UK Primary Care from BMJ Learning
This short film demonstrates the primary care model used in the UK's NHS.
Partial Transcript
Good primary care is the main reason that
makes the UK NHS one of the
most efficient health systems in the
world.
Led by General Practitioners, or GPs
primary-care teams work in general
practice clinics which are also called
surgeries.
They provide comprehensive, continuous and
holistic care to patients.
The vast majority patient contacts are made by
appointments.
Good afternoon, Ley Hill Surgery.
Hello, I'd like to book an appointment please.
Appointments can be made by phone, as in the case here,
by appearing in person, or over the
internet.
Lovely, 3:30 today, Dr. Huang.
Okay, thanks see you later.
My typical day starts,
I would say, a quarter to 8. I get here
at a quarter to 8 and I'll start leaving for
home about quarter to 7. So
between that time,
broadly speaking, I run two clinics:
one morning,
one afternoon,
with home visits during the day
and administrative work.
Ley Hill Surgery is testing the automatic
messaging system
to see if this reduces non-attendance
rates.
This has generally been well-received by
patients but it is too early as yet
to know if this is having a significant
impact on reduction of
non-attendance.
For each of our clinics, morning and afternoon,
I probably see about seventeen patients.
These are
booked appointments. I'll do a couple of
home visits,
on average,
and then there will be lots and lots of administrative work to catch up with. Correspondence
from secondary care colleagues,
results to review, letters from patients
or phone calls to return.
And also management work
to do with running of the practice.
The practice maintains records of all
patients from birth to death.
The bank of files here of the older
paper records used prior to the records
going fully electronic in the year
2000 at the practice.
In the UK,
patients have to register with a general
practice near their homes and they
cannot go to hospital directly for care without referral from the GPs.
This is why we often call GPs
gatekeepers of the health system.
I see patients of
all age groups from children right
through to old age. In fact, I'd say
that only a small minority of
children end up seeing hospital
pediatricians.
Only a small number all mentally ill
patients ever see a psychiatrist.
The great bulk of
medical conditions are dealt with here in
general practice.
We are the gatekeepers, we sort everything
and only refer
problems as required for help
by second care colleagues.
These pictures introduced some of the key
personnel at the practice.
They include doctors, nurses and administration
staff.
The task of delivering healthcare
involves a range of skills working
closely in a team.
There are a number of factors behind the success of
of British General Practice.
As a medical specialty,
General Practice has its origin in the
UK.
It therefore has a long history
and has been a main feature of the
system since the inception of the
NHS in 1948.
GPs are very popular among the public.
They enjoy a high status in the medical
profession.
Good income, at such that the disparity
between GP income and specialists income is minimal.
So that stops being the reason why people choose
whether they're going to become a GP or specialist.
In fact, some of the best
medical students, the best
graduates, choose General Practice as their future careers
The practice is an
undergraduate and postgraduate training
practice and commonly has medical
students and trainee general
practitioners seeing patients.
patients understand this and are usually
happy to play their part in medical
education.
I chose General Practice for my career because I like the idea of being more of a generalist.
So when you're in a hospital specialty you kind of stick to one area whereas I
like the fact that GPs need a breadth of knowledge
and they get loads of experience in different
areas.
I also like the relationship
that you built with patients and also
their families. The whole concept of being
a family doctor and having a bit more of
holistic approach to health care
is also really appealing to me.
And also I really like the flexibility
that GP brings with it.
So it's quite
family-friendly
in terms of working hours and everything
else so, I think those are the main reasons why
I chose GP as my career.
These young doctors
then receive
rigorous and systematic training for
several years.
Therefore the overall quality of our GPs
is improving all the time.
Notice that there is no cash till.
The NHS is a free to access service
and patients do not pay at the
point of use.
There are consultation rooms around the waiting room.
And to ensure privacy and
confidentiality for patients
the speaker plays background music to
prevent any possibility of the consultations being overheard.
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Holistic care in the management of asymptomatic follicular lymphoma
George Follows, MA, BM, BCh, PhD, FRCP, FRCPath from Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK discusses holistic care in the management of asymptomatic follicular lymphoma at the 2017 British Society for Hematology (BSH) Annual Scientific Meeting in Brighton, UK. Asymptomatic patients are usually actively monitored, with no treatment given straight away, also known as ‘watch and wait’. This can cause anxiety, especially in patients who are still coming to terms with their diagnosis. Holistic care is important in these patients, and current advice includes support associations, such as the Lymphoma Association, counselling and diet changes. He states that holistic treatment is very individualized, and that it is difficult to generalize across different patient demographics. This video has been supported by Napp Pharmaceuticals Ltd through an unrestricted educational grant to Magdalen Medical Publishing.
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Does reflexology really work?
(2 Feb 2009) SHOTLIST
London, United Kingdom, 9th December 2008
1.Wide of therapist Rosanna Bickerton and patient entering room for treatment
2.Mid shot of patient getting on treatment bed facing therapist
3.Mid shot of therapist putting cream on hands and rubbing feet
4.Close up of therapist's face
5.Close up of reflexology on foot
6.Close up of patient's face
7.Close up of reflexology on toes
8.SOUNDBITE: (English) Patricia Parnell, reflexology patient
I got off the bed and I felt I'd got much more energy inside me and with glandular fever you do get reoccurrence of it until it finally kind of dispels itself from the system and I did have several more sessions of it, but each time it lasted for a lot less.
9. Various wide and close up of patient lying down and being given reflexology treatment
10.SOUNDBITE: (English) Rosanna Bickerton, reflexologist
We don't know how reflexology works. There are various theories, that we think impulses travelling from the feet where we're working go up via the nerves or the acupuncture meridians to the corresponding part of the body. But we don't really know What we do know is that it has been around for four and a half thousand years, so it has been tested by time as we say.
11.Close up of reflexology on foot
12.Various mid and close of therapist changing towel and starting reflexology on second foot
13.Various close and wide of therapist giving patient reflexology
14.Pan of table with cream and model feet
15.Various close up of model feet with marked out reflexology zones which correspond to other parts of the body
16.SOUNDBITE: (English) Rosanna Bickerton, reflexologist
I think there's definitely a part of reflexology which has this placebo effect. One of our jobs as a reflexologist is to relax our client, or patients and when the patient is relaxed the body has the ability, has the time to get well. The other part of this is the non placebo effect is that we're stimulating very specific points on the feet corresponding to parts of the body, so we're aiming stimulate that part of the body into health and work most effectively.
17. Various of patient being given reflexology
18. Poster showing reflexology points of the ears
19. SOUNDBITE: (English) Professor Edzard Ernst, Professor of Complementary Medicine, University of Exeter
You need to have a comparison and that is actually the principle of a clinical trial. When you do clinical trials on reflexology and there are about a dozen of such studies you'll find that the relaxation effect of reflexology is pretty well documented there's no doubt about it, but whether it has any specific effect beyond relax, whether it has any specific effect beyond relaxation and whether there are any specific points related to specific organs is more than doubtful.
20.Wide of patient finishing therapy
21. Various of poster demonstrating reflexology points
LEAD IN:
Reflexology is becoming an increasingly popular treatment among complementary therapists in the United Kingdom and their apparently growing number of patients.
The British Reflexology Association claims that the therapy which is based around foot massage, can be used to treat a number of stress related conditions.
But while medical doctors are generally happy to accept that there are beneficial effects from a relaxing massage, they dispute whether these can be said to 'cure' any illnesses.
STORYLINE:
After getting glandular fever last year Patricia Parnell felt listless and exhausted.
The fever is caused by a viral infection for which there is no specific treatment. Parnell, like other patients, was told told to take plenty of fluids and avoid exertion and exercise, but a couple of months later
in illness and unblocking them can restore energy and balance.
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NHS to Private Conversion - Success Story
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