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  • Local incentives and general practice: what does the evidence show?
    2026/10/13
    Today, we’re speaking to Matt Conroy. Matt is a PhD fellow at the University of Manchester and also works for NHS Greater Manchester (ICB) as the Head of Primary Care Intelligence. Title of paper: Impact of local enhanced incentive schemes on the performance of general practices within the United Kingdom: a systematic reviewAvailable at: https://doi.org/10.3399/BJGP.2025.0377Most local commissioning bodies in England, known as Integrated Care Boards (ICBs), have developed their own additional local pay-for-performance (P4P) incentive schemes alongside the Quality and Outcomes Framework (QOF). To our knowledge this is the first review to date to summarise existing evidence on the scope and effectiveness of local incentive schemes implemented in general practice in the UK with a focus on the indicators and their alignment with national schemes.TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:00.480 - 00:01:01.140Hi and welcome to BJGP Interviews.I'm Nada Khan and I'm the Senior Research Editor here at the bjgp.Thanks for taking the time today to listen to this podcast.Today we're talking to Matt Conroy.Matt is a PhD fellow based at the University of Manchester and he also works for NHS Greater Manchester ICB as the Head of Primary Care Intelligence.We're here to talk about the paper he's recently published in the bjgp, which is titled the Impact of Local Enhanced Incentive Schemes on the Performance of General Practices within the United A Systematic Review.So, hi, Matt, it's really nice to meet you and to talk about this work and I wonder if, just to start with, if you could explain a bit about what we mean by local incentive schemes in general practice and why you wanted to look at them, and I wonder if you wanted to draw a little bit on your additional role working for the Greater Manchester ICB as well here.Speaker B00:01:01.220 - 00:01:54.400Thanks.I guess by a local deep incentive scheme, we mean something that's kind of locally designed or locally commissioned within a ICB footprint to try and address any particular population health challenges or local nuances that go over and above national policy, things like the Quality and Outcomes Framework.I guess what was really insightful for us through doing this piece of work was actually through an FOI that we undertook.Like 90, 98% of ICBs actually have their own local gene for incentive schemes, but we only identified 17 schemes through the published literature, the last one being from 2018.So getting on for 10 years ago, and the fact that we know that so many ICVs are doing these things, but there's not the evidence body there, there's not the learning and sharing of best practice to really inform policy and help ICVs all try and address their local challenges.Speaker A00:01:55.210 - 00:02:10.650Yeah.And you've mentioned qof and I guess a lot of people are really familiar with qof, and as you mentioned, there are lots of local schemes sitting alongside it.And I wonder if you have an idea of just what sort of things they're trying to incentivize, just from sort of the background to your work.Speaker B00:02:11.210 - 00:04:48.850Yes.So, as part of my day job, I help design and deliver the local GP incentive scheme in Greater Manchester.It's roughly valued about £17 million for this year.And I think what we try to do is use QOF as a bit of a body of evidence, but also look at a lot of our local and national data to really highlight where we think we can make a difference with these local incentive schemes.So, for the 26, 27 financial year, we've done a piece of work to really home in on CBD and diabetes as one area, respiratory as another area, elective care.So we can get the interface between primary and secondary care and also antimicrobial stewardship.I think one of the things that's really fleshed out from that is the impact of non attenders on things like qof.So through qaff, if patients have two or one invites seven days apart, they automatically get exception reported if they don't necessarily attend.But what we found through our local data is actually there's a really strong link between those people and actually poorer CBD control and wide use of healthcare systems.So.So through our local GP insentive scheme, we've really designed almost a narrow cohort that looks at people's individual disease control, looking at things like blood pressure, HbA1c, but also where people haven't attended a review in more than 18 months.So really trying to hone in on specific cohort, acknowledging that those people are really difficult to engage with by proxy.The fact that they've had two invites and not responded.But actually through having a local GP incentive scheme that really highlights these as a specific target cohort group and having dedicated funding alongside it, we can see that from our QOF data, we've had a reduction in exception reporting and ...
