The British journal of general practice : the journal of the Royal College of General Practitioners
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In 2019, the Additional Roles Reimbursement Scheme (ARRS) was introduced in England as a crucial component of the government's manifesto pledge to enhance access to general practice. The primary objective was to recruit 26 000 extra personnel through new roles into general practice. ⋯ This study suggests that the ARRS has the potential to have a positive role in primary care, notably through reduced prescription rates and improved patient satisfaction. Further research is needed to explore the long-term effects of the ARRS on primary care, including patient outcomes and healthcare costs, and the potential barriers to its implementation.
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Presenting to primary care with fatigue is associated with a wide range of conditions, including cancer, although their relative likelihood is unknown. ⋯ This study ranked the likelihood of possible diagnoses in patients who presented with fatigue, to inform diagnostic guidelines and doctors' decisions. Age-specific findings support recommendations to prioritise cancer investigation in older men (aged ≥70 years) with fatigue, but not in women at any age, based solely on the presence of fatigue.
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Paediatric otorrhoea (PO) is a symptom-based diagnosis encompassing acute and chronic ear infections that cause otorrhoea in children and young people (CYP). ⋯ To the authors' knowledge, this is the first longitudinal population-based study investigating PO that demonstrates the burden on primary care. Antimicrobial prescribing predominantly follows National Institute for Health and Care Excellence guidelines using oral amoxicillin. Aminoglycosides are the most frequently prescribed topical antibiotic despite the concern of ototoxicity.
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Better continuity in primary and secondary care is linked to improved health outcomes, but it is unclear whether the sociodemographic determinants of continuity are the same in both settings and whether continuity measures in each setting are associated. ⋯ We found a lack of strong association between continuity of care in GP and outpatient settings. This suggests that fragmented hospital care is not mitigated by increased continuity in GP.
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Presenting to primary care with fatigue is associated with a wide range of conditions, including cancer, although their relative likelihood is unknown. ⋯ This study ranked the likelihood of possible diagnoses in patients who presented with fatigue, to inform diagnostic guidelines and doctors' decisions. Age-specific findings support recommendations to prioritise cancer investigation in older men (aged ≥70 years) with fatigue, but not in women at any age, based solely on the presence of fatigue.