Medical Centre

Appointment lengths in primary healthcare should be flexible to accommodate the needs of each individual patient. This allows for personalized care and ensures that patients receive the appropriate amount of time and attention from their clinician.  It also allows for more efficient use of clinic time as appointments can be scheduled based on the specific needs of each patient rather than a one-size-fits-all approach. Offering flexible appointment lengths can improve patient satisfaction and build trust in the healthcare system. It can be challenging for doctors and other clinical staff to give more time to patients and increase appointment lengths when they are also required to see more patients given the demand for appointments and the shortages of key healthcare workers. Implementing digital technologies such as electronic medical records and online appointment booking, can help to streamline the appointment process and allow clinical staff to see more patients without sacrifici...

 In the fields of clinical medicine and public health, it is important to recognize and acknowledge the inherent uncertainties that exist. This is because these fields deal with complex systems that have a high degree of uncertainty and imprecision. This uncertainly can be in the diagnosis and treatment of individual patients, or in the implementation of public health policies. It is crucial for medical professionals and public health officials to communicate these uncertainties accurately and transparently.  This can help prevent the spread of misinformation and can also help individuals make informed decisions about their health and the use of interventions such as screening or vaccination. Furthermore, it is important to recognize that not all sources of information are equal. It is important to critically evaluate the evidence behind any claims being made. This is especially important in the era of social media, where anyone can share their opinions and ideas, regardless o...

 A real change is on the horizon. In October 2021, Facebook announced that it would rebrand itself as ‘Meta’, and this generated high levels of public interest in the metaverse for the first time. Definitions for the metaverse vary and there is still much uncertainty in its eventual future manifestation. It is perhaps best defined as a fully immersive parallel digital reality where users will be able to interact at a scale previously unimagined. The advent of the metaverse could have transformational impact on every aspect of human life, from our social interactions to what we ascribe real value to. Just as the Internet has completely transformed health, the metaverse will redefine virtual and physical possibilities in health.2 This will have major implications for our health and for healthcare delivery. The coming of age of the metaverse is in due largely to the maturation of technological advances in artificial intelligence and devices that enable the delivery of mixed, augmented...

  Primary Care Clinical Update 8 December 2022   1. Group A Streptococcal infections There has been an increase Group A Streptococcal (GAS) infections in recent months, which has led to at least 15 deaths in children since September. Although GAS rates are higher than expected for this time of year, they have been higher at periods over the last decade as shown in the graph below from the UKHSA.  GAS causes a range of infections including Scarlet Fever and also more severe invasive disease. For more information on management, see: Scarlet fever: a guide for general practitioners. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5649319/ The Centor score can be used to assess the probability of an illness being GAS pharyngitis: Tonsillar exudates, tender anterior cervical adenopathy, absence of cough, history of fever (>38 °C). Penicillin V (or Amoxicillin) is the preferred treatment unless contra-indicated in which case an alternative such as a cephalosporin or clar...

There is currently considerable media coverage and some public anxiety in the UK about Group A streptococcal (GAS) infections. Journalists who write about cases of infectious diseases need to understand the principles of the Poisson distribution. Events such as infections can sometimes cluster in time or space due to chance, and not because there is an underlying cause behind the cluster of cases. Some journalists and doctors are stating that the cases of Group A streptococcal infections we are currently seeing in the UK are from lower levels of immunity because of Covid-19 control measures over the last 2.5 years. This is not necessarily the case and needs further investigation. The UK has experienced large outbreaks of Group A streptococcal infections in the past. For example, the UK had a large outbreak of Group A streptococcal infections between September 2015 and April 2016 (the largest since 1969), resulting in PHE issuing an alert.  The current cluster of Group A streptococc...

Writing in the Journal of the Royal Society of Medicine , myself, Austen El-Osta and Chris Rowe set out a vision for building sustainable, self-driven healthcare spanning primary care, secondary care and the wider health and social care system has been set out by medical innovators. Self-driven healthcare (SDH) is an umbrella term introduced by Innovate UK, the UK’s national innovation agency, to conceptualise aspects of healthcare delivery that can support people in becoming more engaged in managing their own health and wellbeing, rather than being passive receivers of healthcare. In our paper, we describe an SDH ecosystem that supports individuals to take more ownership of their health and wellbeing and in recording their own data (e.g. weight, blood pressure) using a phone app, tablet, computer or Bluetooth device. This self-generated data would then be uploaded onto a secure online SDH portal which holds all their health records, including those generated in the wider healthcare sy...

Topics I presented in my practice’s clinical meeting today: 1. ADHD referral update a. ADHD referrals are rejected by a clinician in the specialist team if thought to be unsuitable for the service but sometimes this is a team decision, so they prefer not to give a specific name on the rejection letter. b. They don’t have the ability to “pause” referrals. Hence, if key information is missing, a referral is rejected as they can’t put it on hold. c.   When making a referral, ensure that the key diagnostic criteria are all included. These should be in the referral form but are also available online. https://selondonccg.nhs.uk/wp-content/uploads/2022/09/SEL-ICS-Adult-ADHD-referral-criteria-v1-2022.pdf d. Private patients and overseas patients. Consultant Connect can be used to get advice quickly and this can allow medication to be continued if indicated for patients with a confirmed diagnosis. Consultant Connect for the ADHD service is currently under-used by local GPs. e. ...