Doctors Lisa and Sara talk to Dr Joanna Bircher, Dr Nikesh Vallabh, Shelley Ryder (SWAN PCN Manager and Transformation Lead) and Dr Fran Fitton. We find out what proactive care is all about and then launch into example projects around dementia care that Shelley and Fran are involved in. We hope this gives people a flavour of what proactive care projects could entail in General Practice in terms of design and implementation.  Later in the year, we hope to bring more examples of projects and how they managed to get them off the ground. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• NHS Long Term Plan, Overview and Summary: https://www.longtermplan.nhs.uk/online-version/overview-and-summary/
• Proactive care: New GM support offer for 20 PCNs: https://gmpcb.org.uk/proactive-care-new-gm-support-offer-for-20-pcns/
• An Introduction to Quality Improvement: https://www.podbean.com/ew/pb-ubnht-114762e

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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: primarycarepodcasts@gmail.com

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

***SUMMER REWIND  - INITIALLY RELEASED ON 31ST JAN 2024***

To get in touch: primarycarepodcasts@gmail.com

Doctors Lisa and Sara talk to Senior Pharmacist Sarah Hafeez about Polypharmacy. She explains the difference between inappropriate and appropriate polypharmacy before talking through some typical cases that illustrate several examples of common scenarios.  This leads to discussions on prioritising concerns, weaning/stopping medications, counselling patients on the effects of Opioids and Gabapentinoids and involving community teams aiming for successful reductions of addiction forming medications. Other gems include a discussion of the potential long term risks of Proton Pump Inhibitors and advice on weaning, remembering to consider anticholinergic burdens as well as handy resources for tackling Polypharmacy, Structured Medications Reviews and medication reductions.

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• Greater Manchester Medicines Management Group: Inappropriate Polypharmacy Review and Treatment Optimisation: Resource Pack (from Dec 2022, accessed Dec 2023): https://gmmmg.nhs.uk/wp-content/uploads/2023/02/GMMMG-Polypharmacy-resource-pack-v3.0.pdf

• Scotland Polypharmacy Resources for Professionals and for Patients: https://www.polypharmacy.scot.nhs.uk/for-patients-and-carers/

• Scottish Polypharmacy Guidance 2018: https://www.therapeutics.scot.nhs.uk/wp-content/uploads/2018/04/Polypharmacy-Guidance-2018.pdf

• Lewis T. Using the NO TEARS tool for medication review. BMJ. 2004 Aug 21;329(7463):434. doi: 10.1136/bmj.329.7463.434. PMID: 15321901; PMCID: PMC514207 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC514207/

• Toolkit for General Practice in Supporting Older People Living with Frailty (includes a great Appendix of the STOPP/START criteria (2017): https://www.england.nhs.uk/wp-content/uploads/2017/03/toolkit-general-practice-frailty-1.pdf

• An example of an Anticholinergic Burdon Resource from West Essex CCG 2020: https://westessexccg.nhs.uk/your-health/medicines-optimisation-and-pharmacy/clinical-guidelines-and-prescribing-formularies/04-central-nervous-system/61-anticholinergic-side-effects-and-prescribing-guidance/file

• Canadian Resource for Deprescribing including reducing medications and some patient information leaflets: https://deprescribing.org/

• Resource for help reducing and stopping medications: https://medstopper.com/

• Me and My Medicines Resource for Patients to look through their medications before reviews or for information: https://meandmymedicines.org.uk/

• Anticholinergic Medications and Risks of Dementia Cochrane Editorial with Reports in Link (Sept 2021): https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.ED000154/full

• Anticholinergic drugs and risk of dementia: Time for action? British Pharmacological Society. Bell B et al Jun 2021 (9:3). Accessed 15/1/2024:  https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1002/prp2.793
• Cognitive Effects of Anticholinergic Load in Women with Overactive Bladder. Clin Interv Aging. 2020; 15: 1493–1503: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457731/
• Greater Manchester Medicines Management Group: Management of Overactive Bladder Including a simple Bladder Diary before and after stopping Medications (Jun 2019): https://gmmmg.nhs.uk/wp-content/uploads/2021/08/Management-of-OAB-in-adults-v3-0-approved-Aug-2019.pdf

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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: primarycarepodcasts@gmail.com

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

This is the second episode in our MSK mini-series. Doctors Lisa and Sara speak to Tom Smith and Charlotte Barker again, who are First Contact Practitioners in Wigan. The focus of this chat is shoulder pain - using a hypothetical case to discuss important history points, red flags, useful examination tips, differential diagnoses and further assessment options.

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• British Elbow and Shoulder Society guidelines: https://bess.ac.uk/national-guidelines/

• British Elbow and Shoulder Society pathways: https://bess.ac.uk/patient-care-pathways-and-guidelines/

• ShoulderDoc: https://www.shoulderdoc.co.uk/

• Patient Exercise Options: https://www.nhs.uk/conditions/nhs-fitness-studio/

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: primarycarepodcasts@gmail.com

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Good consultation skills can hone diagnosis, management plans, safety-netting and safety thereby really affecting patient outcomes. GP and Primary Care Educator Dr Avril Danczak shares her insights into teaching GP trainees and trainers about consultation skills with Lisa and Sara. 

Useful resources: 

• Health Education North West Advanced Communication Skills Resources https://www.nwpgmd.nhs.uk/resources/advanced-communication-skills-reading-list

• Article: Kaiser Permanente: Enhancing Clinician Communication Skills in a Large Healthcare Organization: A longitudinal Case Study https://www.sciencedirect.com/science/article/abs/pii/S0738399105000133

• Book: Silverman, Kurtz and Draper: Skills for Communicating with Patients https://www.amazon.co.uk/Skills-Communicating-Patients-Jonathan-Silverman/dp/1846193656/ref=pd_rhf_se_p_img_2?_encoding=UTF8&psc=1&refRID=T0WVKH6Y145JAJ1VDHCJ

• Book: Platt and Gordon: Field Guide to the Difficult Patient Interview https://www.amazon.co.uk/Field-Guide-Difficult-Patient-Interview/dp/0781747740

• Book: Barry Bub MD: Communication Skills That Heal https://www.amazon.co.uk/Communication-Skills-That-Heal-Professionalism/dp/1857756649 

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT

___

This episode has been made with the support of Health Education North West. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

As part of her role as Associate Dean in Health Education North West, Dr Alison Caldwell looks after GP trainees who sit the AKT and those that may fail. In this episode she shares her pearls of wisdom for preparing and sitting the AKT.

It has lots of useful information for trainees and trainers including how to break down the curriculum and where to best focus learning as well as how to actually do that learning effectively. We also cover how to improve exam technique as well as useful resources and specific advice for those who have tried and failed the exam.

____

Useful resources: 

• Fourteen Fish for GP Trainees: https://www.fourteenfish.com/audience/gptrainee

• RCGP - MRCGP Applied Knowledge Test (AKT): https://www.rcgp.org.uk/training-exams/mrcgp-exam-overview/mrcgp-applied-knowledge-test-akt.aspx

• RCGP- GP Curriculum Overview: https://www.rcgp.org.uk/training-exams/training/gp-curriculum-overview.aspx

• BNF Online: https://bnf.nice.org.uk/

• RCGP - Clinical evidence and data interpretation: https://www.rcgp.org.uk/training-exams/mrcgp-exam-overview/-/media/B4406D5D2E9A492B86AD74BC3FEFD08B.ashx

• Bolton GP scheme - Medical statistics: https://gp-training.hee.nhs.uk/bolton/mrcgp-examinations/

• General Practice Education in Health Education England working across the North West: https://www.nwpgmd.nhs.uk/general-practice-education-north-western-deanery

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT

 ____

This episode has been made with the support of Health Education North West. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara bring back Dr Joanna Bircher and Dr Viren Mehta for this last episode in the COVID-19 series to reflect on all of the positives that have come from the outbreak in general practice, the personal and professional learning that they have had and some focus on staff wellbeing with a few simple ideas on how to support each other.

