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General practice 

General practice
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date: 24 July 2021

Chapter 13: General practice

1 Adapted from The King's Fund. General practice in England: an overview. The King's Fund, 2009. http://www.kingsfund.org.uk/sites/files/kf/general-practice-in-england-overview-sarah-gregory-kings-fund-september-2009.pdf

2 GP capitation fee = £136/6 = £23. A&E figure from Department of Health. Reference costs 2011–12. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213060/2011-12-costs-publication.pdf

3 Marinker M, Peckham PJ (eds). Clinical Futures. London: BMJ Books; 1998.Find this resource:

4 Schneider EC et al. Mirror, mirror 2017: international comparison reflects flaws and opportunities for better US health care. The Commonwealth Fund; 2017. http://www.commonwealthfund.org/interactives/2017/july/mirror-mirror/

5 Starfield (1994) quoted in Taylor RJ et al. General Practice Medicine: An Illustrated Colour Text. Edinburgh: Churchill Livingstone; 2003.Find this resource:

6 Zimmerman GL et al. A ‘stages of change’ approach to helping patients change behavior. Am Fam Physician 2000; 61(5):1409–16. http://www.aafp.org/afp/2000/0301/p1409.htmlFind this resource:

7 Storr E. Motivational interviewing: a positive approach. InnovAiT 2011; 4(9):533–8. doi:10.1093/innovait/inr045. http://www.bradfordvts.co.uk/wp-content/onlineresources/0200consultation/changingbehaviour/motivational%20interviewing%20by%20emma%20storr.pdfFind this resource:

8 WHO/UNICEF. Alma-Ata 1978: Primary Health Care. Geneva: WHO/UNICEF; 1978. http://www.unicef.org/about/history/files/Alma_Ata_conference_1978_report.pdf

9 OpenLearnWorks. Health management, ethics and research module: principles of primary health care. http://labspace.open.ac.uk/mod/oucontent/view.php?id=454398&section=1.5.1

10 Stewart MA et al. Patient-centred medicine: transforming the clinical method (2nd ed). Oxford: Radcliffe Medical Press; 2003.Find this resource:

11 Wilson A, Childs S. The effect of interventions to alter the consultation length of family physicians: a systematic review. Br J Gen Pract 2006; 56(532):876–82. PubMed ID: 17132356. http://pubmedhh.nlm.nih.gov/cgi-bin/abstract.cgi?id=17132356&from=cqsrFind this resource:

12 Balint M. The Doctor, His Patient and the Illness. Edinburgh: Churchill Livingstone; 1957.Find this resource:

13 Byrne PS et al. Doctors talking to patients. London: RCGP; 1976. https://doi.org/10.1017/S0033291700006498

14 Stott NCH et al. The exceptional potential in each primary care consultation. JRCGP 1979; 29:201–5. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2159027/pdf/jroyalcgprac00124-0011.pdf

15 Pendleton D et al. The Consultation: An Approach to Learning and Teaching. Oxford: Oxford University Press; 1984.Find this resource:

16 Neighbour R. The Inner Consultation. Newbury: Petroc Press; 1987.Find this resource:

17 Kurtz S et al. Teaching and Learning Communication Skills in Medicine (2nd ed). Oxford: Radcliffe Medical Press; 2004.Find this resource:

18 Cox K. What doctors need to know. A note on professional performance. Med J Aust 1992; 157(11–12):764–8. PubMed ID: 1454004. https://www.ncbi.nlm.nih.gov/m/pubmed/1454004/#fft

19 Freeman G et al. Continuity of care and the patient experience. The King's Fund; 2010. http://www.kingsfund.org.uk/sites/files/kf/field/field_document/continuity-care-patient-experience-gp-inquiry-research-paper-mar11.pdf

20 NHS Digital. Prescriptions Dispensed in the Community, Statistics for England - 2006-2016. https://digital.nhs.uk/catalogue/PUB30014. [Note: cost per GP is total item cost in England £9,204,900,000/total GPs in England (2016) = 40,490 = £230k.]