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    20 分
  • Does GP income meet expectations? The impact on job satisfaction
    2026/09/29
    Today, we’re speaking to Dr Ben Walker, a post-doctoral associate based at the University of Calgary, who conducted this work while working at the University of Manchester.Title of paper: Relationships of actual and expected levels of income with GP job satisfaction: repeated cross-sectional studyAvailable at: https://doi.org/10.3399/BJGP.2025.0683Recruitment and retention of GPs remains an issue for general practice in England. This work examined the relationship between actual income and income expectations with job satisfaction and intentions to quit. Higher actual income was found to be associated with job satisfaction, but there was little evidence to show that it was associated with intentions to quit. A key and novel finding was that higher income expectations were associated with both lower job satisfaction and higher intentions to quit. The findings suggest that policies that help GPs build accurate income expectations, such as increased transparency for incomes for different GP job roles, may be a means of addressing job dissatisfaction caused by discrepancies between expected and actual income for GPs.TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:01.040 - 00:00:58.350Hello and welcome to BJJP Interviews. I'm Nada Khan and I'm the Senior Research editor at the bjjp. Thanks for taking the time today to listen to this podcast.In today's episode we're talking to Dr. Ben Walker.Ben used to be based as a research fellow at the University of Manchester, but is now working as a postdoctoral associate at the University of Calgary in Canada.We here to talk about the paper he's just published in the BJ GP that's titled Relationships of Actual and Expected Levels of Income with GP Job Satisfaction. A Repeated Cross Sectional Study.So, hi Ben, it's really nice to meet you and to talk about this work and I guess to start us off, I just wanted to talk a little bit about the background to this paper and it's about GP income and job satisfaction, which is clearly a topic that people have plenty of opinions about. But what made you want to look at this question in a bit more detail?Speaker B00:00:58.590 - 00:02:08.930So, yeah, it's something we had been discussing internally as a team for a while, obviously, I mean, working in a primary care group, a lot of the driving motivation for a lot of our work is the GP recruitment and retention crisis. And we've always had, we've had this data for a while on GP income from us via our surveys.We've also had this data on GP income expectations and this has been in the survey forever and we've never, we hadn't used anything with it and basically because a lot of us are economists as well as this concept in economics of the Easterland Paradox or the idea that relative income matters more than actual income for happiness.And so we decided that, well, it would be like, like because we are interested in the GP recruitment and retention crisis, it would be interesting to look at the extent to which relative income matters for GP recruitment and retention. So job satisfaction and intentions to quit being two components of recruitment and retention.Speaker A00:02:09.330 - 00:02:14.290So you mentioned about a survey. So are you talking about the GP Work Life Survey that was done through Manchester?Speaker B00:02:14.370 - 00:02:17.130We are indeed, yeah. So the GP Work Life Survey.Speaker A00:02:17.130 - 00:02:28.110Yeah, yeah. So talk us through that just briefly. So what was that all about? I think, I mean there have been a few publications in the BJGP about it, but what.Who are you surveying through that?Speaker B00:02:28.590 - 00:03:18.400So the GP Work Life Survey has been going since I believe, 1998.It's been run by Manchester for I believe, all of its history and it's a government funded survey and when we do it we are attempting to a sample of the general GP population to basically ask about various things to do with their work life, including more sort of like formal things like their income and how many hours they're working, but also just how satisfied they are with their jobs, different aspects of their jobs. Yeah, so we collect lots of data on the GP to respond, and, yeah, we aim to get as general a sample of a population as we can.Speaker A00:03:18.800 - 00:03:40.000And I think one of the really interesting things about this study is that you're not just asking how much GPs actually earn, but how much they think they should earn.And you mentioned about this paradox that you're interested in in terms of health economics, and I wonder why you think that distinction is important between actual earnings and sort of relative earnings or how much people think they should earn.Speaker B00:03:40.990 - 00:04:21.630So I guess with a lot of things in life, and obviously from this economics paradox, a lot of things are not. It's not necessarily what you have. ...