Thank you to Practice Managers Sara Mayer at Archwood Medical Practice and Michelle Davenport at Heaton Mersey Medical Practice for sharing their insights too.

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Useful resources: 

• Headspace - information about free NHS access: https://help.headspace.com/hc/en-us/articles/360044971154-Headspace-for-the-NHS 

• Looking After You Too coaching: https://people.nhs.uk/lookingafteryoutoo/

• NHS Practitioner Health programme: https://www.practitionerhealth.nhs.uk/accessing-the-service

• RCGP Wellbeing Resources: https://www.rcgp.org.uk/training-exams/practice/gp-wellbeing.aspx

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Now that the Greater Manchester Enabling Safe Certification of Death in the Community service is being stood down, we take the opportunity to talk through the new legislation (from the Coronavirus Act 2020) and how this applies in practice.

Dr Aamna Khan (GP and Clinical Lead for the Enabling Safe Certification of Death in the community service) and Dr Viren Mehta (GP partner, clinical director of his PCN and clinical director for Stockport CCG) take us through this important subject.

They discuss:

• Expected and unexpected deaths and how these should be approached
• Who should be referred to the coroner and when to write COVID-19 on the death certificate
• Verification of death and who can do this
• Who can complete paperwork such as the death certificate and cremation forms and the criteria that now needs to be satisfied to enable this to be done
• Tips on how to complete this paperwork at the moment
• The ways in which the registration process has changed
• Thoughts on how practices and PCNs can think about their systems to make death in the community safer and smoother for everyone involved

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Useful resources: 

• Information and contact details for Greater Manchester Enabling Safe Certification of Deaths in the Community Service: https://gmprimarycare.org.uk/coronavirus/

• Coronavirus Act 2020: http://www.legislation.gov.uk/ukpga/2020/7/contents/enacted

• Red Whale - COVID-19: Death in the community: https://www.gp-update.co.uk/SM4/Mutable/Uploads/pdf_file/28_GP_COVID-19_The-Coronovirus-Act-2020-Death-certification,-cremation-and-burial.pdf

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

At the moment with increased isolation, anxiety and loneliness, social prescribing has become more important than ever.

Sara and Lisa speak to GP Dr Jaweeda Idoo (clinical champion for personalised care in Greater Manchester) and Sophie Glinka (social prescribing lead for people and communities in Greater Manchester) about the role of social prescribing during COVID-19 and indeed in general. They talk about some case studies where social prescribing has been invaluable to the care and support of patients, and showcase the importance of this facet of community care. 

____

Useful resources: 

• The Health Foundation - What makes us healthy? An introduction to the social determinants of health (2018): https://www.health.org.uk/sites/default/files/What-makes-us-healthy-quick-guide.pdf
• International Journal of Epidemiology - Sick individuals and sick populations (2001): https://academic.oup.com/ije/article/30/3/427/736897
• Proceedings of the National Academy of Sciences of the United States of America - Social isolation, loneliness, and all-cause mortality in older men and women (2013): https://www.pnas.org/content/110/15/5797.short

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Staff risk assessments in primary care during COVID-19 are generating many questions such as;

• Which tool?
• How should they be carried out?
• What are the advantages and disadvantages of doing them?
• How does Vitamin D fit in?
• What does this mean for practice?

GPs Sara and Lisa talk to Greater Manchester based GP Dr Jaweeda Idoo and Practice manager Gina Bird about their experiences of staff risk assessments in general practice at the moment. 

____

Useful resources: 

• BMJ Covid-19: Known risk factors fail to explain the increased risk of death among people from ethnic minorities May 2020: https://www.bmj.com/content/369/bmj.m1873
• NHS Staff Risk Assessments: https://www.nhsemployers.org/covid19/health-safety-and-wellbeing/risk-assessments-for-staff
• SAAD Risk Assessment: https://abmacademy.com/saad-risk-scoring-for-bame/
• Welsh Risk Assessment Tool COVID-19 (WRATC): https://www.bapio.co.uk/wp-content/uploads/2020/05/Risk-Assessment-Tool.pdf
• RCOG Covid-19 Advice in Pregnancy: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Recorded in January 2020, this is the long awaited second part of Lisa and Sara’s conversation with Professor Anthony Jones and Consultant Physiotherapist William Gregory from Salford Royal Foundation Trust. In Part 1 we covered diagnosis and in Part 2 we look at management of fibromyalgia including:

• The role of targeted CBT and physiotherapy
• Groups for patient education and support
• The role of medications
• Where secondary care fits in
• Research in the area
• The place alternative therapies occupy for some with this condition
• Natural progression and associated conditions
• Helpful resources for patients and practitioners

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Useful resources: 

• Fibromyalgia Action (FMA) UK website (for patient info and list of local support groups): http://www.fmauk.org/
• Versus Arthritis booklet: https://www.versusarthritis.org/about-arthritis/conditions/fibromyalgia/
• Pain toolkit: https://www.paintoolkit.org/
• Living well with pain: https://livewellwithpain.co.uk/
• Moving Medicine: https://movingmedicine.ac.uk/
• Theatre Performance for all interested in learning about how the brain works in chronic pain: Pain, the Brain and a little bit of Magic: http://research.bmh.manchester.ac.uk/pain//events/PainTheBrainandabitofMagic
• Currently available checklist for Fibromyalgia diagnosis on ACR website: https://www.rheumatology.org/Practice-Quality/Clinical-Support/Criteria/ACR-Endorsed-Criteria
• A version of the 2016 ACR checklist (amended from the 2010 version): https://people.clarkson.edu/~lrussek/2016FMS.pdf

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or make our day and fill out our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

With so much changing in how we work in general practice at the moment, assessing and investigating patients for suspected cancer symptoms can be a challenge. To help talk us through the current situation, Lisa and Sara speak to:

• Dr Sarah Taylor: GP in Fallowfield and Cancer Research UK Cancer Diagnosis Lead for Greater Manchester
• Dr Viren Mehta: GP in Cheadle, Clinical Director at Stockport CCG and Clinical Director at his PCN

We discuss:

• Thoughts around how to assess patients with suspected cancer at the moment, including discussion around the remote nature of working currently and the challenges that come with this
• How to approach ‘cough’ presentations, remembering to continue to consider lung cancer
• Advice around how to decide who to see face to face
• The advice around suspected cancer referrals to secondary care at the moment
• What patients can now expect following a referral to secondary care for suspected cancer

____

Useful resources: 

• Greater Manchester Cancer Lung Pathway Board - Coronavirus (COVID-19) Resource Centre: https://gmcancer.org.uk/coronavirus/
• NICE - Suspected Cancer: Recognition and Referral: https://www.nice.org.uk/guidance/ng12
• BMA - Taking and Using Pictures and Recordings of Patients: https://www.bma.org.uk/advice-and-support/ethics/confidentiality-and-health-records/taking-and-using-pictures-and-recordings-of-patients

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Yesterday was international nurses day and so we wanted to highlight the great work that is being done by our community nurses during COVID-19. Our guests are:

