Primary Care Knowledge Boost

All things General Practice! Join doctors Sara and Lisa as they interview specialists from around Greater Manchester with the aim of improving the confidence and knowledge of local primary care clinicians. The podcast has been made possible due to the support of Wigan CCG and GP Excellence in Greater Manchester.

Listen on:

  • Podbean App
  • Spotify
  • Amazon Music

Episodes

Wednesday Feb 03, 2021

To teach us more about the New Roles in primary care, as well as the development of existing roles in general practice, Dr Ali Lea and Primary and Community Nurse Lead Lesley Royal-Price join us. The plans for Primary Care Work Transformation are described as ‘making sure we have the right team to deliver the best care looking after people the right way for them’. A great tagline that about sums it up.
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Greater Manchester Primary Care Careers: https://gmprimarycarecareers.org.uk/jobs/
Nursing Leadership and Development Programme: https://www.rcn.org.uk/professional-development/professional-services/leadership-programmes
Greater Manchester Primary Care Nurse Forum (including quarterly Webinars): https://gmprimarycarecareers.org.uk/gm-primary-care-and-community-nursing-forum-13-10-2020/
Leadership and Development Programme for Practice Nurses and other Primary Care Roles: https://gmprimarycarecareers.org.uk/generalpractice/careers/nursing/care-programme/
Greater Manchester GP Excellence Resources: https://gpexcellencegm.org.uk/
Greater Manchester Training Hub: https://www.gmthub.co.uk
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This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Remote Consultations

Wednesday Jan 20, 2021

Wednesday Jan 20, 2021

Lisa and Sara talk to Dr Adam Abbs about remote consulting. Dr Abbs is a GP who has written a handbook about remote consulting which has been accredited by the RCGP. Remote consulting has been in our lives for quite some time now, and this doesn’t look likely to change anytime soon so we thought it was worth getting some more hints and tips to make us all the best remote consulters that we can be. We talk about common pitfalls, how to do some examinations remotely and a couple of special situations such as care homes and patients with visual or hearing impairments.
**This is an amended episode from the one originally uploaded this morning as we realised that an older edit had been uploaded in error.
Primary Care Pathways Website, Remote Consulting: https://primarycarepathways.co.uk/covid-19/clinical-assessment/resources-to-support-remote-working-for-doctors
EGP Learning: https://egplearning.co.uk/
Remote Consultations Handbook: https://www.archealth.io/handbook 
GMC Remote Consultations: https://www.gmc-uk.org/ethical-guidance/ethical-hub/remote-consultations 
Healthier Together Website: https://what0-18.nhs.uk/professionals/gp-primary-care-staff/clinical-pathways-remote-assessment 
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT
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This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Wednesday Dec 09, 2020

Lisa and Sara are joined by  Dr Uma Marthi (GP with a Special Interest in Gynaecology) to discuss some common gynaecological presentations in young girls up to teenage years. She takes us through her approach to vaginal bleeding in neonates, vaginal itch in toddlers, breast development and vaginal discharge in teenagers. 
The British Society for Paediatric and Adolescent Gynaecology (great patient leaflets): https://britspag.org/
Royal College of Obstetrics and Gynaecology guidelines: https://www.rcog.org.uk/en/guidelines-research-services/
NHS Resources example, Vaginal Discharge: https://www.nhs.uk/conditions/vaginal-discharge/
Primary Care Women’s Health Forum: https://pcwhf.co.uk/
eLearning for Health, Female Genital Mutilation Module: https://www.e-lfh.org.uk/programmes/female-genital-mutilation/
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT
___
This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Wednesday Nov 25, 2020

Primary Care Knowledge Boost has teamed up with the Greater Manchester GP and GP Nurse Fellowship schemes as well as the Additional roles in General Practice scheme to incorporate episodes related to these topics into our schedule.
Here to explain what fellowships are is GP and GM training hub Clinical Lead Dr Gill Tonge. It was really interesting to hear the thinking behind the fellowships and hear the aims of supporting doctors and nurses after the first year of qualifying. The content is free and relevant to all in primary care and will include episodes on remote working, practice management skills, leadership and quality improvement. 
Greater Manchester Training Hub (Application for Fellowships): https://www.gmthub.co.uk/
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT
___
This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Headaches