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    14 分
  • Diagnosing in the dark: recognising childbirth-related PTSD in general practice
    2026/10/06
    Today, we’re speaking to Dr Megan Foreman, a GP and NIHR Clinical Lecturer based at the University of East Anglia. Title of paper: Diagnosing in the dark: the childbirth-related post-traumatic stress disorder GP evidence gapAvailable at: https://doi.org/10.3399/BJGP.2026.0269TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:00.320 - 00:00:58.460Hi and welcome to BJGP Interviews. I'm Nada Khan and I'm the Senior Research Editor here at the Journal. Thanks for taking the time today to listen to this podcast.In today's episode, we're speaking to Dr. Megan Forman, who is a GP and NIHR Clinical Lecturer based at the University of East Anglia.We're here to discuss the recent analysis piece that she and her team have published in the September issue of the Journal and it's titled Diagnosing in the Dark the Childbirth Related Post Traumatic Stress Disorder GP Evidence Gap. So, hi, Megan, it's really nice to meet you and thanks again for joining us here to talk about this article.I suppose, to start with, could you explain a little bit more about what you mean by birth trauma and childbirth related PTSD? And I suspect that these are probably terms that GPs are not as familiar with that we should be.Speaker B00:00:59.310 - 00:01:46.360Yeah, thank you. So birth trauma is a broader term and that can be.So we're talking here about psychological birth trauma rather than physical birth trauma in the context that we're using it in. We're talking about people who have had a difficult, potentially a pregnancy experience or a birth experience.That's not just looking at birth itself. That can cause ongoing mental health issues and psychological concerns when we talk about PTSD after pregnancy and birth.So what's often referred to as childbirth related ptsd, those are people who meet diagnostic criteria for PTSD as a result of a trauma that was related to their experience from pregnancy or birth. So birth trauma is a broader term and then PTSD is a specific diagnosis.Speaker A00:01:46.520 - 00:02:14.480And we were talking just before we started about the wider reach of this work and how, um, it's been picked up more in the mainstream media. But you've also had people telling you about their stories as well.And what I find quite sad in a way is that there have been a number of reviews around inadequate care in women's health.And I'm really struck by some of the poor outcomes that you mentioned in the article, like high suicide rates in women postnatally as well, which is really shocking, actually.Speaker B00:02:14.880 - 00:03:14.130Yeah, I mean, you mentioned the people who I've spoken to.So I've had a really involved patient participation group with the work that I've been doing, and they've talked about their own experiences, even in situations where they've had really extreme birth complications. So, for example, a neonatal loss or severe physical injury, even in those circumstances, may have struggled to access support.I've also been contacted by a member of the public since the paper was published and since there was media interest in this, talking about her own experiences of birth almost 30 years ago and difficulty in dealing with that going forward. So it clearly is a big issue.It's also important to say that even if a birth looks straightforward medically on paper, it's still possible to develop birth trauma symptoms and indeed ptsd. So it doesn't have to be a birth with serious complications or a poor outcome for somebody to develop these symptoms.Speaker A00:03:14.620 - 00:03:37.180Yeah, and I think that's one of the things that really struck me in the article, is that birth trauma is very subjective and that these issues can happen like, just like you're saying, just after what might appear to have been or appears to be a medically uncomplicated birth. And I think that's probably really important for GPs to understand in terms of what this will look like when women present to their gps as well.Speaker B00:03:37.260 - 00:04:27.610Yes.And I think an important consideration is that when women keep referring to women, but I include in that people with other gender identities who have a baby, but when women go into pregnancy, they come to pregnancy with all of their past experiences.And we know that people who have had difficult previous experiences, so for example, intimate partner violence, previous adverse childhood experiences, substance abuse or pre existing mental health problems, these people are particularly at risk of developing PTSD after birth. And it can be something that develops after what looks like a normal birth on paper.So it's really important that we consider birth trauma and PTSD in people, even when it appears that the birth is straightforward and that we still are inquiring about these symptoms to make sure that they're identified.Speaker A00:04:27.850 - 00:04:40.970And we'll come back ...