• Lesley Royle-Pryor: Primary and Community Nurse Lead for Greater Manchester Health and Social Care Partnership
• Moira Ogunsakin: Greater Manchester Training Hub Lead Nurse, Lead Nurse for Practice Renewal for Salford Primary Care Together and Practice Nurse in Salford
• Dr Joanna Bircher: GP Partner in Tameside and Glossop and Clinical Director of the GP Excellence programme

We discuss:

• What life is like for practice nurses and district nurses at the moment and what has changed since COVID-19
• The challenges that community nurses face at the moment
• How practices can continue to adapt their nursing work going forward
• Places to look for support as a community nurse
• Thoughts on how other members of the practice team can support nursing colleagues at the minute and going forward

____

Useful resources: 

• Asthma UK - How to use your inhaler: https://www.asthma.org.uk/advice/inhaler-videos/
• Royal College of Nursing - COVID-19: https://www.rcn.org.uk/covid-19
• Nursing and Midwifery Council - COVID-19: https://www.nmc.org.uk/news/coronavirus/
• Wound Care at Home: https://www.scribd.com/document/461038756/Wound-Care-at-Home?secret_password=3bSG1Z3zL26wPiiZFRDp

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to doctors involved in primary care research to give an overview of what developments are happening in COVID-19 research in the community at the moment. Our guests are:

Professor Philip Evans - GP, Associate Professor of General Practice at The University of Exeter, National Speciality Lead for Primary Care at NIHR, Cluster Lead at Clinical Research Network National Speciality Hub

Dr Sheila McCorkindale - GP, Local Clinical Research Speciality Lead at NIHR Clinical Research Network, Greater Manchester 

Dr Nick Thomas  - GP, Clinical Research Speciality Lead with NIHR, Clinical Research Lead at the Clinical Innovation and Research Centre at RCGP 

We discuss:

• The ‘PRINCIPLE’ study, the first clinical trial in COVID-19 patients consulting in primary care  
• The RCGP Research and Surveillance programmes
• The National Institute for Health Research programmes

We reflect on the joined up nature of research efforts between branches and within Primary and Secondary care, contributing to all teams working towards the common goal to help patients nationally at this unprecedented time. 

Note: We have taken down episode 4 (managing death in the community) in our COVID-19 series as the Enabling Safe Certification of Death Service has been updated, making parts of the episode no longer relevant. You can check our their FAQ in the resources below for the most up to date information about the service.

____

Useful resources: 

• Enabling Safe Certification of Death Service FAQ: https://gmprimarycare.org.uk/coronavirus/
• The National Institute for Health Research (NIHR) Clinical Research Network (CRN) website: https://www.nihr.ac.uk/explore-nihr/support/clinical-research-network.htm
• The Urgent Public Health (UPH) studies: https://www.nihr.ac.uk/covid-19/
• The ‘PRINCIPLE’ (Platform Randomised trial of INterventions against COVID-19 In older peoPLE) study:  https://www.phctrials.ox.ac.uk/principle-trial
• NIHR: Be Part of Research: https://bepartofresearch.nihr.ac.uk/
• RCGP: Research and Surveillance Centre programmes: https://www.rcgp.org.uk/clinical-and-research/our-programmes/research-and-surveillance-centre.aspx
• COVID-19 Symptom Tracker App: https://covid.joinzoe.com/​
• Moodbuster: https://www.mentalhealth.org.uk/research/moodbuster​
• Clinical Practice Research Datalink (CPRD): https://www.cprd.com/

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

This is the first episode in a three part MSK mini-series, which aims to briefly capture important features in history, examination and further investigations of common joint presentations. Doctors Sara and Lisa speak to Tom Smith and Charlotte Barker who are First Contact Physiotherapists in Wigan. Back pain is the focus of this episode, with a fictional case used to chat through history, examination, red flags and further assessment of this very common primary care topic.

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• Getting it right first time (GIRFT): https://gettingitrightfirsttime.co.uk/interactive-pathway-to-help-diagnose-and-treat-cauda-equina-syndrome-without-delay-is-now-live/

• National Spine Network, National Back Pain and Radicular Pain Pathway: https://www.nationalspinenetwork.co.uk/National-Back-Pain-and-Radicular-Pain-Pathway 

• MACP cauda equina information cards: https://www.macpweb.org/learning-resources/cauda-equina-information-cards.aspx

• NICE guidelines for back pain and sciatica: https://www.nice.org.uk/guidance/ng59

• International Framework for Red Flags for Potential Serious Spinal Pathologies - Finucane et al 2020: https://www.jospt.org/doi/epdf/10.2519/jospt.2020.9971

• Patient Exercise Options: https://www.southtees.nhs.uk/services/back-pain/backtracks/my-backtracks-playlist/

• Patient Exercise Options: https://www.nhs.uk/conditions/nhs-fitness-studio/

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: primarycarepodcasts@gmail.com

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara take a short break from full recording this week. They give an update on what to hopefully expect from episodes over the next few weeks as well as sharing a couple of useful links and information from listeners.

Useful resources: 

• Bereavement helpline number: 0800 2600 400
• Centre for Evidence Based Medicine, Oxford: https://www.cebm.net/
• NHS England Time for Care: https://www.england.nhs.uk/gp/gpfv/redesign/gpdp/releasing-time/

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

There have been a lot of questions within primary care regarding shielding and vulnerable patients. Sara and Lisa speak to Dr Joanna Bircher and Dr Viren Mehta about the confusion and get their thoughts on the subject.

In the episode we cover:

• Demystifying all of the terminology and putting it into simpler terms.
• What has been asked of primary care with regards to these lists of patients, tips on how to complete these tasks and where to look for help.
• How to support extremely vulnerable/shielded and vulnerable patients as a practice, and how to safely manage clinical issues that arise for these people during COVID-19.
• Other groups of patients that might need extra support but don’t fall into the shielded (extremely vulnerable, high risk) category.
• Patient employment issues in primary care with relation to shielding.

____

Useful resources: 

• Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19 (17th April 2020): https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19
• NHS Guidance and updates for GPs - Highest clinical risk patients: https://www.england.nhs.uk/coronavirus/publication/guidance-and-updates-for-gps-at-risk-patients/
• RCGP - Shielding vulnerable patients from Covid-19 (April 2020): https://elearning.rcgp.org.uk/course/view.php?id=377
• NHS Digital - Coronavirus (COVID-19): Shielded patients list: https://digital.nhs.uk/coronavirus/shielded-patient-list
• NHS Standard operating procedures: https://www.england.nhs.uk/coronavirus/primary-care/general-practice/standard-operating-procedures/
• COVID-19: guidance for employees, employers and businesses: https://www.gov.uk/government/publications/guidance-to-employers-and-businesses-about-covid-19
• Identifying and helping to protect patients most at risk from COVID-19: https://www.rcplondon.ac.uk/news/identifying-and-helping-protect-patients-most-risk-covid-19
• BMA - Identifying patients at highest risk from COVID-19: advice for GPs (16th April 2020): https://www.bma.org.uk/news-and-opinion/identifying-patients-at-highest-risk-from-covid-19-advice-for-gps
• Lymphoma Action - Guidance on shielding for people who have lymphoma: https://lymphoma-action.org.uk/about-lymphoma-covid-19-and-lymphoma/guidance-shielding-people-who-have-lymphoma
• Myeloma UK - COVID-19: What measures should I be following?: https://www.myeloma.org.uk/news-and-stories/covid-19-information-hub/covid-19-what-measures-should-i-be-following/ 
• Blood Cancer UK - Coronavirus and blood cancer: https://bloodcancer.org.uk/support-for-you/coronavirus-covid-19/coronavirus-blood-cancer/
• MPN Voice - COVID-19 Outbreak: Advice for Patients with Myeloproliferative Neoplasms (MPNs) (30th March 2020): https://www.mpnvoice.org.uk/coronavirus-covid-19-advice-and-information/coronavirus_covid_19_advice_for_people_with_mpns.aspx
• CLL Support - Latest advice on COVID-19 (15th April 2020): https://www.cllsupport.org.uk/latest-advice-on-covid-19/
• Clinical guide for the management of Rheumatology patients during the coronavirus pandemic (8th April 2020): https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/clinical-guide-rheumatology-patients-v2-08-april-2020.pdf
• British Society for Gastroenterology expanded consensus advice for the management of IBD during the COVID-19 pandemic (6th April 2020): https://www.bsg.org.uk/covid-19-advice/bsg-advice-for-management-of-inflammatory-bowel-diseases-during-the-covid-19-pandemic/
• NICE - COVID-19 rapid guideline: severe asthma (3rd April 2020): https://www.nice.org.uk/guidance/ng166
• British Thoracic Society - COVID-19: identifying patients for shielding: https://www.brit-thoracic.org.uk/about-us/covid-19-identifying-patients-for-shielding/
• Good SAM Volunteer app: Patient referral form: https://www.goodsamapp.org/NHSreferral

