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Patients would rather see a GP than pharmacists and nurses, study finds

Patients would rather see a GP than pharmacists and nurses, study finds

Glasgow Times12 hours ago
A study found that people often like to see a GP and still prefer in-person appointments, considering them the 'gold standard'.
The review of 33 existing studies, from the University of Southampton, also found patients often like to choose a specific doctor to maintain continuity of care.
Trust and confidence decreased when patients wanted to see a GP but were directed to a nurse or other health worker instead, it added.
The study noted people also wanted easier ways to book GP appointments, clearer phone options, shorter recorded messages, and simple online routes with quick responses.
It comes after the Government published its 10-year health plan which intends to massively increase use of the NHS App, as well as recruit more GPs.
An improved app will give patients more control over booking, moving and cancelling appointments, as well as quicker access to medics and other forms of care.
The new study, published in the British Journal of General Practice, suggested confidence and trust scores appeared to be lower when people wanted a face-to-face appointment and received a call instead.
The public also wanted clear details on the roles of different NHS workers, it found.
Lead author Helen Atherton, professor of primary care research, said: 'Patients want a deeper connection with their doctor's practice, better communication, and the choice to see the right professional in the best way for them.
'The NHS needs to better understand what people want so it can shape its services to work for patients.
'Ignoring these fundamental needs will only exacerbate the issues it currently faces.'
Writing in the journal, Prof Atherton and colleagues added: 'Patients wanted a nearby practice, with clean waiting rooms, easy appointment booking using simple systems and with short waiting times, and to be kept informed about the process.'
In particular, researchers found that, for medication reviews and long-term conditions, patients preferred seeing someone they were familiar with.
The research also suggested that, where a patient's condition was worsening, 69.5% of patients reported preferring to consult a GP than a pharmacist and 42.7% strongly agreed or agreed that they would prefer to consult with a GP rather than a pharmacist.
Professor Kamila Hawthorne, chair of the Royal College of GPs, said: 'It's really encouraging to see how much patients value the care, and continuity of care, their GP provides – there are some things that only a GP can do for their patients, but it's also important that patients don't feel somehow short-changed if they're offered an appointment with another member of our highly-skilled multi-disciplinary team.
'Not all patients need to see a GP. Procedures such as blood tests, routine management of non-complex long-term conditions, the monitoring of repeat prescriptions, or assessment of a painful joint, for example, can be carried out by some of the various other members of the team who now work in general practice, such as nursing staff, mental health professionals, clinical pharmacists and physiotherapists.
'This also alleviates workload on GPs, allowing us to spend time with those patients with complex health needs who really do need our expert medical attention.
'However, we know that even when working as part of multi-disciplinary teams, patients often struggle to access their GP when they need to – and we share their frustrations.
A GP writes a prescription in his practice room at the Temple Fortune Health Centre GP Practice near Golders Green, London (Anthony Devlin/PA)
'This is due to decades of under-funding of general practice and poor workforce planning, which has meant patient need for our care has escalated in recent years, while GP numbers have sadly not risen in step.
'We need thousands more GPs, and the recently published 10-Year health plan commits to providing these.
'We're now looking ahead to the revised long-term workforce plan, due later this year, to see how the Government plans to recruit more GPs and keep more GPs in the profession for longer – but also address some of the nonsensical issues GPs are reporting that they can't find appropriate employment upon qualification.'
Henry Gregg, chief executive of the National Pharmacy Association, said: 'It's not surprising that people want to see a GP when they go to a GP surgery but all our research and experience shows that people are very happy to visit a pharmacy if they can access treatment or advice quickly without having to wait to see a GP.
'Pharmacists are highly trained medical professionals who offer first-class care for a range of ailments quickly and conveniently and will send patients to a GP or hospital if needs be.
'Increasingly people will be able to pop into a community pharmacy and see a highly qualitied pharmacist for things like screening, check-ups, HRT, weight management or ongoing care without lengthy waits, freeing their NHS colleagues in hospitals and GPs to do more and offering patients the choice and convenience we all want to see.'
Royal College of Nursing chief nursing officer, Lynn Woolsey, said: 'Nursing staff are an integral part of any general practice delivering a range of services to patients.
'They lead public health clinics, run screening and vaccination programmes, support patients in the management of chronic disease and can diagnose and prescribe.'
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Health regulator issues warning as vaccine given to millions is linked to debilitating illness
Health regulator issues warning as vaccine given to millions is linked to debilitating illness