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    21 分
  • AI scribes: The impact on the consultation, the notes and relationships in practice
    2026/09/15
    Today, we’re speaking to Dr Emma Ladds, a GP partner and DPhil candidate at the Nuffield Department of Primary Care Health Sciences at the University of Oxford. We’re here today to discuss the recent article she and her colleagues have written for the journal, titled, ‘Ambient scribes in general practice — help or hindrance?’Title of paper: Ambient scribes in general practice — help or hindrance?Available at: https://doi.org/10.3399/BJGP.2026.0097TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:00.320 - 00:01:15.600Hi and welcome back to BJGP interviews after our summer off. I'm Nada Khan and I'm one of the Associate editors of the Journal. Thanks for listening to this podcast today.In today's episode, we're talking to Dr. Emma lads. Emma is a GP partner and a DPHIL candidate at the Nuffield Department of Primary Care Health Sciences at the University of Oxford.We're here today to talk about the recent article that she and her colleagues have written for the analysis section of the Journal. And the article is titled Ambient Scribes in General Practice. Help or Hindrance? So, hi again, Emma. It's lovely to speak to you about this work.And I think one of the reasons we were interested in picking up this article is that it's really highly topical and it's in an area that I think a lot of people are wondering what to do in their day to day practice.And I think that some of the issues that you've highlighted in the article do speak to some of the concerns that people are raising, but also some of the challenges with the implementation in practice. But I guess before we get onto some of the issues that you raise in the paper, can you just explain what we mean by an AI or ambient scribe?Speaker B00:01:16.160 - 00:01:45.660Well, it's the technologies based on artificial intelligence that detects conversations, so between the patient and gp, or between GP and other colleagues. And in consultations, it then generates a summary of what's been discussed, but also does some other things as well.So, for example, it might add some coding labels for specific things that are mentioned, and then all of that goes into the patient's electronic health record.Speaker A00:01:45.980 - 00:02:15.130And I think that these tools are often presented, at least to some of the GP colleagues that I know and work with, as almost like an obvious win for general practice. So less documentation, more efficiency, and maybe more time with patients.But what made you want to just take a pause and think about some of the assumptions behind some of those quick wins that people might be thinking about, thinking about.Speaker B00:02:15.450 - 00:03:31.980And I mean, I think it's interesting, isn't it, because ever since we started to introduce different technologies into the consultations, there's often been an assumption that every new thing would be a quick win.And even since the introduction of the computer, you make for greater efficiency and it will be easier to store data, to retrieve data, to share data, et cetera. And of course, a lot of the time what those technologies do is they drive particular activities.I think it's been interesting just to think about how introduction of different technologies and platforms and digital approaches has driven a much more transactional, quantifiable way of working.And those things that can be recorded and can be captured in technologies or enabled by technologies have been promoted, perhaps at the expense of some of the less quantifiable, more nuanced activity. So suppose it was looking at that journey of technologies and just trying to think about what this next step might also add to that picture.Speaker A00:03:32.220 - 00:03:41.820And one of the things you talk about in the article is that AI scribes could create what you call false efficiencies. But can you unpick what you mean by that?Speaker B00:03:42.300 - 00:04:53.150I think there's this assumption that actually the summaries and the codes that AI scribes will generate will be very time saving for gps. And no GP ever has enough time. So everybody's looking for, as you put it, the quick wins.And some of the challenges with the outputs from AI inscribes are that they often produce very long transcripts because they're trying to capture a summary of everything that was discussed and that gets entered into the record. And obviously it takes time for subsequent clinicians to look through those kind of summaries. So that could be a fold sufficiency.But also, I mean, it can add false labels or generate errors and that requires checking as well. So it's not that it just produces an accurate summary and then that's out there.Actually, the clinician still has to go back and double check that everything's been done correctly. So even though they don't have to do the actual typing, there's still a level of processing that they have to do of ...
