Talking General Practice

Emma and Nick discuss the key news stories affecting general practice. They talk about how the GP contract change that requires practices to keep their online consultation systems on throughout core hours is affecting workload in general practice, as well as the increasingly bitter war of words between the government and the BMA about this issue.They look ahead to next week’s England LMCs conference, where GP leaders will debate next steps on industrial action as a result of the dispute over online access.They also discuss the latest NHS planning guidance and what that means for GPs, some good news from Scotland on the GP contract there and Nick’s recent analysis on how GP premises funding is being spent in England.This week’s good news story is about practices delivering award-winning end of life care.This episode was presented by GPonline editor Emma Bower and deputy editor Nick Bostock. It was produced by Czarina Deen.Useful links●     'No progress' on GP contract reform as BMA frozen out of Carr-Hill review●     Government plans new target for GPs to offer urgent patients same-day appointments●     GPs in Scotland end dispute as £531m funding deal agreed●     Practices forced to hire extra staff to manage online consultation workload●     LMCs to vote on major escalation of GP industrial action●     Most GP practices say £1.1bn contract has not eased financial pressure●     How are ICBs spending the £102m GP premises fund?●     GPs and practices recognised for providing outstanding end-of-life care●     RCGP/Marie Curie Daffodil standards - more details

Emma speaks to GP Dr Callum Leese about the importance of physical activity and how primary care professionals can promote it to their patients.Callum is a GP in Aberfeldy, Scotland, and also works at the University of Dundee, where his research focuses on physical activity promotion and implementation in primary care. He is also the Royal College of GPs co-lead for physical activity.In this conversation, Callum talks about his research, including work with the WHO looking at physical activity promotion in policy across Europe, and RCGP initiatives like the Active Practice Charter and parkrun practices and how these can benefit both patients and staff.He offers advice for GPs on how to raise the issue of physical activity in consultations and discusses the importance of tailoring exercise advice to patients with specific health conditions.He also talks about a fantastic initiative he’s involved with, which is aiming for his home town of Aberfeldy to become the healthiest town in Scotland, and his work with the British Society of Lifestyle Medicine, where he leads the physical activity special interest group.This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.Useful linksRCGP physical activity hubRCGP parkrun practicesMoving Medicine - website from Faculty of Sports and Exercise MedicineBritish Society of Lifestyle MedicineCallum’s Movement Prescription podcastAberfeldy healthiest town website

This week we look at the rapidly advancing field of genomics, which is becoming increasingly relevant to everyday primary care. Emma speaks to Dr Jude Hayward and Dr Imran Rafi, who are the Royal College of GPs’ joint clinical representatives for genomics. Jude is a GP with an extended role in genomic medicine and Imran is a reader in primary care and genomics at St. George's University in London.Jude and Imran discuss the most significant changes genomics is set to bring over the next decade, including its potential use in predicting risk for common conditions, rise of pharmacogenomics and whether the government’s 10-year plan’s vision for the role of genomics is realistic.They also talk about some of the practical challenges facing GPs, such as how to handle patients presenting with results from direct-to-consumer genetic tests, the ethical considerations around data and consent, and the importance of ensuring advances in genomics help to narrow rather than widen health inequalities.And they also explore the opportunities for GPs to develop an extended role in this fascinating area of medicine.This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.Useful linksGeNotes - genomics notes for cliniciansGP with extended role in clinical genetics/genomics - RCGP frameworkRCGP eLearning - Genomics toolkitRCGP position statement on direct to consumer genomics testing

GPonline is the media partner for the RCGP annual conference and this is the second of two special episodes of Talking General Practice from the event Newport in Wales this week.In this episode we look at what health minister Stephen Kinnock said about overhauling the Carr-Hill formula and the BMA dispute over online consultations and what delegates thought about this. We also highlight what RCGP chair Professor Kamila Hawthorne had to say in her speech about primary care funding and GP retention.Emma talks to RCGP vice chairs Professor Margaret Ikpoh and Dr Thomas Patel-Campbell about the results of the college’s latest member survey, the importance of investing in primary care and how the increase in anti-immigration and right-wing rhetoric is affecting GPs.She also speaks to RCGP Wales chair Dr Rowena Christmas about being the subject of a book that tells the story of rural general practice and the college’s manifesto for next year’s Senedd elections and talks to outgoing RCGP president Dr Richard Vautrey.Useful links●     Find all of GPonline’s coverage from this week’s conference at gponline.com/rcgp●     Health minister describes online consultation dispute as ‘phoney war’●     Government launches review of 'not fit for purpose' GP funding formula●     GPs face unsafe workload and fear neighbourhoods will make it worse, RCGP warnsSupported by SymproveThis episode of Talking General Practice has been supported by Symprove. Based on an external survey of 432 healthcare professionals, Symprove was the number one probiotic, recommended by gastroenterologists, dietitians and GPs. The unique water-based solution delivers live bacteria to the colon and is proven in randomised controlled trials by leading institutions. 92% of people report a benefit within 12 weeks in real-world.Healthcare professionals can trial Symprove for free. Visit professionals.symprove.com and sign up for a virtual meeting to hear more about the research behind Symprove and get your free 12-week pack.

Emma speaks to Royal College of GPs chair Professor Kamila Hawthorne ahead of the RCGP’s annual conference in Newport in Wales, which starts on Thursday this week.GPonline is the media partner for the annual conference, and this is the first of two episodes that we’ll be producing from the event.Kamila is nearing the end of her three years as RCGP chair and in this interview, she reflects on the highs and lows of her time in the post. She talks about the experiences of dealing with multiple health secretaries and navigating the contentious issue of physician assistants in general practice.She also discusses the government's 10-year health plan and what it could mean for general practice, her fears about the future of the partnership model, and what the RCGP wants to see in the new NHS workforce plan. And she explains why she believes there is still a bright future for general practice despite the challenges.This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.Read all of GPonline’s coverage from the RCGP annual conference this week at https://www.gpponline.com/rcgp  Supported by SymproveThis episode of Talking General Practice has been supported by Symprove. Based on an external survey of 432 healthcare professionals, Symprove was the number one probiotic, recommended by gastroenterologists, dietitians and GPs. The unique water-based solution delivers live bacteria to the colon and is proven in randomised controlled trials by leading institutions. 92% of people report a benefit within 12 weeks in real-world.Healthcare professionals can trial Symprove for free. Visit professionals.symprove.com and sign up for a virtual meeting to hear more about the research behind Symprove and get your free 12-week pack.

This week Emma and NIck talk about the BMA’s decision to re-enter dispute with the government in England, the online access plans that have led us to this point and what both the BMA and the government have to say about all of this. They also look at what re-entering dispute could mean for the profession.They talk about the upcoming NHS workforce plan, which is due to be published before the end of the year after the government launched a call for evidence. And they discuss the BMA’s latest survey on the state of GP premises and what’s required to fix the crumbling primary care estate.Our good news story this week is about a GP who has this week been attempting to break the record for running round the perimeter of Cornwall in an effort to raise money and awareness of early-onset dementia, which has affected her mum.This episode was presented by GPonline editor Emma Bower and deputy editor Nick Bostock. It was produced by Czarina Deen.Complete our survey looking at online access and other issues affecting GPs here Useful linksDr Elsey Davis fundraising pageTrack Dr Davis’s progressGPs are standing up for patient safety by declaring dispute, says BMAStreeting dismisses GP fears over online access as 'forces of conservatism'Government 'mystified' over GP stance on online accessMouldy, cracked and cramped: BMA poll exposes GP premises crisis

This week Emma speaks to Professor Brendan Delaney, a GP in London and Professor of Medical Informatics and Decision Making at Imperial College London. Brendan’s research work covers artificial intelligence in medical diagnosis and learning health systems and he is a real expert in this field.Artificial intelligence is likely to have a huge impact across society and its role in healthcare is expected to grow exponentially in the coming years. But what will this mean in practice for GPs on the ground?In this conversation, Brendan talks about the research he is involved with that is looking at how AI can be used to support diagnosis in primary care. We also discuss whether developments in AI in medicine could de-skill doctors, the vital importance of medical device regulation when using these new tools, and the key issues of clinical liability and data security.Brendan also shares his thoughts on the government's vision for an AI-enabled NHS and how realistic this vision is as well as his hopes for how this new technology could shape general practice in the coming years. And he has advice for how GPs can prepare for a future where technology will play an even greater role in medicine.This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.Useful linksTransformer-based deep learning model for the diagnosis of suspected lung cancer in primary care based on electronic health record data - the study Brendan mentions in the interviewMore of Brendan’s research workIX - Imperial College London’s cross-department AI initiativeAI tools in general practice and liability - advice for GPsUsing AI transcribing software in general practice - medicolegal considerations

This week Emma speaks to Dr Helen Thomas, a GP in Hampshire and a member of the group Healthcare Professionals for Safer Screens.Helen has been involved with developing screening tools and training resources to help clinicians identify problematic smartphone use in young people which might be affecting their mental health.In this conversation Helen explains the evidence linking excessive screen time to worsening mental health outcomes, poor sleep, and developmental delays, and highlights the harmful content algorithms push to young users.She explains why it's vital for GPs to ask about device use when consulting with young people presenting with mental health issues and the screening tools and resources that can help clinicians do this.And she discusses the wider changes needed to tackle this issue, including what the government should be doing.This conversation includes discussion of self harm and suicide.This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.Useful links Health Professionals for Safer ScreensHealth Professionals for Safer Screens resources - including screening tool, health intervention information and training worldsHow TikTok harms boys and girls differently - the Guardian video that Emma mentions in this conversationDetails of Esther Ghey’s campaign to ban smartphones in schools - from BBCJonathan Haidt’s Let Grow movement, which Helen mentions in this conversation