Daily Mail​

time29 minutes ago

  • Daily Mail​

Health regulator issues warning as vaccine given to millions is linked to debilitating illness

NHS staff must now warn patients of a rare neurological reaction linked to a new vaccine given to millions of pensioners and pregnant women after a string of cases. The Medicines and Healthcare products Regulatory Agency (MHRA) issued the alert for two versions of a jab that protects against respiratory syncytial virus (RSV). This alert was issued after reports of 21 patients—all over 60—developing Guillain-Barré syndrome after being vaccinated. Guillain-Barré syndrome is a rare but serious neurological disorder which needs urgent treatment in hospital to prevent it progressing. It can affect people's senses, movement, breathing and heartbeat and usual starts in the arms and legs before spreading to other areas. The alert doesn't mean the jab has been withdrawn, just that staff need to inform patients of the link so any who develop the reaction get the help they need as soon as possible. In fact, experts said the benefits of being protected against RSV, which kills 8,000 adults and 100 babies each year and hospitalises many more, outweighs the small risk of Guillain-Barre syndrome, so it is still recommended to get it if offered. The MHRA issued the alert for both the Abrysvo RSV jab—made by Pfizer of Covid vaccine fame—and another RSV jab called Arexvy, made by GSK. Abrysvo is available in the NHS while latter is available privately. The MHRA alert reads: 'Healthcare professionals should advise all recipients of Abrysvo and Arexvy that they should be alert to signs and symptoms of Guillain-Barré syndrome and, if they occur, to seek immediate medical attention as it requires urgent treatment in hospital.' While warnings that the jab may cause the syndrome are included in patient safety information leaflets NHS staff will now have to warn patients directly. The watchdog's warning follows a similar one issued by US health chiefs who in January. 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Every drug approved for use in Britain has to go through safety trials before being made available to the public. But there is an unavoidable risk that rare reactions may have been missed, which is where the Yellow Card system comes in. If a worrying pattern emerges it can lead to drugs' approval being reviewed, having new warnings added to the labels or the medication potentially being taken off the market completely. As anyone can use the system—patients as well as their medics—a reaction being linked to a vaccine or drug is not proof it was responsible. The MHRA highlights that some reactions may simply be coincidence. For example, a patient given an RSV jab may develop Guillain-Barre syndrome, but the vaccine itself may not be responsible. Guillain-Barré syndrome is a poorly understood condition. It occurs when the body's immune system, which normally protects people from infection, mistakenly attacks healthy nerve cells. While most patients recover within a year, some are left with permanent nerve damage. What triggers the immune system to attack nerve cells in Guillain-Barré syndrome isn't understood. But, as the syndrome can also occur following an infection with a virus or bacteria, some experts suspect it's caused by a misfiring of the immune system in response to a foreign substance, be that a pathogen or a vaccine. Such reactions, from both infections or RSV vaccines, are rare, with the risk estimated to be about one in every 1,000. RSV vaccines, which were only approved in the UK last year, offer protection to older adults and babies who are at increased risk of becoming seriously ill if infected. The virus can cause dangerous breathing problems in babies as well as pneumonia in older people, both of which may require hospital stays. RSV jabs are offered to pregnant women so that the protection passes to the developing baby, reducing their risk of severe infection by about 70 per cent. Government data shows that 62 per cent of eligible older adults and about half of pregnant offered the RSV vaccine on the NHS in England had the jab. The latest NHS data—for the 2023-2024 financial year—recorded about 3,000 admissions for Guillain-Barré syndrome in England's hospitals though some cases could be the same patient needing to admitted multiple times that year.