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    20 分
  • The NHS Health Check and mortality: do they help people live longer?
    2026/09/22
    Today, we’re speaking to Dr Jasjot Saund, a public health registrar based in London. Title of paper: Association of the NHS Health Check with all-cause mortality: a longitudinal cohort study in primary careAvailable at: https://doi.org/10.3399/BJGP.2025.0451The NHS Health Check (NHS-HC) has been shown to improve detection and management of surrogate markers of health, such as blood pressure and cholesterol. The long-term impact, however, is less evidenced, with mortality reductions seen in a UK Biobank cohort and no mortality reduction seen in a Cochrane review of general health checks, including those outside the UK. The current study added real-world evidence from a diverse UK urban population, and a 15-year study period. Survival analysis of GP electronic health record data shows reduced mortality in those who attended an NHS-HC compared with those who did not. These findings should be interpreted cautiously given the observational nature of the study design.TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:01.440 - 00:00:58.570Hi and welcome to BJGP Interviews. I'm Nada Khan and I'm the senior research editor of the Journal. Thanks for taking the time today to listen to this podcast.In today's episode, we're talking to Dr. Jazjot Sound, a public health registrar based in London.We're here to discuss the paper she's recently published here in the BJGP titled Association of the NHS Health Check with All Cause Mortality, A Longitudinal Cohort Study in Primary Care. So thanks very much for joining us here today, Jazja.It's really great to talk about this work and I think just before we get into the study itself, we know that NHS health checks are something that most GPs will probably be very familiar with, but maybe we don't always stop and think about the evidence behind them. So, just to start off, I wonder if you can explain to us a little bit about, about what the NHS Health Check program is actually designed to do.Speaker B00:00:59.050 - 00:02:16.370Yeah, absolutely.So the NHS Health Check program was rolled out in 2009 and it's essentially a population level preventative initiative, focusing particularly on cardiovascular disease, but potentially wider as well.And so it's specifically targeted at people who are between the ages of 40 and 75 and who don't already have a, a cardiovascular disease or a known cardiovascular disease. And I think that's really important because it's targeting people who are potentially at risk or have undetected disease.And what this means is, so ultimately the health check itself, it consists of a check that's usually undertaken by primary care, so looking at lifestyle factors, modifiable risk factors, biochemical tests, as well as sort of just other general checks. And importantly, this is embedded into primary care pathways.So essentially it's ensuring that these patients are followed up if they are determined to be high risk and potentially put on prescriptions or followed up with lifestyle modifications. So that's generally what the health check is at the moment.Speaker A00:02:16.690 - 00:02:31.070Brilliant. Yeah. And I guess the big question behind this paper is, do they actually make a difference?And I wonder what did we actually know about the impact of NHS health checks before you started this work? So what was out there in the literature already?Speaker B00:02:31.550 - 00:04:07.320Yeah, so there is a, a huge amount of evidence in different parts of the health check. So you might be aware already that it's a multifaceted intervention. So there's, there's the process bits like uptake and invitation.So there's a big amount of evidence that's been telling us that it's really important that we even just the method of invitation can be really influential on who takes up the health check. But then there's also the specific parts of the check itself.So how we communicate risk to patients, for example, can have an impact on how people go home and take on lifestyle advice. And then there's the body of evidence that's closer to where this paper sits, which is looking at clinical outcomes.And there is a whole body of evidence looking at surrogate markers, so things like does it shift the marker on blood pressure or bmi. And then there's the evidence on mortality, for example, or clinical endpoints such as stroke.And so far the evidence is predominantly positive to say we do see a change in clinical outcomes.And more recently, there was a paper in 2024 which was using a UK Biobank cohort and shows that there was an impact, a positive impact on disease, end stage disease, as well as mortality. But as the paper sort of addresses, there's some gaps in this evidence, which is what we. What we hoped to fill.Speaker A00:04:07.560 - 00:04:25.280Yeah.And I guess I wondered if you could just talk us through the data used for this study, because this was a really large real ...
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    16 分
  • Reflecting on the last season of the BJGP podcast
    2026/07/07
    In this episode, we look back at the last season of the BJGP podcast and reflect on some of the work we’ve discussed. TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:00.560 - 00:11:08.620Hi, and welcome to the BJGP podcast. I'm Nada Khan, one of the associate editors of the Journal.And we've reached the end of another podcast season, and before we take a short break for the summer, we thought we'd look back at some of the papers we've covered and pick out a few highlights and common threads between them.And looking back at the different podcasts over this this past season, it seemed that although each conversation started with a completely different research question, by the end we all seemed to be talking about the same thing, and that was, how can general practice work better for patients in today's increasingly complex healthcare system?And although we talked about a wide range of different topics, we covered cancer diagnosis, dementia, women's health, medical education, and we even talked to Garth Funston about artificial intelligence. They all came back to this same underlying challenge.And we know that general practice has always dealt with complexity, and that's not really anything new, but the kind of complexity we're dealing with now feels different. Patients are living longer with multiple conditions. Care is spread even more so across increasing numbers of services than ever before.Technology is changing the way that we work, and somehow, amongst all that, we're still trying to preserve those relationships that have always sat at the heart of general practice. And I think another thing that really struck me was that very few of the papers and researchers were talking about making dramatic changes.And instead we had a lot of discussions about how we could make systems we already have, just work a little bit better. So making it easier to navigate, getting people more connected, more equitable, and more human as well.So one of the first interviews we recorded was with Katharina Savolkul about why medical students choose or don't choose a career in general practice. And on the surface, it's comes across a bit like workforce paper.We know that we need more gps, and understanding career choice is clearly important, but I think we talked about something a little bit bigger, which is, what kind of profession are we asking people to join? And this review highlighted positive GP placements, so good role models and the hidden curriculum as well.And although we often focus on recruitment targets, Katharina reminded us that students choose career because of the experiences they have and the values that they see lived out.And interestingly, continuity of care remains one of the biggest reasons people are still drawn towards becoming GPs, even though many of us worry that that's becoming harder to achieve in practice. And I think that continuity became one of those defining threads that ran through a lot of the interviews that followed.And we had Ewan Lawson join the podcast to speak to Charlotte Morris about dementia care. And what they talked about was that participants weren't really asking for more investigations or different medications.What they wanted to feel was to be known and to have someone who understood who they were before their diagnosis recognize those changes over time and stayed alongside them as their condition progressed.And I guess listening to that interview made me realize that it's not just about seeing the same gp, but it's about patients feeling that someone is carrying the thread of their story over time. And I had a really similar feeling talking to Dr. Tory Ford about recurrent vulvovaginal thrush.And these were two qualitative papers about diagnosis and healthcare experiences. But I think by the end of the interview, we were talking about something much broader.And as clinicians, we think sometimes about those bite sized consultations, but patients don't at all. At least this was the experience that I think that we drew out from Tori's work.And in this work, I think Tori highlighted that people experience illness as a continuous journey. And although in a system where continuity of care might be challenged, clinicians might see episodes of care, but patients live their whole story.And I think that's why sometimes recurrent conditions can feel so frustrating for patients, not because, particularly those individual episodes of care consultations are poor, but because if there's discontinuity, no one's joining those consultations together.And I think the more interviews we recorded, I pulled out another pattern, and that's that whether we're talking about dementia, recurrent thrush, pediatric safety or postnatal care, patients and families were doing a lot of work.So an extraordinary amount of invisible work, they were chasing referrals, following up on test results, ...
