RCGP news

This page shows a summary of the latest news from the Royal College of General Practitioners RSS News Feed.

GPs on 'permanent alert' for signs of meningitis, says College

"GPs are on permanent alert for signs of meningitis in their patients and we do speak to the parents of babies and young children about what they need to look out for which may indicate that an illness could be developing into something much more serious.

"The College would certainly welcome new resources that GPs could share and discuss with patients and parents of young children, that raise awareness of the symptoms of meningitis, so that people can get the best possible care as quickly as possible.

"GPs also recognise that parents and carers are the ones who really know their child best and that listening to a parents' concerns about their child is often an important indicator of whether something is not right. This is something we will always try to take into account, along with any other physical, psychological and social factors potentially impacting on the health of the patient in front of us.

"Sepsis is a Spotlight project for the RCGP and we have developed high quality resources to support GPs and other members of the practice team identify possible cases of sepsis, which also includes a 'symptom checker' to illustrate the signs and symptoms to look out for."

Contraceptive services 'at a crossroads' due to frustrating cuts, says RCGP

"It's also incredibly frustrating, because we've actually had years of improvement in the quality of sexual and reproductive healthcare in the UK; we've seen teenage pregnancy rates halved; we've seen take up of long acting reversible contraceptives (LARCs) increasing.

"But the most recent data shows prescriptions for LARCs – reliable, cost-effective contraception – decreasing. We're at a crossroads, whereby all the progress we've made is under serious threat, and we fear it will be some of our most vulnerable patients who are affected most.

"The complex and fragmented way sexual and reproductive health services in the community are now commissioned is something the College has called out in our recent 'Time to Act' report. Funding for one service might come from NHS England, funding for another from the Local Authority, and yet funding for another from the local Clinical Commissioning Group – it's so confusing to navigate for GPs and our teams, never mind patients.

"We're hearing of GP practices that have been running LARC-fitting clinics, but not being adequately funded to do so. That simply isn't sustainable when you think of the intense resource and workforce pressures facing general practice at the moment. There is also a lack of funding for the appropriate training for staff to fit LARCs safely - it's patchy across the country.

"So much progress had been made in this area in recent years and the service is too important to be allowed to fall into decline. It is vital that this decimation of services is stopped, and the trend immediately reversed."

Connection between lifestyle factors and overall health 'remains clear', says College

She said: "It's testament to the tremendous efforts of our NHS and public health services that more people are now living longer, but with this achievement comes the reality that more of us are also living with multiple, long-term conditions, such as diabetes, heart disease and dementia.

"As this report shows, there are a number of reasons why some people are more likely to develop these conditions than others, including genetic predisposition and socio-economic factors, but there remains a clear connection between the quality of our patients' lifestyle and their overall health.

"It's so encouraging to see that smoking prevalence has dropped to just 15% over the last seven years, for example, but the chances of people developing illnesses like diabetes is still worryingly high, and frequently is the result of poor diet and lack of exercise as well as genetic factors.

"GPs are acutely aware of these dangers, which is why we will always try to take into account the physical, psychological and social aspects of the person sitting in front of us, including how their lifestyle might be affecting their health and the ways in which they can work to improve it. Often simple lifestyle changes can have a big impact on long-term health and wellbeing.

"With many patients coming to see their doctor with more than problem, however, finding time to properly assess someone's lifestyle can be difficult within the constraints of a standard 10-minute consultation.

"GPs and our teams make the vast majority of NHS patient contacts, and with our growing and ageing population, our workload is escalating both in terms of volume and complexity.

"We desperately need to see NHS England's GP Forward View, which promises more investment and more GPs, to be delivered, in full – and we also need to see general practice receive an additional £2.5bn extra a year as part of the NHS's long term plan, so that we can continue to deliver the care our patients need and deserve."

Society-wide approach needed to address 'extremely serious' self-poisoning rates in young people, says RCGP

"The self-poisoning methods being used by young people –  whether that be the misuse of paracetamol, alcohol, opioids, or something else – can have dangerous implications on a person's short and long term physical and mental health. It is particularly troubling that there has been a big rise in paracetamol poisoning of children as young as 10 years, especially as these drugs are so readily available, both in and out of the home.

"GPs play an important role in identifying and then managing the care of children and young patients with mental health conditions and we know that alternatives to drug therapy, such as talking therapies and CBT can be very beneficial for young people with mental health conditions, but access to these is often patchy across the country, especially services targeted for young people.

"Self-poisoning in young people is also linked to a much higher likelihood of suicide within 10 years so it is crucial that we tackle this with a strong society-wide approach which includes parents, schools, healthcare professionals and government working together to provide high quality mental health treatment and support to those at-risk.

"Mental health is an enduring priority for the College, and we have developed a number of resources for GPs and our teams to support them in delivering the best care possible for patients with mental health conditions of all ages."

Alcohol guidelines 'set for a reason', says RCGP

Any form of substance misuse can have serious, negative consequences on our patients' health and wellbeing. Alcohol intake has been linked to a range of serious, chronic diseases including liver disease, heart disease, diabetes, dementia and some cancers.

