Primary Care Knowledge Boost

The next in our series talking about additional roles in primary care is all about paramedics in general practice. Lisa and Sara speak to Scott Murray, who has been working as a paramedic within primary care for some time now, having transitioned through acute care and urgent care. He talks us through his journey, why he chose to move to primary care and some tips for both paramedics and the general practice team about how to make that transition.
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Health Education England: Paramedics in Primary Care: (Resource link for paramedics interested in General Practice and for General Practitioners and Practice Managers interested in taking on paramedics): https://www.hee.nhs.uk/our-work/primary-care/first-contact-practitioners-advanced-practitioners-paramedics
Greater Manchester Primary Care Careers: https://gmprimarycarecareers.org.uk/jobs/
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.

Lisa and Sara are joined by Dr Amar Rughani to discuss his approach to leadership. We talk about the importance of considering our influence, place in the world and how to achieve our goals. We consider our motivations for doing what we are doing in life; the importance of taking that step back to really consider why, how and what we are doing in the world and in general practice. From this we can then consider what we want the future to look like. Future episodes will then focus on how to get there.
To get in touch with Amar: [email protected]
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Book: Amar Rughani and Joanna Bircher (2020) The Leadership Hike, Shaping Primary Care Together, First Edition, CRC Press: https://www.routledge.com/The-Leadership-Hike-Shaping-Primary-Care-Together/Rughani-Bircher/p/book/9780367236984
Book: Erich Fromm (2003) Man for Himself First Edition Routledge Classics: https://www.bookdepository.com/Man-for-Himself-Erich-Fromm/9780805014037?ref=grid-view&qid=1612957185376&sr=1-2
Book: Roger Neighbour (2015) The Inner Consultation: How to Develop an Effective and Intuitive Consulting Style, Second Edition, CRC Press: https://blackwells.co.uk/bookshop/product/9781857756791?gC=5a105e8b&gclid=Cj0KCQiApY6BBhCsARIsAOI_GjZXqwnpj-8-NEg_nzo5sFRFej67mV70jhmMP5BQ9Ot-il7VJsyypp8aAuQOEALw_wcB
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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.

As part of their mini-series in Primary Care New Roles, Lisa and Sara spoke with Physician Associate Ricky Staniland to get an idea of how he became a Physician Associate in General Practice and what his role includes at present. Definite learning points were just how varied and useful Physician associates can be in practice. As part of her role as clinical director of Primary Care Workforce and Greater Manchester Training Hub, Dr Ali Lea joins the discussion.
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Greater Manchester Primary Care Careers: https://gmprimarycarecareers.org.uk/jobs/
Health Education England: Physician Associates in Primary Care: (Resource link for Physician Associates interesting in General Practice and for General Practitioners and Practice Managers interested in taking on Physician Associates): https://www.hee.nhs.uk/our-work/primary-care/physician-associates-primary-care
North West Physician Associate Training Programmes: https://www.nwpgmd.nhs.uk/physician_associate
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.

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.

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.

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
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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.

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
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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.

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
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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.

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
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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.

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
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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.