21 Cushing A, Metcalfe R. Optimizing medicines management: from compliance to concordance Ther Clin Risk Manag 2007; 3(6):1047–58. PubMed ID: 18516274. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2387303/Find this resource:

22 American College of Preventive Medicine. Medication adherence: improving health outcomes time tool: a resource from the American College of Preventive Medicine. 2011. http://www.acpm.org/?MedAdhereTTProviders

23 Bergman-Evans B. AIDES to improving medication adherence in older adults. Geriatr Nurs 2006;27:174–82. PubMed ID: 17378797. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2203247/table/tbl1/

24 Campbell NC et al. Treating hypertension with guidelines in general practise. BMJ 2004; 329(7465):523–4. PubMed ID: 15345603. http://bmj.bmjjournals.com/cgi/content/full/329/7465/523?ehomFind this resource:

25 Heneghan C et al. Hypertension guideline recommendations in general practice: awareness, agreement, adoption, and adherence. Br J Gen Pract 2007; 57(545):948–52. Comment in: Br J Gen Pract 2007; 57(545):939–40, & Br J Gen Pract 2008; 58(549):277. PubMed ID: 18252069. http://www.ncbi.nlm.nih.gov/m/pubmed/18252069/Find this resource:

26 Eccles MP et al. Is untargeted educational outreach visiting delivered by pharmaceutical advisers effective in primary care? A pragmatic randomized controlled trial. Implement Sci 2007; 2(1):23. PubMed ID: 17655748. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994680/Find this resource:

27 Baird et al. Understanding pressures in general practice. The King’s Fund; May 2016. https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/Understanding-GP-pressures-Kings-Fund-May-2016.pdf

28 Patient. Clinical negligence and the electronic patient record. Patient; 2015. http://www.patient.co.uk/doctor/clinical-negligence-and-the-electronic-patient-record

29 North Staffordshire Local Medical Committee. General practitioner visiting guidelines. North Staffordshire Local Medical Committee; June 2008. http://www.northstaffslmc.co.uk/archive/Documents/VISGUIDE%20revised.pdf

30 NICE. Depression in adults with a chronic physical health problem: recognition and management (CG91). NICE; 2009. https://www.nice.org.uk/guidance/cg91/chapter/1-Guidance#step-1-recognition-assessment-and-initial-management-in-primary-care-and-general-hospital

31 British Geriatrics Society. Fit for Frailty. British Geriatrics Society; 2018. https://www.bgs.org.uk/sites/default/files/content/resources/files/2018-05-14/fff2_short.pdf

32 NICE. Dementia, disability and frailty in later life – mid-life approaches to delay or prevent onset (NG16). NICE: 2015. https://www.nice.org.uk/guidance/ng16

33 Office for National Statistics. Sickness absence in the labour market: 2016. Analysis describing sickness absence rates of workers in the UK labour market. https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/labourproductivity/articles/sicknessabsenceinthelabourmarket/2016

34 DVLA. Assessing fitness to drive - a guide for medical professionals. DVLA; 2018. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/670819/assessing-fitness-to-drive-a-guide-for-medical-professionals.pdf

35 Department for Transport. Drug driving and medicine: advice for healthcare professionals. Department for Transport; 2014. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/325275/healthcare-profs-drug-driving.pdf

36 Civil Aviation Authority. Assessing fitness to fly. Guidelines for health professionals. http://www.caa.co.uk/Passengers/Before-you-fly/Am-I-fit-to-fly/Guidance-for-health-professionals/Assessing-fitness-to-fly/

37 General Medical Council (GMC). End of life care: when to consider making a do not attempt CPR (DNACPR) decision. GMC; 2013. http://www.gmc-uk.org/guidance/ethical_guidance/end_of_life_DNACPR_decision.asp

38 NHS Scotland. Do not attempt cardiopulmonary resuscitation: integrated adult policy. NHS Scotland; 2010. http://www.scotland.gov.uk/resource/doc/312784/0098903.pdf

39 Huber M. How should we define health? BMJ 2011; 343:d4163. PubMed ID: 21791490. http://www.bmj.com/content/343/bmj.d4163

40 Editorial. What is health? The ability to adapt. Lancet 2009; 373(9666):781. https://doi.org/10.1016/S0140-6736(09)60456-6Find this resource:

41 Tudor Hart J. Three decades of the inverse care law. Commentary. BMJ 2000; 320:18–19. PubMed ID: 10671038. http://www.ncbi.nlm.nih.gov/pubmed/10671038

42 The Black Report. Inequalities in Health: Report of a Research Working Party. London: DHSS, 1980.Find this resource:

43 RCGP. General Practice 2022. RCGP; 2012. http://www.rcgp.org.uk/policy/rcgp-policy-areas/general-practice-2022.aspx

44 The King’s Fund. What is Social Prescribing? The King’s Fund; 2017. https://www.kingsfund.org.uk/publications/social-prescribing