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

A current concern for primary care clinicians is how to manage end of life care in the context of the COVID-19 pandemic. Lisa and Sara are joined by Dr Liam Hosie, Dr Adam Firth and Dr Viren Mehta who have sifted through the key information and guidelines that are available on this topic.

We talk about:

• Advanced care planning
• Common symptoms for patients with COVID-19 at the end of life
• Discuss 5 guidelines (including NICE, RCGP, Hospice UK) relevant to this topic and some take home messages
• Anticipatory medication and stock issues
• Post death support for families and for clinicians

____

Useful resources: 

• Dr Adam Firth Stockport Grand Round: Making sense of symptom control guidance in suspected COVID - a GPs perspective: https://app.box.com/s/in48s14ee7r1c0pzk2i63m914gr1p0um

• NG31 NICE Guidelines: Care of dying adults in the last days of life (Dec 2015): https://www.nice.org.uk/guidance/ng31

• GMMMG Guidelines: Palliative care pain and symptom control: http://gmmmg.nhs.uk/docs/guidance/GMMMG-Palliative-Care-Pain-and-Symptom-Control-Guidelines-for-Adults-v1-1.pdf#search=%22end%20of%20life%22

• RCGP: Community palliative, end of life and bereavement care in the COVID-19 pandemic (March 2020): https://elearning.rcgp.org.uk/pluginfile.php/149342/mod_resource/content/1/COVID%20Community%20symptom%20control%20and%20end%20of%20life%20care%20for%20General%20Practice%20FINAL.PDF

• NICE COVID-19 rapid guideline: Managing symptoms (including at the end of life) in the community (Apr 2020): https://www.nice.org.uk/guidance/ng163

• Hospice UK guidance including advice for carers and health care professionals: https://www.hospiceuk.org/what-we-offer/clinical-and-care-support/coronavirus-guidance

• Harvard Business Review: That Discomfort You’re Feeling Is Grief: https://hbr.org/2020/03/that-discomfort-youre-feeling-is-grief

• Funerals and Dying in Absentia: Inspiration and tips during COVID-19: http://www.orderofthegooddeath.com/funerals-dying-in-absentia-inspiration-tips-during-covid-19

• RCGP: End of Life Care Quality Improvement Resources: https://www.rcgp.org.uk/clinical-and-research/resources/a-to-z-clinical-resources/daffodil-standards/end-of-life-care-quality-improvement-resources.aspx

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara are joined by GPs Dr Viren Mehta and Dr Joanna Bircher who summarise new guidelines and evidence relevant in primary care this week.

Covered this episode:

• Clinically recognised natural courses of COVID-19 infection
• Remotely assessing and risk stratifying COVID-19 patients
• Learning points from the updated standard operating procedures from NHS England
• Salient points from the new NICE guidelines on managing pneumonia in adults in the community
• Briefly touch on the updated PHE guidance on PPE

____

Useful resources: 

• NICE COVID-19 rapid guideline managing suspected or confirmed pneumonia in adults in the community: https://www.nice.org.uk/guidance/ng165/resources/covid19-rapid-guideline-managing-suspected-or-confirmed-pneumonia-in-adults-in-the-community-pdf-66141902429125
• Primary care pathways website: https://primarycarepathways.co.uk/
• Centre for evidence based medicine: https://www.cebm.net/covid-19/
• PHE what level of PPE, recommended PPE for primary, OP and community care: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/877599/T2_Recommended_PPE_for_primary_outpatient_and_community_care_by_setting_poster.pdf

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

In this, our second of the COVID-19 specific episodes, GPs Lisa and Sara are joined electronically by Dr Dan Bunstone (GP and Clinical Director of Warrington CCG and Chief Medical Officer at Push Doctor) and Dr Joanna Bircher (GP partner, clinical director for GPExcellence and Pandemic Lead for her PCN).

We discuss:

• Advantages of telephone and video consultations including how to use the golden minute, picking up cues on video consults and when they might be most useful.
• Safety points around confirming patient identity and others that may be in the room. 
• The need for excellent documentation for non face to face consultations. 
• Tips for good safety netting. 
• Logistics of picking up prescriptions and how to protect shielded groups. 

____

Useful resources 

• Faculty of Sexual and Reproductive Health Covid-19 specific guidelines:  https://www.fsrh.org/fsrh-and-covid-19-resources-and-information-for-srh/
• Trisha Greenhalgh's excellent BMJ article: Covid-19: a remote assessment in primary care:https://www.bmj.com/content/368/bmj.m1182
• eGP learning great telephone consultations tips https://egplearning.co.uk/quick-telephone-consultation-tips-for-primary-care/
• Red Whale Emotional and Psychological Survival Guide:  https://www.gp-update.co.uk/SM4/Mutable/Uploads/pdf_file/PEARL-Emotional-and-Psychological-wellbeing%5B2%5D-EDITED.pdf
• Website collating useful COVID-19 links: https://primarycarepathways.co.uk/covid19

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

We have decided to take a break from our normal release schedule to do a special, weekly series about the COVID-19 situation which is unfolding. Our hope is that we can provide some useful and practical information for everyone within primary care during this difficult time. 

In this first episode we talk to Dr Joanna Bircher (GP partner, clinical director for GPExcellence and Pandemic Lead for her PCN) and Dr Viren Mehta (GP partner, clinical director of his PCN and clinical director for Stockport CCG). 

• We summarise some of the Standard Operating Procedure from 19th March with practical tips on how to implement this.

• We think about ways that surgeries can reduce their footfall and protect staff and patients from exposure.

• We also touch on which normal general practice services should continue during this time and where to look for guidance.

• We talk about some ways to look after your staff, and speak specifically about home visits.

____

Useful resources: 

• NHS England Standard Operating Procedure for General Practice (19th March 2020): https://www.england.nhs.uk/coronavirus/primary-care/general-practice/standard-operating-procedures/

• RCGP Guidance on workload prioritisation during COVID-19 (23rd March 2020): https://www.rcgp.org.uk/-/media/Files/Policy/A-Z-policy/2020/covid19/RCGP%20guidance/202003233RCGPGuidanceprioritisationroutineworkduringCovidFINAL

• PPE video for UK primary care: https://www.youtube.com/watch?v=Zpg64grevO0

• Website collating useful COVID-19 links: https://primarycarepathways.co.uk/covid19

 ____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

In this week’s episode Lisa and Sara speak to Professor Anthony Jones and Consultant Physiotherapist William Gregory from Salford Royal Foundation Trust to learn more about Fibromyalgia. In part 1 we cover what the condition involves, the central sensitisation theory, useful examination tips and differentials to consider. We also talk about simple ways of explaining a diagnosis of Fibromyalgia to your patients. 

In part 2 (which will be released in 2 weeks), we break down management options as well as hearing about research and resources helpful to patients and practitioners.

____

Useful resources: 

• Fibromyalgia prevalence at 1 in 10:  Mansfield et al (2016) A systematic review and meta-analysis of the prevalence of chronic widespread pain in the general population. Pain 157:1  https://www.ncbi.nlm.nih.gov/pubmed/26270591

• American College of Rheumatology (ACR)  2016 fibromyalgia diagnostic criteria: Wolfe F, Clauw DJ, FitzCharles M, Goldenberg D, Hauser W, Katz RS, Russell IJ, Mease PJ, Russell A, Walitt B. 2016 Revisions to the 2010/2011 Fibromyalgia Diagnostic Criteria. Arthritis Rheumatol. 2016;68 (suppl 10)   https://www.ncbi.nlm.nih.gov/pubmed/27916278

• Currently available checklist for Fibromyalgia diagnosis on ACR website:   https://www.rheumatology.org/Practice-Quality/Clinical-Support/Criteria/ACR-Endorsed-Criteria

• A version of the 2016 ACR checklist (amended from the 2010 version):  https://people.clarkson.edu/~lrussek/2016FMS.pdf

• National Rheumatoid Arthritis Society - Have you got the S factor?: https://www.nras.org.uk/have-you-got-the-s-factor-

• FMA UK website (for patient info and list of local support groups): http://www.fmauk.org/

• Changes in healthcare utilisation pre- versus post- diagnosis; Hughes et al (2006) The impact of a diagnosis of fibromyalgia on healthcare resource use by primary care patients in the UK. Arthritis and Rheumatism (54, 1, p177-183) https://www.ncbi.nlm.nih.gov/pubmed/16385513

 ____

Have feedback or suggestions? You can help us know how we are doing with our 3 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Bronchiectasis can sometimes be overlooked amongst the other, more common lung conditions such as COPD. Because of this, it can be difficult for primary care clinicians to be fully aware of how to comprehensively diagnose and manage patients who have this condition. 

Lisa and Sara talk to respiratory consultant Dr Ashish about bronchiectasis. We learn exactly what this condition is, what the risk factors are for developing it, and when we should be suspicious of it as a cause. We also talk through important differentials to think about, what to look for on examination and which investigations to do (and the reliability of these). We finish by hearing about the role of sputum samples and what we can be doing in Primary Care to manage patients with bronchiectasis alongside Secondary Care.

____

Useful resources: 

• Table showing targeted antibiotic choices in bronchiectasis on NICE CKS: https://cks.nice.org.uk/bronchiectasis#!scenario:1 

 ____

Have feedback or suggestions? You can help us know how we are doing with our 3 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Interstitial lung disease (ILD) can be difficult to identify in primary care and unfortunately for some patients, currently carries a poor prognosis; the median survival for those with idiopathic pulmonary fibrosis is only 3–3.5 years (https://www.england.nhs.uk/wp-content/uploads/2018/08/Interstitial-lung-disease-service-adult.pdf).

Lisa and Sara talk to respiratory consultant Dr Ashish about this condition. We learn about when to be suspicious about a diagnosis of ILD, who is at risk and the symptoms and signs. We also hear about the reliability of the different investigations that are recommended in primary care and what happens after we have referred someone to outpatient respiratory clinic. We end with talking through how to manage exacerbations in these patients, prognosis and a little bit about fitness to fly.

____

Useful resources: 

• IPF Lung Sounds: https://www.insightsinipf.com/clinical-resources/auscultation/gallery/

• GMMMG Shared Care Guidelines: http://gmmmg.nhs.uk/html/gmmmg_app_scgs.php

• Fitness to Fly article from British Thoracic Society Standards of Care Committee: 'Managing passengers with respiratory disease planning air travel': https://thorax.bmj.com/content/57/4/289

 ____

Have feedback or suggestions? You can help us know how we are doing with our 3 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Worldwide, sepsis kills more people than cancer (https://www.bbc.co.uk/news/health-51138859). In 2050 it is predicted antibiotic resistance will kill more than cancer (http://bsac.org.uk/securing-new-drugs-for-future-generations/). What a difficult balance!

Lisa and Sara opportunistically talk to Trafford GP Dr Anya Leaver about antibiotic prescribing in Greater Manchester. We discuss the issues, recent changes in local guidelines, helpful tips to improve prescribing practice, great resources and ideas for practice audits. 

____

Useful resources: 

• Trafford’s two page CCG Antibiotic guidelines. Not online but may be available on request from: trccg.engage.trafford@nhs.net

• Other Greater Manchester CCG Medicine Management Teams available from link: http://psnc.org.uk/greater-manchester-lpc/service-information/medicines-management-and-guidance/

• GMMMG Antimicrobial Guidelines: http://gmmmg.nhs.uk/html/cgp.php

• TARGET leaflets for patients from RCGP (including 'Treating your infection UTI'): https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/amr/target-antibiotics-toolkit.aspx

• 'When should I worry?' leaflets and online resources including e-learning: http://www.whenshouldiworry.com/

• Fever Pain score for sore throats: https://ctu1.phc.ox.ac.uk/feverpain/index.php

• Why the guidelines were changed for treating Chlamydia: https://www.bashhguidelines.org/current-guidelines/urethritis-and-cervicitis/chlamydia-2015/

• ESPAUR report (national data on antibiotic prescribing and resistance): https://www.gov.uk/government/publications/english-surveillance-programme-antimicrobial-utilisation-and-resistance-espaur-report

 ____

Have feedback or suggestions? You can help us know how we are doing with our 3 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to Senior Pharmacist Sarah Hafeez about Polypharmacy. She explains the difference between inappropriate and appropriate polypharmacy before talking through some typical cases that illustrate several examples of common scenarios.  This leads to discussions on prioritising concerns, weaning/stopping medications, counselling patients on the effects of Opioids and Gabapentinoids and involving community teams aiming for successful reductions of addiction forming medications. Other gems include a discussion of the potential long term risks of Proton Pump Inhibitors and advice on weaning, remembering to consider anticholinergic burdens as well as handy resources for tackling Polypharmacy, Structured Medications Reviews and medication reductions.