Wednesday Nov 11, 2020

Wednesday Nov 11, 2020

In this episode, Lisa and Sara speak to consultant neurologist, Dr Matt Jones about headaches.
The discussion has a focus on the diagnosis and categorisation of common headaches with a touch of management at the end. We talk through where Dr Jones starts when taking a headache history and how he categorises them. We also discuss features that would be concerning to him, as well as thinking about who he would admit on the day. We then go through examination in the light of COVID-19 and helpful tips about headache management.
North West Headache Management Guideline (2015): http://gmmmg.nhs.uk/docs/guidance/Headache-guidelines-algorithm-temporary-version-30-04-19.pdf
The Migraine Trust: https://www.migrainetrust.org/
Headaches in over 12s: diagnosis and management (Nov 2015): https://www.nice.org.uk/guidance/cg150 
National Migraine Centre: Heads Up Podcast all about Migraine: https://www.nationalmigrainecentre.org.uk/migraine-and-headaches/heads-up-podcast/
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT
___
This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

HIV in Primary Care

Wednesday Oct 28, 2020

Wednesday Oct 28, 2020

Lisa and Sara are joined by GP and HIV lead for Greater Manchester Dr Marlon Morais and Yvonne Richards, an inspiring positive speaker from George House Trust to talk about HIV in Greater Manchester. We cover what it is, it’s prevalence and opportunities for testing. We then go on to speak about the importance of early diagnosis and effective treatment before hearing from Yvonne about her personal journey with HIV that led her to become a passionate advocate for women living with HIV.
The resources are detailed below and we are grateful to Yvonne, Marlon, Victoria Morris and Paul Fairweather for helping to make this episode possible as well as helping to compile these.
Latest Government Prevalence Data on HIV in the UK: https://www.gov.uk/guidance/hiv-overall-prevalence
NICE HIV testing Guidelines: https://www.nice.org.uk/guidance/ng60/chapter/Recommendations#offering-and-recommending-hiv-testing-in-different-settings
British HIV Association (BHIVA) HIV Testing Guidance: https://www.bhiva.org/HIV-testing-guidelines
HIV Indicator Diseases, those in which an HIV test is recommended: http://www.eurotest.org/Portals/0/Indicator%20diseases/CHIP_Guidance%20in%20short_UK_updated%20JUN2016_mlj.pdf
Manchester HIV Charity George House Trust: https://ght.org.uk/
Liverpool Interaction Checker for HIV Medications: https://www.hiv-druginteractions.org/checker
iChart HIV Medication Interaction Checker for Phone: https://play.google.com/store/apps/details?id=com.liverpooluni.icharthiv&hl=en_GB
Fingertips Public Health Profiles (can be used to find out the HIV prevalence in UK regions): https://fingertips.phe.org.uk/search/HIV
UK Wide Charity Terrence Higgins Trust: https://www.tht.org.uk/
Terrence Higgins Trust on Facebook: https://www.facebook.com/6316017331/posts/10158506443587332/?sfnsn=scwspmo
AIDS Maps (HIV and AIDS Charity): https://www.aidsmap.com/
Positively UK HIV Charity: https://positivelyuk.org/
Sophia Forum HIV Charity (focus on politics and women with HIV): https://sophiaforum.net/
National AIDS Trust: https://www.nat.org.uk/
CHIVA: Children’s HIV Association: https://www.chiva.org.uk/
HIV i-Base (HIV Charity focusing on HIV information and advocacy, pictorial approach to HIV): https://i-base.info/
HIV AIDS Foundation: https://www.eltonjohnaidsfoundation.org
HIV: Let's sort this together: https://sorthiv.org.uk/
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT
___
This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Dealing with Uncertainty

Wednesday Oct 14, 2020

Wednesday Oct 14, 2020

In this episode Lisa and Sara talk to Dr Avril Danczak, a GP with an interest in managing uncertainty in medicine which led to her co-authoring the RCGP published book called Mapping Uncertainty in Medicine.We cover what uncertainty is, and why it is important to address this within medicine and general practice.We talk about ‘what to do when you don’t know what to do’, how to classify and identify different forms of uncertainty and then think about how you can go about addressing and managing this uncertainty in a structured way.
Useful resources: 
Book: Mapping uncertainty in medicine, what to do when you don’t know what to do; Avril Danczak, Alison Lea and Geraldine Murphy (2016): https://www.amazon.co.uk/Mapping-Uncertainty-Medicine-What-When/dp/0850844053
Paper: Varieties of uncertainty in medicine; Paul Han, William Klein and Neeraj Arora (2011): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3146626/
Paper: Dealing with uncertainty in general practice: an essential skill for the general practitioner; Margaret O’Riordan et al: https://pubmed.ncbi.nlm.nih.gov/21781433/
Bradford VTS Resources on decisions, diagnoses and uncertainty: https://www.bradfordvts.co.uk/clinical-skills/decisions-diagnoses-uncertainty/
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT
___
This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Polycystic Ovarian Syndrome

Wednesday Sep 30, 2020

Wednesday Sep 30, 2020

This week’s podcast episode is all about Polycystic Ovarian Syndrome with Tameside Consultant Obstetrician & Gynaecologist Dr Mahshid Nickkho-Amiry. It’s a detailed look at the subject using an example case, following this from diagnosis to management. 
Useful resources: 
Royal College of Obstetricians and Gynaecologists - Patient Leaflet on Polycystic Ovarian Syndrome (2015): https://www.rcog.org.uk/en/patients/patient-leaflets/polycystic-ovary-syndrome-pcos-what-it-means-for-your-long-term-health/
Verity - Self Help Charity with excellent online resources for patients:https://www.verity-pcos.org.uk/
NICE - Clinical Knowledge Summaries: https://cks.nice.org.uk/topics/polycystic-ovary-syndrome/
RCOG - Green Top guidelines - Long terms consequences of PCOS (Nov 2014): https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_33.pdf
International evidence-based guideline for the assessment and management of polycystic ovary syndrome (2018):https://pcwhf.co.uk/wp-content/uploads/2018/12/PCOS_Evidence-Based-Guidelines_20181009.pdf
Guidelines - Diagnosis and Management of Polycystic Ovarian Syndrome (Jun 2020): https://www.guidelines.co.uk/womens-health/pcos-uk-guideline/236071.article
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT
___
This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

GI Symptoms in Palliative Care

Wednesday Sep 16, 2020

Wednesday Sep 16, 2020

Managing the common palliative symptoms of nausea, vomiting and constipation can make a world of difference to the quality of life of our patients. This week, Lisa and Sara are joined again by Drs Liam Hosie and Anna Murray to continue their discussion about managing palliative patients in general practice. 
We cover important features in a history that point to the cause of symptoms for nausea/vomiting and constipation. The causes of nausea and vomiting are then broken down to four categories and we consider what medications might work best for these. We go on to discuss managing constipation and point to a helpful guide for further reference.
Useful resources: 
Greater Manchester Medicines Management Group, Palliative Care Pain and Symptom Control for Adults (Fifth Edition, Nov 2019): http://gmmmg.nhs.uk/docs/guidance/GMMMG-Palliative-Care-Pain-and-Symptom-Control-Guidelines-for-Adults-v1-1.pdf#search=%22nausea%22
NICE Clinical Knowledge Summaries, Palliative Care - Nausea and Vomiting: https://cks.nice.org.uk/topics/palliative-care-nausea-vomiting/
NICE Clinical Knowledge Summaries, Palliative Care - Constipation: https://cks.nice.org.uk/topics/palliative-care-constipation/
Wigan & Leigh Hospice Symptom Management Guidelines for the Care of Adults in the Last Hours or Days of Life (Community Version 3): https://d2abk28tx5gxte.cloudfront.net/app/uploads/2018/11/26165005/symptom_management_guidance_end_of_life_adults_community_v3.pdf
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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT
___
This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Pain in Palliative Care

Wednesday Sep 02, 2020

Wednesday Sep 02, 2020

To help us brush up on managing palliative patients with pain, Lisa and Sara speak to Dr Anna Murray (Palliative Care Specialist, WWL) and GP Lead Dr Liam Hosie (Palliative Care and GP, WWL).
We start with a general approach to pain and then move on to consider the causes, discuss opioid titrations as well as adjuvant therapies. We also touch on agitation and breathlessness and when to consider changing the routes of medication.
Useful resources: 
GMMMG Palliative Care Pain and Symptom Control Guidelines for Adults:http://gmmmg.nhs.uk/docs/guidance/GMMMG-Palliative-Care-Pain-and-Symptom-Control-Guidelines-for-Adults-v1-1.pdf
Wigan & Leigh Hospice Symptom Management Guidelines for the Care of Adults in the Last Hours or Days of Life (Community Version 3): https://d2abk28tx5gxte.cloudfront.net/app/uploads/2018/11/26165005/symptom_management_guidance_end_of_life_adults_community_v3.pdf
___
We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://www.surveymonkey.co.uk/r/YLN6GKT
___
This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 
The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.
Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.
The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

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