Abstract
RCGP SCA preparation courses
The RCGP is offering both 1-day and 3-day comprehensive Simulated Consultation Assessment (SCA) preparation courses to equip trainees with the skills, strategies and confidence to help them pass the SCA. Courses, run monthly, offer interactive sessions with experienced trainers and examiners, providing realistic scenarios and expert guidance.
More information can be found at www.rcgp.org.uk/mrcgp-exams/courses
Housing letter
The balance between being paid for the work we do and charging or not helping people who can least afford to ask for help is becoming progressively more difficult.
‘When he asks for a letter to validate his need
I do not think
This is not NHS work.
I think of all the reasons a man deserves a home.
I think of the terrible rawness that makes a man weep.’
This is a quote from a poem written by Rebecca Quinn, a London GP.
There are no right answers to this sort of dilemma. I suggest you read the whole poem and talk with your practice and peers on how it makes you feel.
Quinn R (2023) Housing letters: The dilemma. British Journal of General Practice 73(732): 319–320. DOI: 10.3399/bjgp23X733401.
Check up
We all see patients who ask for blood tests to ‘check everything is ok’. This ’10-minute consultation’ article gives a suggested plan, including finding out the underlying health worries, looking for specific risk factors and explaining false positives and the risk–benefit ratio. Two patient reviewers gave feedback on the article and made suggestions for questions, such as ‘If you didn’t have this [symptom, worry, problem] would you still need the blood tests?‘
I need to declare a competing interest – I belong to the same RCGP overdiagnosis group as two of the authors.
Buss L, Spitzer D and Watson J (2023) Can I have blood tests to check everything is alright? BMJ 382(8393): 204–205. DOI: 10.1136/bmj-2023-075728.
Zero carbon
Laura-Jane Smith and her colleagues have published a timely article looking at ways to reduce the carbon footprint of asthma care. As well as focusing on choice of asthma inhaler, they also focus on correct diagnosis and taking opportunities to review asthma care to optimise treatment and reduce waste.
If you are interested, Greener Practice has resources to help.
Smith LJ, Bhugra R, Kelani R, et al. (2023) Towards zero carbon healthcare: Asthma care. BMJ 382(8389): 34–37. DOI: 10.1136/bmj-2022-072328.
Sustainable Christmas dinners
I have been doing some work with medical students recently about the Planetary Health Diet, considering how we can improve eating habits for the benefit of both people and the planet. Considering the excess food and waste that often comes at this time of year, I was interested to read the tips provided in this article from The Independent on how to make your Christmas dinner more sustainable.
Webb S. How can you make Christmas dinner more sustainable? The Independent. Available at: www.independent.co.uk/climate-change/infact/christmas-dinner-sustainable-b1973003.html (accessed 26 August 2023).
Exercising indoors
For our older patients, the colder weather may make it more challenging to get outside to keep physically active. However, encouraging them to keep moving is vital to prevent individuals becoming more frail over the winter months. Why not suggest the simple exercise videos or handouts provided by Age UK? A great range of movements that can be done indoors and will help to maintain strength.
www.ageuk.org.uk/information-advice/health-wellbeing/exercise/
Academic primary care
For those of you who may be pursuing, or interested in an academic career, two articles from the British Journal of General Practice are worth a read. The first addresses the challenges, but also is a call to arms to have primary care better represented in research. The second is a more recent and very helpful ‘Top Tips’. From my own experience and observing close colleagues in academic general practice all points are spot on!
Faraz Mughal F, Atherton H, Reeve J, et al. (2022) Academic primary care: Challenges and opportunities. British Journal of General Practice 72(716): 104–105. DOI: 10.3399/bjgp22X718577.
Wanat M, Redmond P, Barry T, et al. (2023) Ten things I wish I had known about academic primary care. British Journal of General Practice 73(729): 176–177. DOI: 10.3399/bjgp23X732465.
Palliative patients at Christmas
For many patients and their carers, this Christmas may be particularly challenging and emotional. I found this article helpful not only for patients with palliative conditions who may be apprehensive about the festive season, but many of the tips would also be really helpful for carers.
patient.info/news-and-features/coping-with-christmas-when-you-have-a-terminal-illness
Mocktails and merriment
At this time of year, alcohol consumption will rise with both short- and long-term effects. I do believe part of the job of primary care is to continually promote and nudge patients towards healthier lifestyle choices. If your practice does this on a website or information board, what about highlighting non-alcoholic options? The following links contains recipes for non-alcohol cocktails, including a seasonal non-alcohol cider and a celebratory non-alcohol bellini. You might also want to point patients towards the ‘drink free days’ app promoted by the NHS.
Future Me
While New Year’s resolutions often seem to be dismissed – too easily broken, too hard to keep – I do always like to consider this time of year as an opportunity for reflection and consideration of the future. I recently came across the idea of a ‘Future Me’ list – a list of things that you want to do, achieve, become – dreams, ambitions, things you would put on a bucket list. What I had not realized, is that there is a ‘Future Me’ website, on which you can plan to send yourself emails at a specific point in the future, to motivate yourself, remind yourself of something to do or to reflect and celebrate what you have achieved.
Eczema at Christmas
Why does patients’ eczema gets worse over the festive season? There may be lots of triggers for this: stress, central heating being on more, different foods, lack of routine … this post provides some helpful tips that can be passed on to patients to help at this time of year.
Christmas disease
Factor IX disease is called Christmas disease because the disease was first described in a 5-year-old boy called Stephen Christmas. There are many medical eponyms. There is a debate about the modern acceptability of these names – many are named after mainly white men, some with unpleasant political and humanitarian associations. Do we keep the names but ensure the history is discussed? Do we add a more balanced selection of names or do we change the disease names?
Stuart Smith J, Scott K and Johnston M (2022) Where are all the women? Available at: litfl.com/where-are-all-the-women (accessed 5 August 2023).