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• Greater Manchester Medicines Management Group: Inappropriate Polypharmacy Review and Treatment Optimisation: Resource Pack (from Dec 2022, accessed Dec 2023): https://gmmmg.nhs.uk/wp-content/uploads/2023/02/GMMMG-Polypharmacy-resource-pack-v3.0.pdf

• Scotland Polypharmacy Resources for Professionals and for Patients: https://www.polypharmacy.scot.nhs.uk/for-patients-and-carers/

• Scottish Polypharmacy Guidance 2018: https://www.therapeutics.scot.nhs.uk/wp-content/uploads/2018/04/Polypharmacy-Guidance-2018.pdf

• Lewis T. Using the NO TEARS tool for medication review. BMJ. 2004 Aug 21;329(7463):434. doi: 10.1136/bmj.329.7463.434. PMID: 15321901; PMCID: PMC514207 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC514207/

• Toolkit for General Practice in Supporting Older People Living with Frailty (includes a great Appendix of the STOPP/START criteria (2017): https://www.england.nhs.uk/wp-content/uploads/2017/03/toolkit-general-practice-frailty-1.pdf

• An example of an Anticholinergic Burdon Resource from West Essex CCG 2020: https://westessexccg.nhs.uk/your-health/medicines-optimisation-and-pharmacy/clinical-guidelines-and-prescribing-formularies/04-central-nervous-system/61-anticholinergic-side-effects-and-prescribing-guidance/file

• Canadian Resource for Deprescribing including reducing medications and some patient information leaflets: https://deprescribing.org/

• Resource for help reducing and stopping medications: https://medstopper.com/

• Me and My Medicines Resource for Patients to look through their medications before reviews or for information: https://meandmymedicines.org.uk/

• Anticholinergic Medications and Risks of Dementia Cochrane Editorial with Reports in Link (Sept 2021): https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.ED000154/full

• Anticholinergic drugs and risk of dementia: Time for action? British Pharmacological Society. Bell B et al Jun 2021 (9:3). Accessed 15/1/2024:  https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1002/prp2.793
• Cognitive Effects of Anticholinergic Load in Women with Overactive Bladder. Clin Interv Aging. 2020; 15: 1493–1503: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457731/
• Greater Manchester Medicines Management Group: Management of Overactive Bladder Including a simple Bladder Diary before and after stopping Medications (Jun 2019): https://gmmmg.nhs.uk/wp-content/uploads/2021/08/Management-of-OAB-in-adults-v3-0-approved-Aug-2019.pdf

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: primarycarepodcasts@gmail.com

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to several different primary care professionals about portfolio working.

Dr Anya Leaver, Dr Hussain Gandhi, Practice Nurse Alyson Rimmer, Dr Nikesh Vallabh, and Dr Saira Zaman share with us their journey into Primary Care, how they got involved in their different roles outside of clinical work, what it means to them and advice for those out there wanting to explore adding variety to their working week.  

____

Useful resources: 

• eGP Learning (made by Dr Gandhi): https://egplearning.co.uk/
• PED Course with Health Education North West: https://www.nwpgmd.nhs.uk/ped-2019-study-day-one
• Post-CCT Fellowships with Health Education North West: https://www.nwpgmd.nhs.uk/post-cct-gp-fellowship-programme-hee-nw-20192020

 ____

Have feedback or suggestions? You can help us know how we are doing with our 3 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to GPwSI, Dr Rachel Hilton about Urticaria (aka hives/wheals). 

She talks us through the pathophysiology, causes, potential triggers, history, examination and management of this sometimes difficult area.

____

Useful resources: 

• Skin Support Website (urticaria page): http://skinsupport.org.uk/conditions-details/urticaria-and-angioedema
• British Association of Dermatologists (urticaria leaflet): http://www.bad.org.uk/for-the-public/patient-information-leaflets/urticaria-and-angioedema
• NICE CKS urticaria: https://cks.nice.org.uk/urticaria#!diagnosis

 ____

Have feedback or suggestions? You can help us know how we are doing with our 3 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to GPwSI, Dr Rachel Hilton about Generalised Itching.

She talks us through how to approach a patient presenting with generalised itching, the common and important causes, useful investigations and the management that we can try in primary care for these patients. 

____

Useful resources: 

• BATHE Study, BMJ 2018: https://www.bmj.com/content/361/bmj.k1332
• Skin Support Website (pruritus page): http://skinsupport.org.uk/conditions-details/pruritus
• British Association of Dermatologists (pruritus leaflet): http://www.bad.org.uk/for-the-public/patient-information-leaflets/pruritus
• NICE CKS Widespread Itching Causes: https://cks.nice.org.uk/itch-widespread#!backgroundSub:1

 ____

Have feedback or suggestions? You can help us know how we are doing with our 3 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG and GP Excellence in Greater Manchester. Given that they are recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to Dr Rebecca Baron from Health Education England about Resilience. This is part two of a two-part series about Resilience. In this episode we continue the theme of exploring resources available to healthcare professionals around resilience; books and research that have advanced the field. Rebecca gives us her learning points from these. ____

Resources mentioned in the episode:

• When “resilience” becomes a dirty word - BMJ article by David Oliver July 2017 https://www.bmj.com/content/358/bmj.j3604

• 'eGPLearning PodBlast' podcast - episode about Wellbeing with Dr Helen Garr: https://www.podbean.com/eu/pb-w2jut-c480f4

• 'You are not a frog' podcast by Dr Rachel Morris all about Resilience: https://shapesfordoctors.com/podcasts/

• NHS Practitioner Health Programme https://php.nhs.uk/ or call 020 3049 4505

• Positivity book by Barbara Fredrickson https://amzn.to/2OFrOcw

• Rainy Brain, Sunny Brain book by Elaine Fox https://amzn.to/2DfE6D2

• Building Physician Resilience Canadian Family Physician May 2008 https://www.nwpgmd.nhs.uk/resources/building-physician-resilience

• Foundation for Positive Mental Health http://www.foundationforpositivementalhealth.com/

• Thinking, Fast and Slow book by Daniel Kahneman https://amzn.to/2XO3Pfo

• The New Leaders book by Daniel Goleman https://amzn.to/2KP8Miy

• The 7 Habits of Highly Effective People book by Stephen R. Covey https://amzn.to/34jcOHM

• Health Education North West Resilience resources: https://www.nwpgmd.nhs.uk/taxonomy/term/6

• Why We Sleep book by Matthew Walker https://amzn.to/35ugNkW

• The Business of Sleep book by Vicki Culpin https://amzn.to/37AINoV

• The Body Keeps a Score book by Bessel van der Kolk https://amzn.to/2XIuVEw

• Eat that Frog book by Brian Tracy https://amzn.to/33jNaBc

____

We would love your feedback & suggestions…Let us know how we are doing with our 5 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

____

This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to Dr Rebecca Baron from Health Education England about Resilience.

This is part one of a two part series about Resilience. In this episode we talk about what Resilience is and how it started as a concept in general and in healthcare. We also hear about the neuroscience behind Resilience and Rebecca goes through some resources that she has found particularly helpful herself.

____

Resources mentioned in the episode: 

• BMJ article by David Oliver - When “resilience” becomes a dirty word:  https://www.bmj.com/content/358/bmj.j3604
• 'eGPLearning PodBlast' podcast - episode about Wellbeing with Dr Helen Garr:  https://www.podbean.com/eu/pb-w2jut-c480f4
• 'You are not a frog' podcast by Dr Rachel Morris all about Resilience:  https://shapesfordoctors.com/podcasts/
• NHS Practitioner Health Programme https://php.nhs.uk/ or call 020 3049 4505
• The Body Keeps the Score book by Bessel van der Kolk: https://amzn.to/34wKpxp 
• The Chimp Paradox book by Professor Steve Peters: https://amzn.to/2JKIlKm 
• Blink: The Power of Thinking Without Thinking book by Malcolm Gladwell: https://amzn.to/2C7Dizl 
• Flourish book by Martin Seligman: https://amzn.to/2NGJvrH 
• Health Education North West Resilience resources: https://www.nwpgmd.nhs.uk/taxonomy/term/6

 ____

Have feedback or suggestions? You can help us know how we are doing with our 5 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to Consultant Haematologist Dr Chris Gregory about Immunoglobulins.

The subject is approached from the point of view of primary care clinicians ordering immunoglobulin blood tests. We get Dr Gregory's opinion on when it is useful to order an immunoglobulins blood test and go through the possible meaning of all the different types of results. We discuss raised immunoglobulin tests and the difference between monoclonal and polyclonal rises. We discuss the diagnosis of MGUS (monoclonal gammopathy of undetermined significance) and myeloma. 