'I called NHS dentists for 7 years but couldn't get in, so pulled my teeth out'
'I called NHS dentists for 7 years but couldn't get in, so pulled my teeth out'

Daily Mirror

time30 minutes ago

  • Daily Mirror

'I called NHS dentists for 7 years but couldn't get in, so pulled my teeth out'

NHS dental crisis left Linda Colla having to pull out her last three teeth after being unable to get an NHS dentist for seven years [warning graphic video] A desperate pensioner pulled out her last three teeth because she was unable to get an NHS dentist. Linda Colla, 76, had been calling around practices for seven years trying to get an appointment but has just been stuck on waiting lists. The Mirror visited Linda in Devon as part of a series of special reports from one of Britain's worst dentistry deserts. The British Dental Association has demanded that Labour urgently reforms the NHS dental contract to end the 'horror show'. Local MP Caroline Voaden told the Mirror that not a single dentist in South Devon is now taking on new NHS patients. ‌ ‌ Linda, a retired charity manager who receives pension credit, said: 'My gums were all inflamed and were so painful I could only eat baby food and soup. I couldn't eat anything solid. In the end I just pulled my teeth out. I just kept wiggling it and wiggling it until it came out. When I went through childbirth with my daughter they always told me I had a high pain threshold.' Without the three teeth to anchor it, Linda's lower denture plate wouldn't fit. She eventually found the money to pay a private dentist £200 to fit a new one. The mother-of-two said: 'My plate had to be adapted to have the three teeth put in but that cost me £200 which was my week's pension gone in one fell swoop. ‌ 'I'm a pensioner and I should have free NHS dental treatment but I can't get it, despite all the years I've paid into the NHS through taxes and National Insurance contributions. 'Let's face it, if you paid into an insurance company and then when you needed them they didn't deliver then there would be hell to pay. But that is what the government is doing. ‌ READ MORE: 'I pulled my own tooth out with a pipe wrench because of the unbearable toothache' 'Now I'm in a situation now where at the moment my dentures aren't too bad but at some point I've either got to have them realigned or replaced. I'm going to have to find £1,500 for dentures and I'm on pension credit - one of the poorest people in the country so they tell me - I can't afford that. And I shouldn't have to go into debt to see a dentist.' A number of different question responses in last year's GP Patient Survey suggested Devon is one of the places in the country where it is hardest to get an appointment with an NHS dentist. Linda said: 'It's the most awful thing because your face is what you present to people. When you lose your teeth, you're losing a heck of a lot of self-confidence. My self-confidence went down the plughole. So I do worry for all the children that are losing their teeth. When they start off with bad oral health that is going to dog them for the rest of their lives.' ‌ After a decade of real terms funding cuts under the Tories the £3 billion NHS dental budget for England is now only enough to treat around half of the population. Linda said: 'There's not the budget for dentists to be able to take on more on the NHS, this is what I was told. They can't work for nothing. I must have called about a dozen NHS dentists and I'm willing to travel 20 miles but I can't get in anywhere. I could afford to go private I'd get a dentist tomorrow.' ‌ Caroline Voaden, Lib Dem MP for South Devon, told the Mirror: 'Scarily, stories like Linda's are not rare – with not a single dentist in South Devon taking on NHS patients. Urgent action is needed to attract and reward dentists who practise in less-served areas.' The British Dental Association warned the Public Accounts Committee earlier this year that the Treasury has become reliant on practices delivering care at a loss - fuelling an exodus of NHS dentists into lucrative private work. ‌ Caroline Voaden MP added: 'Remuneration is one part of this, but we should also explore a contract that gives dentists greater flexibility, reduces red tape, and promotes the kind of work-life balance that mirrors what they find in the private sector. 