My understanding was, if it was moved to largely self referral it would cut DNAs, as motivation to self refer would correlate with likelihood of engagement.
Perhaps a follow up study of attendance rates for self referrals vs GP referrals would be useful?
I think we have at some point to push patients to take responsibility for their own health - physical and mental. GPs cannot do it all. Changing your own mental health requires a huge amount of motivations, far more than calling IAPT.
Surely, from a logistical perspective, if they managed to get to the GP then they can manage to self refer. I suspect most people would tell you that self referral to IAPT is easier than waiting on the phone to get a GP appointment at 8am!
Decriminalisation, supervised injection sites, widespread supervised injectable heroin and housing the entrenched user - a combination of the Canadian, Portuguese and Swiss models. Doesn’t win votes though, so it’s a long way off. Think of the money that would be saved in the criminal justice system, the fall of the gang culture surrounding the sale of drugs and how that money could be spent on the people that need it.
I agree, a very interesting read and will definitely influence my practice. Out of the 10,000 patients there is no mention of how many had high platelet counts and what was the cut off? The sample size could be quite small? A platelet count over 450 is very alarming?
Why would anyone ever say anything else on the feedback?
Just like the average patient feedback scores of 90-something percent!
I wonder who funded that study....
Physios provide better care than oncologists 0 in 1000 compared to 100s in 1000 mortality. Absolute nonsense statistics.
Far too many confounders for this to show a cause and effect especially considering all 12 drugs of completely different classes and mechanisms showed no difference. Does this just not show depressed people who don’t exercise and overeat also tend to take medication?
If we get them off their opiates and then release them they tend to overdose and die.
The clonazepam and gabapentinoids side of things often comes from the community originally and we do our best to get these whilst in custody, but often they come out and are put straight back on them by well-meaning GPs due to the lack of communication. We almost never start them in prison.
I agree with "Don't believe the hype" - it would be ideally placed to help community GPs say now and continue to say no. Communication is poor currently leaving these guys able to exploit the system.
I was unemployed for four months trying to reinstate myself on the Performers List after voluntarily removing myself in an attempt to save the GMC fees for two years travelling out of the country. 3600 appts lost. Not to mention my losses.
£900,000 for me please!!
Not eligible for discounts on the ebook either. All quite misleading.
Can’t get it to work as an ebook without downloading a whole new app. Won’t read within the browser at all. Plus VAT added so £27 for the electronic version I cannot access from a computer at work. Think carefully before buying. I expect I will be asking for a refund.
Bet it was over pregabalin
Are we really going to put someone on allopurinol for life after one episode, that may never recur, with all the expense, possible side effects and polypharmacy involved? Seems overkill to me and hardly a holistic approach. What is the supposed downside to delaying? Possible 1st MTPJ OA? Is that something that come up often on GP lists? If there were a risk of other pathology then we would likely be discussing allopurinol anyway.
I would have thought this would be good news? Cut polypharmcay, cut expense, cut workload, cut risk.... why are we moaning?
If you are an A&E consultant how much sick pay, annual leave, study leave, training, pension and indemnity does your pay include?
With a positive spin from the press.... "Incredible efficiency in General Practice as GPs manage increasing workload with decreasing numbers of staff and funding".
If I saw a raised Plt count with no obvious cause I wouldn't think it would be too unreasonable to have a quick feel of the tummy, PR, CXR, faecal calprotectin and urine dip. Cheap and cheerful and could potentially save a life or two? It would put you in a much safer position to then recheck the Plt in a month or two.
Brew the perfect storm and then deconstruct.
When is debrief? In the middle of the trainer's afternoon surgery?