 ____

Have feedback or suggestions? You can help us know how we are doing with our 3 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to Consultant Haematologist Dr Chris Gregory about B12 and folate deficiency.

In this episode we talk about B12 and folate deficiency; How to investigate further and manage these results as well as touching on other causes of macrocytosis including haemolytic anaemia. 

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Useful resources: 

• British Society for Haematology guidelines 'Diagnosis of B12 and Folate Deficiency': click here

(https://b-s-h.org.uk/guidelines/guidelines/diagnosis-of-b12-and-folate-deficiency/)

 ____

Have feedback or suggestions? You can help us know how we are doing with our 5 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

 ____

This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to Consultant Haematologist Dr Chris Gregory about anaemia and iron deficiency.

In this episode we talk generally about anaemia, how to interpret full blood count results and iron deficiency anaemia.

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Useful resources: 

• Blood Journal article 'So you know how to treat iron deficiency anemia': click here

http://www.bloodjournal.org/content/126/17/1971?sso-checked=true

 ____

Have feedback or suggestions? You can help us know how we are doing with our 5 minute survey: click here

 ____

This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to GP Dr Gatenby about contraception.

In this episode we talk about when contraception becomes effective when starting or swapping contraception types, quick starting pills, post-natal/breast feeding considerations for contraception as well as contraception around peri-menopause.

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Useful resources: 

• FSRH up to date guidance for all contraception matters: click here
• Stockley's interactions checker (requires subscription): click here

 ____

Have feedback or suggestions? You can help us know how we are doing with our 5 minute survey: click here

 ____

This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to GP Dr Gatenby about contraception.

In this episode we talk about why contraception is so important, types of contraception, the new ways to take the COCP, the differences between preparations of pills, different bleeding patterns on hormonal contraception and options to manage these.

 ____

Useful resources: 

• FSRH up to date guidance for all contraception matters: click here

 ____

Have feedback or suggestions? You can help us know how we are doing with our 5 minute survey: click here

 ____

This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara speak with Dr Anne Connolly, a GP with a special in Gynaecology, trained hysteroscopist, and founding member of the Primary Care Women's Health Forum, where she just stepped down as chair in 2023. They speak about the importance of raising awareness about women’s health problems such as heavy menstrual bleeding, how underappreciated it can be, and the impact it can have on women’s lives. They then use cases to illustrate the assessment and management of heavy menstrual bleeding, making sure to touch on risk factors, concerning features and differentials.

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• Who pays this doctor: https://www.whopaysthisdoctor.org/

• Primary care women’s health forum: https://pcwhf.co.uk/#

• NICE NG88 Heavy Menstrual Bleeding Guidelines (May 2021): https://www.nice.org.uk/guidance/ng88

• NICE guidelines for Red Flags for Gynaecological Cancers (Updated Dec 2021): https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#gynaecological-cancers

• Cancer Research UK: https://www.cancerresearchuk.org/about-cancer/

• Jo’s Trust for Cervical Cancer: https://www.jostrust.org.uk/

• The Eve Appeal: UK Charity funding research and raising awareness of the five gynaecological cancers – womb, ovarian, cervical, vulval and vaginal: https://eveappeal.org.uk/

• Go Girls: UK Charity Supporting Women with gynaecological cancers: https://www.gogirlssupport.org/

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: primarycarepodcasts@gmail.com

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to Consultant Cardiologist Dr Karthikeyan about palpitations and atrial fibrillation.

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Resources mentioned in the episode:

• BMJ best practice article about pheochromocytoma: click here (requires login)
• NICE CKS, anti-coagulation: click here
• NICE CKS atrial fibrillation: click here

 ____

Have feedback or suggestions? You can help us know how we are doing with our 5 minute survey: click here

 ____

This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to Consultant Cardiologist Dr Karthikeyan about cardiac causes for blackouts.

 ____

Resources mentioned in the episode:

- GMC guidance on reporting driving concerns: click here - DVLA fitness to drive guidance: click here 

 ____

Have feedback or suggestions? You can help us know how we are doing with our 5 minute survey: click here 

 ____

This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to Consultant Cardiologist Dr Arya about Heart failure.

Have feedback or suggestions? You can help us know how we are doing with our 5 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

-------------------------

This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to Consultant Gastroenterologist Dr Bliss about Irritable Bowel Syndrome. 

***THIS EPISODE HAS BEEN RE-UPLOADED WITH ADDITIONAL INFORMATION ABOUT CA125 BLOOD TESTS***

Have feedback or suggestions? You can help us know how we are doing with our 5 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

-------------------------

This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to Consultant Gastroenterologist Dr Bliss about abnormal liver function tests. 

Here is a link to the NAFLD score calculator

Have feedback or suggestions? You can get in touch by either emailing us directly at primarycarepodcasts@gmail.com or on Twitter @PCKBpodcast

You can help us know how we are doing with our 5 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

-------------------------

This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Lisa and Sara talk to Consultant Gastroenterologist Dr Bliss about acid reflux. 

Have feedback or suggestions? You can get in touch by either emailing us directly at primarycarepodcasts@gmail.com or on Twitter @PCKBpodcast

You can help us know how we are doing with our 5 minute survey: https://www.surveymonkey.co.uk/r/YYQ763C

-------------------------

This podcast has been made with the support of Wigan CCG. Given that they are recorded with Wigan clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa talk to Dr Mahindra Chincholkar, a consultant anaesthetist and Clinical Director Manchester and Salford Pain Centre. They take a detailed dive into the concept of pain and chronic pain, and then Mahindra explains his stepwise approach to assessing and managing chronic pain through the use of an anonymous case. 

Greater Manchester healthcare professionals have collaborated to design the Greater Manchester Pain Management Resources Hub that gathers helpful tools and resources in one place. The Hub brings together a variety of useful resources including guidance to support effective consultations, patient self-management information to share, clinician aids and tools, shared learning and education, how to use data to understand the local population, and information to access related services across the conurbation.

“Pain Killers” do not stop pain, they mask it, and prolonged use can lead to lasting harm including addiction. Healthcare professionals can use the new NHS Greater Manchester Pain Management Resources Hub to support their patients to safely reduce opioids and identify alternatives. Take a look and explore more here: Greater Manchester Pain Management Resources Hub

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• Case report about nail in the boot (original article inaccessible): Fisher et al BMJ 1995

• Permission to Move Book: https://www.permissiontomove.com/books

• Tame the Beast: https://www.tamethebeast.org/#tame-the-beast

• Flippin’ Pain: https://flippinpain.co.uk/

• British Pain Society: https://www.britishpainsociety.org/

• Faculty of Pain Medicine: https://fpm.ac.uk/

• The Pain Toolkit: https://www.paintoolkit.org/

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: primarycarepodcasts@gmail.com

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa discuss the podcast episodes over the year. We talk about our longer term learning points, how the year has gone and what's to come.