'The sad truth is that this Government has been in office for a year now and has often spoken about reforming the NHS dental contract. But in the same period, South Devon has lost three dental surgeries, and more are on the brink. While the Government weighs its options, this crisis is deepening.' ‌ Last week the Government published its Ten Year Health Plan which pledged that "by 2035 the NHS dental system will be transformed" - but the British Dental Association insists contract reform must happen much sooner. READ MORE: Keir Starmer's plan to 'rewire' NHS explained – why you won't have to go to hospital The professional body estimates a typical practice loses over £40 delivering a set of NHS dentures and £7 for every new patient exam. A Parliamentary report by the Health Select Committee has described the state of NHS dentistry as "unacceptable in the 21st century". The NHS contract effectively sets quotas on the maximum number of NHS patients a dentist can see as it caps the number of procedures they can perform each year. ‌ BDA chair Eddie Crouch said: 'The crisis in NHS dentistry was made in Westminster. A failed contract has left patients taking matters into their own hands, or flying abroad for care that should be available in their own backyard. We can end this horror show, but we need to see real urgency and ambition.' Dentists for All campaign Save NHS Dentistry petition Sign our petition to save NHS dentistry and make it fit for the 21st century Our 3 demands Everyone should have access to an NHS dentist More than 12 million people were unable to access NHS dental care last year – more than 1 in 4 adults in England. At the same time 90% of dental practices are no longer accepting new NHS adult patients. Data from the House of Commons Library showed 40% of children didn't have their recommended annual check-up last year. Restore funding for dental services and recruit more NHS dentists The UK spends the smallest proportion of its heath budget on dental care of any European nation. Government spending on dental services in England was cut by a quarter in real terms between 2010 and 2020. The number of NHS dentists is down by more than 500 to 24,151 since the pandemic. Change the contracts A Parliamentary report by the Health Select Committee has branded the current NHS dentists' contracts as 'not fit for purpose' and described the state of the service as "unacceptable in the 21st century". The system effectively sets quotas on the maximum number of NHS patients a dentist can see as it caps the number of procedures they can perform each year. Dentists also get paid the same for delivering three or 20 fillings, often leaving them out of pocket. The system should be changed so it enables dentists to treat on the basis of patient need. Have you had to resort to drastic measures because you couldn't access an NHS dentist? Are you a parent struggling to get an appointment for a child? Email or call 0800 282591 The Government is rolling out 700,000 extra emergency dental appointments and bringing in supervising toothbrushing for three to five year olds in the most deprived areas of the country. It is currently in negotiations with the British Dental Association about reforming the NHS dental contract.

