a need for a user- and environmentally-friendly device to improve urine collection. Although using UCDs can be difficult for women experiencing UTI symptoms, they may be appropriate for asymptomatic sampling in other clinical populations.