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    11 分
  • Quick wins or eat the frog? How GPs prioritise their day
    2026/06/30
    Today, we’re speaking to Andrew McClarey, who works as a GP and Education co-ordinator Lead for General Practice in the Scottish Centre for Simulation and Clinical Human Factors. Title of paper: “Quick wins” vs “eating the frog”: Exploring general practitioners’ prioritisation dilemmasAvailable at: https://doi.org/10.3399/BJGP.2025.0628Link to tactical decision making games: https://archive.johs.org.uk/article/doi/10.54531/svvw4195This is the first study to look at the factors which experienced GPs consider when prioritising their acute workload. Several themes have emerged which highlight the importance of prioritisation training in General Practice. These themes could be used to teach prioritisation decision making to GP registrars or in the creation of continuing professional development resources for experienced GPs.TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:00.400 - 00:00:56.560Hi and welcome to BJ GP Interviews. I'm Nada Khan and I'm one of the Associate editors of the Journal. Thanks for listening to this podcast today.In today's episode, we're speaking to Dr. Andrew McClary.Andrew is a GP partner and he also works as Education Coordinator, Lead for General Practice in the Scottish Centre for Simulation and Clinical Human Factors. We're here today to discuss the paper that he's recently published in the bjjp.And the paper is titled Quick Wins versus Eating the Frog, Exploring general practitioners Prioritization dilemmas. So, hi, Andrew, it's really nice to meet you.And this paper really stood out to us, I think, because prioritisation is something that gps do every day, but it's not really something that we discuss explicitly. I'm just interested in what made you do this work and made you interested in studying it.Speaker B00:00:57.200 - 00:02:00.600It's interesting, I think, that for me, I finished my GP training just after the pandemic and therefore I did a lot of my training during the COVID pandemic. And around then the face of general practice, like most things in life, changed completely overnight.We moved on to telephone consulting and being encouraged to have empty waiting rooms.And I think around the same time we realized that we probably couldn't continue doing what we had been doing, which was being everything to everyone, which brought us on to prioritizing our workload. We have to decide who needs seen, who does not, and when are they seen. And that was a real gap for me in the training that I was provided.And I found myself going into working as a fully qualified GP without really an awareness of how to prioritise in a, in a sensible way. And I think that's where this interest was born out of.Speaker A00:02:00.760 - 00:02:42.050And before we get into what you found, it's probably worth saying a little bit about how you approach the study. So this was a qualitative interview study involving gps from a range of practices and career stages.And what you did was you really explored how they prioritized work during the course of a typical surgery.And then I guess through those interviews you looked at sort of the strategies and influences and trade offs that shaped those decisions in everyday general practice. But one of the things I found really interesting was that prioritization wasn't just about clinical urgency.And I wonder if you could talk through some of the other factors that GPs are weighing up quickly, I suppose, when they're deciding what to tackle first.Speaker B00:02:42.690 - 00:06:17.800Absolutely.It was very interesting, the themes that emerged from the data and also actually how much agreement There was amongst the gps in the focus groups, as we're not traditionally a group of people who agree about very much. So one thing that GP is particularly interested in, there's five main themes. One is about the system awareness.So we're aware about our own surgeries and where the pressure points are.For example, we're low on particular acute slots today, or there's a certain type of patient that is coming in more frequently at the moment, so we're aware of that. But it's not just having that awareness, it's also being able to adjust how we consult based on the pressures that the system are under.For example, if there are a lot of children or fevers coming in, we want to see them all face to face. We ask the admin team, just bring them all in face to face and we'll see them that way, rather than setting everything up over the phone.So it's not just an awareness of the system, but actually adjusting ourselves to that demand. Another one is the time management. What's the most efficient use of my time?How am I going to get out on time this evening for nursery pickup or whatever else I have to do in the evening? But it's not just our time, it's also the system's time.So what I mean by that is, I know if I try and refer to a hospital service in the afternoon, ...