45 Fletcher AE et al. Population-based multidimensional assessment of older people in UK general practice: a cluster-randomised factorial trial. Lancet 2004; 364(9446):1667–77. PubMed ID: 15530627. http://pubmedhh.nlm.nih.gov/cgi-bin/abstract.cgi?id=15530627&from=cqsrFind this resource:

46 British Heart Foundation. Do more exercise? I’d rather die! BHF, September, 2007. ('Only 38% of Brits would be motivated to do more exercise if their life depended on it, a survey for the British Heart Foundation reveals today'.) http://www.gponline.com/exercise-id-rather-die/article/932952

47 UNICEF. Child poverty in perspective: an overview of child well-being in rich countries. UNICEF; 2007. https://www.unicef.org/media/files/ChildPovertyReport.pdf

48 Luo W et al. [Comparison between the effectiveness of two oral health education program for middle-school students.] Hua Xi Kou Qiang Yi Xue Za Zhi 2007; 25(3):266–8. PubMed ID: 17629203. http://pubmedhh.nlm.nih.gov/cgi-bin/abstract.cgi?id=17629203&from=cqsrFind this resource:

49 Zarocostas J. How posters promote publish health behaviour. BMJ 2010;340:c964. PubMed ID: 20159891. https://doi.org/10.1136/bmj.c964

50 Jorgensen T et al. Effect of screening and lifestyle counselling on incidence of ischaemic heart disease in general population: Inter99 randomised trial. BMJ 2014; 348:3617. PubMed ID: 24912589. http://www.ncbi.nlm.nih.gov/pubmed/?term=24912589

51 NICE. Smoking prevention and cessation overview. NICE. http://pathways.nice.org.uk/pathways/smoking

52 Raw M et al. Smoking cessation: evidence based recommendations for the healthcare system. BMJ 1999; 318(7177):182–5. PubMed ID: 9888919. http://bmj.bmjjournals.com/cgi/content/full/318/7177/182Find this resource:

53 Whittaker R, et al. Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev 2012; 11:CD006611. PubMed ID: 23152238. http://www.ncbi.nlm.nih.gov/m/pubmed/23152238/?i=6&from=tobacco%20text%20messaaging

54 Office for National Statistics. Statistical bulletin: Alcohol-specific deaths in the UK: registered in 2016. Deaths in the UK which are known to be direct consequences of alcohol misuse. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/bulletins/alcoholrelateddeathsintheunitedkingdom/registeredin2016

55 Anderson P. Effectiveness of general practice interventions for patients with harmful alcohol consumption. Br J Gen Pract 1993; 43(374):386–9. PubMed ID: 8251237. http://pubmedhh.nlm.nih.gov/cgi-bin/abstract.cgi?id=8251237&from=cqsrFind this resource:

56 Herbal Medicines. https://www.nhs.uk/conditions/herbal-medicines/

57 Ernst E. Is reflexology and effective intervention? A systematic review of randomised controlled trials. Med J Aust 2009; 191(5):263–6. PubMed ID: 19740047. https://www.ncbi.nlm.nih.gov/pubmed/19740047Find this resource:

58 Sundberg T et al. Towards a model for integrative medicine in Swedish primary care. BMC Health Serv Res 2007; 7:107 PubMed ID: 17623105. http://pubmedhh.nlm.nih.gov/cgi-bin/abstract.cgi?id=17623105&from=cqsr

59 Hardip S et al. The sensitivity and specificity of four questions (HARK) to identify intimate partner violence: a diagnostic accuracy study in general practice. BMC Fam Pract 2007; 8:49. PubMed ID: 17727730. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2034562/

60 Arie S. Derbyshire village wins court battle. BMJ 2006; 333(7566):461. PubMed ID: 16946323. http://www.bmj.com/cgi/content/full/333/7566/461-aFind this resource:

61 Reductio Ad Absurdum. In: Internet Encyclopedia of Philosophy. http://www.iep.utm.edu/r/reductio.htm

62 Griffiths C et al. How effective are expert patient (lay led) education programmes for chronic disease? BMJ 2007; 334(7606):1254–6. PubMed ID: 17569933. http://www.bmj.com/cgi/content/full/334/7606/1254Find this resource: