Abstract
Early childhood
An Academy of Medical Sciences report has highlighted a series of numbers describing childhood in the United Kingdom, including: 30th out of 49 for infant mortality in OECD (Organisation for Economic Cooperation and Development) countries; one fifth of children aged five years are overweight or obese; a quarter of all five-year-olds affected by tooth decay.
All of the numbers show a socio-economic gradient. Although much of the change needed at societal level, the report highlights the need for change in the way we in healthcare, look after children.
The Faculty of Public Health in conjunction with other national bodies and charities has produced a report on ‘Good food for children’. They discuss and make recommendations about free school meals, the National Breakfast Programme and Healthy Start vouchers.
The Academy of Medical Sciences (2024), Prioritising early childhood to promote the nation’s health, wellbeing and prosperity. Available at: acmedsci.ac.uk/file-download/96280233 (accessed 1 March 2024).
The Faculty of Public Health (2024) Health of the next generation. Good food for children Available at: www.fph.org.uk/media/zehhk0dg/good-food-for-children-full-report.pdf (accessed 1 March 2024).
Being a good doctor
It can be very easy to just work very hard for many hours as a GP. Professor Cassandra has set up a website focusing on medical virtues and vices to help us think about our role as generalists.
New to the UK
The British Medical Association has produced a set of free resources for doctors new to the United Kingdom.
Cervical cancer vaccine
A study by Public Health Scotland has shown no cases of invasive cervical cancer found in women who were vaccinated at ages 12 and 13, and in those vaccinated aged 14–22 a significant reduction in cases.
Palmer T, Kavanagh K, Cuschieri K, et al. (2024) Invasive cervical cancer incidence following bivalent human papillomavirus vaccination: A population-based observational study of age at immunization, dose, and deprivation. Journal of the National Cancer Institute, djad263. DOI: 10.1093/jnci/djad263.
Welcome new readers
At the start of another academic/training year, some of you may be receiving InnovAiT for the first time as new GPSTs, some may now have become a ‘First Five’, some of you may be trainers picking this up as you welcome new trainees to your practice. Personally, I always feel fortunate to effectively have two ‘starts’ within each lap around the sun, another opportunity as the summer ends to consider the (academic) year ahead, make plans and goals, consider what matters most. I hope for those new readers you enjoy picking up jour monthly copy of InnovAiT, and that it adds to your learning not only within but also outside the box.
Migraine resource
I recently came across a really helpful patient information webpage/leaflet from the Walton Centre on managing migraine. The information around what causes migraine is helpful and in a good level of detail, and I like the management steps, all built on lifestyle approaches first – not only in preventing migraines, but also in managing the acute onset of a migraine.
www.thewaltoncentre.nhs.uk/patient-leaflets/migraine-a-comprehensive-guide/479279
Physical activity in osteoarthritis
I am always on the lookout for resources for patients to help incorporate physical activity into their lives. I was impressed with the Versus Arthritis page on physical activity, which has an exercise programme for those awaiting or recovering from joint surgery, as well as other videos and stretching programmes for individuals with osteoarthritis.
https://versusarthritis.org/about-arthritis/healthcare-professionals/physical-activity
GP trainees as educators
Many readers will have been involved in delivery of teaching to undergraduate students, foundation programme and potentially other trainees. As the article by Bull et al. (2024) identifies, this is often an ‘add on’ rather than a core part of training. What are your thoughts on this? Is teaching something we should be hoping all GPs will be involved in to some extent, with a need to ensure high quality primary care teaching to inspire and promote medical students and junior doctors? Or given the pressures of training and exams is it something that should remain more of a ‘specialist interest’?
Bull S, Coster S, Scott K, et al. (2024) GP trainees as teachers: A rapid review of the barriers, facilitators and outcomes. Education for Primary Care, 1–16. DOI: 10.1080/14739879.2023.2278369.
Anabolic steroid use
I was interested to come across this article (and learn a new acronym!); the authors present a clinical guideline for identifying, investigating and initial management of patients presenting with image and performance-enhancing drugs (IPEDs). Well worth reviewing, particularly if this is a particular problem in your practice population.
Gibbons S, Moulding M, Bailey K, et al. (2024) Essential blood testing in the patient using androgenic anabolic steroids: A clinical practice guideline for primary care. British Journal of General Practice 74(741): 187–190. DOI: 10.3399/bjgp24X737013.
Bone health
Recent experiences both personal and professional have made me reflect on bone health as we age. I was impressed with the International Osteoporosis Foundation’s webpage. It has a risk calculator – which although it doesn’t calculate a score, unike FRAX, it helps patients to identify their own possible risk factors – highlighting commonly used drugs like selective serotonin reuptake inhibitors. There is also a calcium calculator, enabling individuals to work out whether they are consuming enough of this nutrient in their diet.
So long fit notes?
At the time of writing, Rishi Sunak had announced plans to change the system for fit notes to remove this role and responsibility from GPs. I have differing opinions on this – what about you? I have had conversations with patients in which the fit note system appears to have worked particularly well, navigating the patient’s time off and return to work in a supportive and well-communicated way. At other times, fit note discussions feel like fruitless conversations. I am certainly intrigued to see how proposals develop.
Self-help leaflets
Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust has a wide range of mental health leaflets including several specifically for prisoners, easy read and other accessibility font changes and translation into multiple languages.
Parachute books
A parachute book is a picture book that can be used to help talk about new or difficult circumstances and emotions. The Little Parachutes website allows you to search for books on a particular topic e.g. having a prosthetic eye, or the at home parent having cancer treatment.
Coproduction
Healthcare Improvement Scotland has produced a Participation Toolkit that gives examples of different ways to engage with patients. If you are thinking of a quality improvement project, there is a large range of ideas for engaging with, collecting feedback from, and sharing results with patients.
www.hisengage.scot/equipping-professionals/participation-toolkit
Dementia
Bangor University has produced some leaflets with simple hints for people supporting someone living with dementia. the leaflets are available in both Welsh and English