"GPs are not killjoys, and although there is not completely safe level of alcohol intake, the upper drinking limits are set for a reason, and we would encourage everyone to try and stick to limiting their intake to a maximum of 14 units a week, with at least two alcohol-free days every week.

"It's always good to see balanced public awareness campaigns being launched to encourage patients to take note of how much they drink and, in turn, make sensible lifestyle choices that could drastically improve their health and wellbeing.

RCGP encourages all primary care professionals to get their flu jab this winter

"Just being healthcare professionals puts us at higher risk of contracting influenza as we mix with so many people, and there is now clear evidence that unvaccinated frontline NHS staff are frequently asymptomatic carriers of the flu virus, so are unaware that they are passing it on to vulnerable patients. Getting vaccinated not only protects yourself, but your colleagues and patients.

"Flu puts an incredible amount of pressure on general practice and the wider NHS every year, so it’s important that we take whatever steps we can to stop the spread of the virus, in the best interests of ourselves and our teams, our patients, and the national health service."

Heart age self-test results should prompt changes to our health habits, says College

"Today's figures show that as a nation we are taking our heart health for granted. Being overweight or obese increases your risk of having a heart attack and causes many other health issues, but we can all take simple steps to improve our health by being more active and doing regular exercise, cutting down on unhealthy foods and alcohol and stopping smoking.

"Healthy cholesterol and blood pressure levels are a key part of good cardiovascular health and these can be checked at routine appointments with a member of the team at your local surgery. Anyone who has a family history of heart disease, or who is worried by the findings of the new self-test, can seek further help from reputable sources like NHS choices or from a healthcare professional who can advise on next steps."

GPs welcome new advice on 'jargon-free' communication with patients

"When we're all so busy, it's easy to use language we're most familiar with as doctors, and other forms of short hand and jargon that might even be difficult for doctors working in one specialty to understand from doctors working in another, so for patients it could be really confusing.

"By hospital doctors writing any letters directly to patients, with their GP copied in so we are always aware of what is happening regarding our patient’s care, it should make the process more patient-centred, and make them feel more involved in their care, which will be beneficial for everyone. However, it must result in a patient-centred letter that allows the patient to understand what has happened, what has been found, and what the future plan should be. I have seen a number of patients who have asked me to 'translate' the letter they have received from the hospital, which has been little more than a medical summary.

"This is a really important change to the way doctors communicate with patients, and I'm pleased that through the Academy the concept has gained support from all specialties – it's now important to get the message out to healthcare professionals across the NHS, and start the wheels in motion."

Better communication between hospitals and GPs could have 'huge impact' on heart care, says College

He said: "Heart failure is a very serious condition and one that GPs are acutely attuned to look out for in patients - but in the early stages of the disease, some symptoms can be vague and more likely to indicate other, more common conditions.

"Nevertheless, GPs and our teams will routinely monitor our patients at-risk of heart disease through cholesterol and blood pressure testing - as well as advocating healthy lifestyles for patients, and offering advice to help them make lifestyle changes that could reduce their risk of heart disease. We will take a holistic approach to care, and strive to include our patients in the decision making about their treatment, wherever possible.

"Whilst the paper shows that more patients with heart disease have had appropriate tests in primary care over the past couple of decades, even better access for GPs to diagnostic tools in the community would certainly help to improve detection of heart disease.

"Currently, GPs often have to rely on 'red flag symptoms' that could indicate heart failure, such as breathlessness, swelling in the legs, or general fatigue. Symptoms can be different from patient to patient, and few present with all the tell-tale signs of heart failure, which makes it difficult to identify without access to more sophisticated tests - and particularly challenging within the constraints of a standard 10-minute consultation.

"There also needs to be improved communication between hospitals and GPs which, as this research shows, can have a huge impact on the quality of follow-up care for heart failure patients, and the starting point for this will be greatly enhanced, joined up IT systems between primary and secondary care.

"Ultimately, general practice makes the vast majority of NHS patient contacts, alleviating pressures on secondary care by acting as the gateway to specialist services. We need the tools to be able to do this, which is why the College is calling for £2.5bn extra a year as part of the Prime Minister's long-term plan for the NHS - on top of what has already been promised in NHS England's GP Forward View, which needs to be delivered in full, and as a matter of urgency.

Better access to mental health therapists promises to 'radically change' care, says College

She said: "As a profession, GPs are embracing the development of GP-led multi-disciplinary teams, working together in the best interests of patients – and the skills that mental health therapists bring to the general practice team are very welcome.

"It's estimated that 90% of patients with mental health conditions first present in general practice, but many patients are having to wait far too long to access specialist services in the community, that could be of great benefit to them.

"Having ready access to specially-trained mental health therapists in primary care, who are integrated into the general practice team, has the power to radically change how we're able to deliver care to our patients, and hopefully improve outcomes for patients with mental health conditions.

"NHS England's GP Forward View promises that every GP practice in the country will have access to one of 3,000 new mental health therapists by 2020/21. We understand that this is on track, but many GPs are unclear about how to access these new roles and how they will be integrated into general practice, so today’s guidance, which promises greater clarity, is welcome.

"As we strive to deliver parity of esteem between physical and mental health, these roles will be vital to support GPs, who are working under intense pressures, and ensure our patients receive the best possible care they need and deserve."