‘Lofty ambition, very little detail': Readers react to Labour's 10-year plan for the NHS
‘Lofty ambition, very little detail': Readers react to Labour's 10-year plan for the NHS

The Independent

timean hour ago

  • The Independent

‘Lofty ambition, very little detail': Readers react to Labour's 10-year plan for the NHS

Labour's recently unveiled 10-year plan for the NHS has sparked a lively debate among Independent readers, many of whom are cautiously weighing its promises against the past. The plan, unveiled last week by Sir Keir Starmer and Health Secretary Wes Streeting, includes ambitious goals such as 'a doctor in your pocket' through a greatly enhanced NHS smartphone app, 24/7 health advice, easier online appointments, and a shift towards preventative medicine and neighbourhood health centres. When we asked whether you thought Labour's 10-year NHS plan could deliver real improvements, nearly half (47 per cent) of readers said no, citing a lack of funding, staff, and detail. Another 28 per cent said the ambition is right, but delivery will be the real test, while 25 per cent believed it is the bold, long-term reform the NHS requires. Many said the plans represent a welcome move towards modernising a service often criticised for being stuck in analogue times. Yet, despite the optimism around the digital and structural reforms, several readers remained sceptical about whether the plan could deliver the improvements the NHS so desperately needs, with concerns focusing on funding, staffing shortages, and the lack of detailed delivery mechanisms. With the NHS under constant pressure from an ageing population and rising demand, the question of how these reforms will be implemented was front and centre. Here is what readers had to say about the plan's prospects and challenges: 'All just empty words and no delivery' I can say that I am going to travel to the Moon and back – but if I don't say how I intend to do it, how I intend to pay for it, and how anyone will know that I have done it, it is all just empty words and no delivery. The NHS has a huge recruitment/retention problem, and it is going to need tens of thousands of extra staff. In addition, Streeting has run away from Social Care, which is the one thing that will solve the NHS crisis. So like every other plan, it will not be resourced properly – but there will be lots of highly paid executives involved, working out of fancy offices, until the next plan comes along... ListenVeryCarefully 'Prevention is not a quick fix' Prevention work is already undertaken by Public Health departments in local authorities, in collaboration with the NHS. This is absolutely nothing new. Councils spend millions on Public Health preventive work. The problem is that prevention can take years to show an effect or to realise savings for the NHS. Many people don't seem to get that. Preventive work is not a quick fix. To be honest, I am sick of successive governments and highly funded think tanks producing report after report when we already know the answers. Flossie 'They know the answers' The announcement is very short on detail, particularly on how they will help prevent ill health. Successive governments have commissioned reports on diet, exercise, and active travel for years – they know the answers. Why the reluctance to announce them and any sort of delivery plan? Holly 'Like a nurse reorganising the Houses of Parliament' Again, the government is seduced into reorganising the organisers and office teams. Non-clinical people always do this, and it makes no difference – it's like a nurse reorganising the Houses of Parliament. Plain hopeless. Emperor's new clothes. Having been through five of these restructures, I can say they never change or improve anything. As always, they want less clinical activity and more admin... Diane1234 'We can't afford an NHS that fixes everything' The biggest problem with the NHS is that we want it to fix every ailment – from cuts and scrapes to organ transplants. Sooner or later, we have to face up to the fact that we can't afford an NHS that tries to fix everything, including things we should take responsibility for, such as obesity. Issuing painkillers to just about every patient who has a procedure is also ludicrous, as paracetamol or ibuprofen costs about 39p a pack in a no-frills supermarket. Using the NHS should be limited to "must do" and "could do" – not "it would be nice if I could use it because I'm too idle to sort out my minor problem myself". We are nearing the point where we will need to pay a small charge for all the high blood pressure pills and statins issued to the older population. They're all on them. onmyown 'Primary prevention works – but it's never been prioritised' Primary prevention has always been the Cinderella service within our health system, because it is not "sexy" and requires hard graft to change attitudes and promote health. But quite simply, it works. As a retired health visitor with more than 40 years in practice, I can categorically state that if you invest in taking health into the community, it will work. For too long, resources have been directed into much more expensive tertiary care. I really hope this time they mean it. HappilyRetiredWoman 'Nothing new' This is nothing new – we've been trying to transfer care from hospitals to communities for years (since Thatcher and "care in the community"). This appears to be a blueprint to shut down more hospitals or reduce funding. This isn't what's needed – just the opposite. Community services are already stretched. Doctors' surgeries are reducing services, and waiting times are too long. Pharmacies are closing down and being sold due to a lack of funding. This 10-year plan is just the usual political BS that won't get to grips with the real problems. ChrisMatthews 'This is the future – and it's already happening' A very good idea. Not far from where I live, there are two modern NHS clinics where diagnostic procedures are performed without the need to travel miles to the general hospital. This is the future, and this is what has already been done in many more advanced European countries. Pomerol95 'Abolish the CQC – there's £50m saved' I recently changed my GP because I was unhappy with the service. The contrast between the two services is stark, and I wondered how it could be that