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    18 分
  • Parents as partners - Improving paediatric safety in general practice
    2026/06/23
    Today, we’re speaking to Dr Tom Purchase, a GP and Health and Care Research Wales NIHR doctoral fellow.Title of paper: Co-generating ideas for safer paediatric care in general practice with parents and stakeholdersAvailable at: https://doi.org/10.3399/BJGP.2025.0690Research has highlighted the important role parents play in in paediatric patient safety, for example, through mitigating safety incidents in general practice, yet their perspectives have rarely shaped system-level improvements. This study co-generated and prioritised ideas for change with parents and key stakeholders, identifying feasible and impactful strategies to improve paediatric safety in primary care. These strategies centred around practice communication, accessing care records and results, and fostering a culture of shared learning and development. Parents are willing and able to contribute meaningfully to safety improvement efforts, and their insights align with national patient safety priorities. Clinicians and policy makers can use these findings to strengthen collaboration with families, tailor safety interventions to local needs, and embed parent voices into the design of safer care systems.TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:00.480 - 00:00:49.500Hello and welcome today to BJGP Interviews. I'm Nada Khan and I'm one of the Associate editors of the Journal. Thanks for listening again to this podcast.In today's episode, we're talking to Dr. Tom Purchase. Tom is a GP and a health and Care Research Wales NIHR Doctoral Fellow.We're here today to talk about the paper he's just published in the bjgp and the paper is titled Co Generating Ideas for Safer Pediatric Care in General Practice with Parents and Stakeholders.So, hi, Tom, it's really great to meet you and to talk about your work, but before we talk about the study itself, I'm interested to know what first got you interested in pediatric patient safety in general practice.Speaker B00:00:50.060 - 00:02:26.850Thanks. It's born, I think, out of an extension of the work that we've been doing within the patient safety team within Cardiff University.So a lot of what we do is looking at incident reports, safety incident reports, and trying to pick out what are the, you know, high level key learning points and takeaway messages from those.And then within the team, we started to think about, as well as the types of incidents and the types of harms that are occurring within pediatric incidents. For example, how are parents involved?And it was a bit of a novel approach to what we normally do, trying to have that extra aspect within the incidents and figuring out how parents were either helping to contribute or to mitigate against the incidents, not just looking at the incidents themselves. So that was the starting point, really.And then once we'd started digging into that data and identifying that, actually the majority of the time, which is in one of the papers that was published last year in BJGP, 77% of the reports we were looking at specifically around general practice showed that parents were taking these mitigatory actions that, you know, positive actions that were able to prevent harm or further harm from occurring to their child, for example, chasing results or chasing referrals or importantly, being able to speak up. And then that highlighted, I think, the importance of parents being able to have a voice and advocating on behalf of their child.And that really sparked, I think, the interest, and therefore this part of the.Speaker A00:02:26.850 - 00:02:46.490Project, and I think that's a really interesting thing about this paper, is that it focuses on parents and parents not just as observers of care, but as active contributors to safety. And I wonder what your thoughts are about why that's an important shift in how we think about these things.I think you've touched on it a bit, but yeah, I'm interested to know a bit more about that.Speaker B00:02:46.810 - 00:03:55.980I think it is a really important aspect of care, but also particularly safety, which maybe is untapped in terms of parents as a resource as to how we can keep children safe.We know that children on the whole are more, maybe not more vulnerable, but certainly are a vulnerable group when it comes to patient care in general and patient safety.And that's because they're so heavily reliant on others to speak on their behalf, to make sure somebody else is looking out for their healthcare needs. And therefore they are probably playing a part within the world of patient safety.And there are good studies from hospital relating to incident reports that show that parents are capable of picking up issues early on. They're able to detect issues that maybe other parts or people within the system aren't detecting.And as I mentioned, our paper from last year specifically looking at general practice showed that ...
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