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: primarycarepodcasts@gmail.com

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa talk to Dr Sadaat Ahmed about Frailty. We discuss definitions, frailty syndromes, frailty scores and the need to take care with these. We talk through a case to showcase how recognising frailty and managing the controllable areas can make a big difference to patients' lives and slow or even sometimes reverse frailty. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• British Geriatrics Society Fit For Frailty Guidelines: https://www.bgs.org.uk/resources/resource-series/fit-for-frailty
• British Geriatrics Society Comprehensive Geriatrics Assessment Primary Care Toolkit: https://www.bgs.org.uk/resources/resource-series/comprehensive-geriatric-assessment-toolkit-for-primary-care-practitioners
• National Osteoporosis Guidelines Group: https://www.nogg.org.uk/
• British Geriatrics Society Frailty eLearning Hub: https://www.bgs.org.uk/elearning-0
• The dangers of diagnosing frailty based on automatically calculated electronic Frailty Scores: https://www.england.nhs.uk/wp-content/uploads/2017/04/gms-contract-batch-coding-statement.pdf
• RCGP Internal and External Resources around Frailty: https://www.rcgp.org.uk/your-career/gp-extended-roles/Useful-resources-for-frailty

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: primarycarepodcasts@gmail.com

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

The importance of addressing climate change and sustainability is gaining more traction across the NHS. In order to find out more about the situation, and what can be done within Primary Care, Doctors Sara and Lisa talk to Dr David McKelvey who is a GP from Salford and NHS Greater Manchester Integrated Care Clinical Lead in Sustainability in Primary Care.

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• Greater Manchester Primary Care Provider Board - Sustainability in general practice: https://gmpcb.org.uk/sustainability/sustainability-in-general-practice/
• Greater Manchester Medicines Management Group - Three steps for Greener Respiratory Care: https://gmmmg.nhs.uk/wp-content/uploads/2022/08/Greener-inhaler-poster-Staff-FINAL.pdf
• Patient decision aid on asthma inhalers and climate change (Aug 2022): https://www.nice.org.uk/guidance/ng80/resources/inhalers-for-asthma-patient-decision-aid-pdf-6727144573
• The GP Excellence Podcast - How can you support sustainability in General Practice? https://omny.fm/shows/gp-excellence-podcast/how-can-you-support-sustainability-in-general-prac
• Royal College of General Practice Climate change and sustainability resources page: https://www.rcgp.org.uk/representing-you/policy-areas/sustainable-development
• Royal College of General Practice Net Zero Hub: https://elearning.rcgp.org.uk/course/view.php?id=650
• 10 Step Plan for Primary Care Sustainability in GM https://gmpcb.org.uk/sustainability/sustainability-10-step-plan/
• Planetary Boundaries – an up-to-date interview between Kevin Anderson and Johan Rockstrom.  https://www.youtube.com/watch?v=lLq8e73-FAw
• The 2023 state of the climate report - Entering uncharted territory: https://academic.oup.com/bioscience/advance-article/doi/10.1093/biosci/biad080/7319571
• NHS Green Plan – a video about what’s happening. https://youtu.be/Nap2p4EeUQo
• Greater Manchester Greener Practice Group: https://www.greenerpractice.co.uk/join-our-network/local-groups/greater-manchester/
• Take the jump – steps individuals can do: https://takethejump.org/
• Open Prescribing Green NHS: https://openprescribing.net/icb/QOP/measures/?tags=greenernhs
• Health for Extinction Rebellion: https://healthforxr.com/

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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: primarycarepodcasts@gmail.com

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa talk to a GP involved in Primary Care Research Dr Imran Ghafoor and Ewa Grzegorska, a Research Support Facilitator from the National Health and Clinical Research Institute about Research in Primary Care. We talk through Dr Ghafoor’s journey into being part of Primary Care Research, what embarking on Research Projects in Primary Care might look like, from the straightforward to the more involved, and some of the practicalities and financial considerations. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• If you want to contact the research Team from today Directly:

Researchsupport.CRNGM@NIHR.ac.uk or  I.gafoor1@NHS.net

• National Institute of Health and Care Research: https://www.nihr.ac.uk/
• Clinicians wanting to Train up in Research Initial Training Module Good Clinical Practice (through National Institute for Health and Care Research): https://www.nihr.ac.uk/health-and-care-professionals/learning-and-support/good-clinical-practice.htm
• Implementation of inclisiran in UK primary care for patients with atherosclerotic cardiovascular disease (ASCVD) or ASCVD-risk equivalents: rationale and design of VICTORION-Spirit, a pragmatic phase IIIb, randomised controlled study: https://www.ijclinicaltrials.com/index.php/ijct/article/view/672
• Safety and Efficacy of Dexpramipexole in Eosinophilic Asthma (EXHALE): A randomized controlled trial (mentioned and not published yet): https://pubmed.ncbi.nlm.nih.gov/37277072/
• National Institute of Health and Care Research List of Possible Studies of Interest: https://bepartofresearch.nihr.ac.uk/results/search-results
• Some Primary Care professionals may also want to be a participant in research (which in itself is a nice way to see what it's all about). The best way to do this is to go to https://www.researchforthefuture.org/ 

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: primarycarepodcasts@gmail.com

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

To find out more about how Dentistry works in England, Doctors Lisa and Sara talk to Greater Manchester Workforce Lead for Dentistry Mukhtar Ahmad. We cover how Dental Services are set up and funded in England and some current challenges. We move on to specific questions about how General Practice and Dentistry can help each other. Themes include; information sharing, Bisphosphonates, Chemotherapy, Radiotherapy and Diabetes. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• BMA Advice and Support Patients presenting with dental problems (Sept 2020): https://www.bma.org.uk/advice-and-support/gp-practices/gp-service-provision/patients-presenting-with-dental-problems?fbclid=IwAR1-rLLfHumLXMZSXxnb8UF_4acvgbTTcPYmvSQHa8VX18fM0Yn-8fCBoAk
• Scottish Dental Resources for Professionals: https://www.scottishdental.org/professionals/
• Scottish Dental Clinical Effectiveness Programme. Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs (March 2022): https://www.sdcep.org.uk/published-guidance/anticoagulants-and-antiplatelets/
• NHS Choices: Find A Dentist: https://www.nhs.uk/service-search/find-a-dentist
• Baby Teeth Do Matter: https://babyteethdomatter.org/

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: primarycarepodcasts@gmail.com

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to Palliative Care Consultant Lesley Henson and Specialty Doctor Caitriona MacDermott for a discussion on common issues Primary Care Clinicians face when dealing with patients at the end of life and their families. We discuss Hospice admission criteria and the role of the hospice. We then look at how they approach questions around palliative symptoms like breathlessness, reduced oral intake and this leads on to a conversation about assessing and discussing options around hydration. We get their approach to answering questions around prognosis and navigating the scenario where relatives/carers might see the set of symptoms differently to other carers. 

Useful resources: 

• Hospice UK: What is Hospice Care: https://www.hospiceuk.org/information-and-support/your-guide-hospice-and-end-life-care/im-looking-hospice-care/what-hospice

• Greater Manchester Palliative Care Symptom Control Guidelines for Adults (2019): https://www.england.nhs.uk/north-west/wp-content/uploads/sites/48/2020/01/Palliative-Care-Pain-and-Symptom-Control-Guidelines.pdf

• Clinical Knowledge Summaries: Palliative Care General Issues: https://cks.nice.org.uk/topics/palliative-care-general-issues/

• Pain Assessment Tool for People with Dementia or Communication Difficulties from Doncaster and Bassetlaw NHS Hospitals (2015): https://www.dbth.nhs.uk/wp-content/uploads/2018/10/DBH-Pain-Tool.pdf

• MacMillan Resources: Managing Breathlessness, advice for Patients: https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/breathlessness/managing-everyday-life-with-breathlessness?gad_source=1&gclid=cjwkcajwrckxbhbmeiwaivf8rhfcgjkvqpsq-is9gahloaxjoyq9tsfxwykwym08ewcsyoluupn-1xocq1sqavd_bwe&gclsrc=aw.ds

• Cancer Research UK Resource for Patients and relatives around Breathing Problems for Patients with Cancer: https://www.cancerresearchuk.org/about-cancer/coping/physically/breathing-problems

_____

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: primarycarepodcasts@gmail.com

_____

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.