there is such inconsistency at such a basic level. My old GP had a CQC rating of "good", but it was far from that. I dug around a bit and found that the last time the CQC had assessed the practice was in 2016 – nearly a decade ago. The problem with such rating systems, beloved of the competition-obsessed Tories, is that they're actually worse than useless. They create an illusion of competence where it doesn't exist. Plainly, it isn't practical for one organisation to continuously monitor standards throughout the healthcare system, so it should be blindingly obvious that this is not an appropriate way to ensure consistency of service. Abolish the CQC – there's £50m a year saved. RickC 'District hospitals and prevention – let's hope it happens' Moving frontline services to community care centres would be a very positive move. Re-establishing the district hospital would be very popular. Shifting the emphasis to the prevention of illness and the improvement of public health systems is also a laudable aim. Let's hope this can be achieved in 10 years! PaleHorse 'Lofty ambition, very little detail' I cannot see anything concrete in this statement – plenty of lofty ambition, but very little detail. I like the idea of local health centres providing access to diagnostic services. If they are allowed to invest in new equipment, it will speed up the move to digital services. Moonraker2025 'Dangerous to cut cure before prevention pays off' Prevention vs cure is logically all very well – but do we know how to reliably prevent sickness that might put people in hospital? For many conditions, effective systems for prevention might take more than a decade to have much effect. So, no money is saved through needing less for cure for 10 years or more. It is very dangerous to run down curative services until we see the new investment in prevention paying dividends. I suppose Streeting will require the NHS to blame the unwell for not following prevention guidelines – as a sort of "not our responsibility: you did this to yourself". Simplesimon 'So… it won't happen' It would take a lot of cash; the NHS doesn't have it because the Treasury doesn't have it... It would require the UK economy to improve dramatically... It won't. Or they could increase taxes, particularly for the wealthy, but they won't do that, as it would upset their donors – and higher taxes aren't why the donors put them in power... So… it won't happen. ScoobytheDog 'Nothing really new here' After spending nearly fifty years working in the NHS, I think this all seems to have been said before. So nothing really new here, but the sentiment is a good one. How to deliver it will be the real test. Sparrow 'Remember Blair's polyclinics?' If Labour don't put in the funding and increase the staffing, this latest NHS plan will fail. Remember Blair's polyclinics, anyone? rcourt130864 'No understanding of cause and effect' There seems to be no vision at all. No understanding of cause and effect. For example, the "food" industry, peddling its processed junk, has made people ill and obese. But rather than tackle the cause, expensive weight-loss drug injections are prescribed. Likewise, the alcohol industry. Either a lack of vision, or the government has been 'bought off' by wealthy pressure groups. Heisenberg97 'The NHS is a public service, not a business' It can work – the basic problem has always been that the NHS was never intended to be a business and cannot be run as one. It is a public service. Before the advent of business management techniques (plied by business consultants), it was the envy of the world as a health service, not measured by being a profitable public company-style business. I worked on this well over 20 years ago. Clinical and non-clinical should be treated separately. Fixed assets should be NHS-owned (not government-owned), giving them control over expansion, upgrades etc. Build a model based on the production side and the service side. The production side is more predictable and can be proactive. In the NHS, you could represent this by likening it to a catalogue of products: tests, scans, standard operations (hip, knee replacements etc.), and all post-operative support can be included as 'products'. The supplier or deliverer of the individual products does not have to be the NHS, but coordination should be through an NHS functional system. The NHS could rent on-site space to a service provider who would, for example, equip an area where scans, x-rays etc. are provided to patients on referral from an NHS-approved doctor on an agreed service contract. I challenge the view that to outsource these services is 'selling off' the NHS. The service side of any operation, on the other hand, is always more reactive (as in any business) and needs skilled resources with the flexibility, training, and tools to provide support to the patient. They need the best resources to handle unclassified 'breakdowns' and set in motion a recovery plan that covers not just fixing the problem, but getting the patient back to normal (or a new normal). This is the NHS's core function and is the public service that we all expect. ArcticFox 'Not a plan, just a wish list' First, it almost certainly isn't a "plan" in the sense that anyone in business would recognise. I bet it is just a wish list of things they want to happen, much like the recently published "Modern Industrial Strategy", lacking any detail as to how it's actually going to be delivered, what the key milestones are, who is going to be responsible, what resourcing and cash is going to be dedicated towards it, and what the measures of success will be. Equally, I doubt there is any delivery structure in place, or transformation programme governance, or anything like that. Second, Labour is going to be out of office come 2028 or 2029 for the next 30 years, and whoever takes over from them will almost certainly tear this plan up. They don't have ten years, and they must know that by now. So honestly, what's the point in publishing a "ten-year plan"? It's just performative at this stage. sj99 The conversation isn't over. To join in, all you need to do is register your details, then you can take part in the discussion. You can also sign up by clicking 'log in' on the top right-hand corner of the screen.

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