Primary Care Knowledge Boost

Doctors Sara and Lisa talk to Dr Wasim Javed, ST6 in Cardiology, about the diagnosis and management of Angina. Taking a theoretical case we talk through symptoms, differentials, diagnosis, including the guidelines and practicalities of different types of functional and non-functional tests, as well types of angina and their management. It was useful to understand the initial management once diagnosed, and where further investigations or referrals/discussions with cardiology come in. As well as the above, we discuss the difference between medical management and stenting and some of the third line anti-anginal medications. 
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
NICE guidelines on Stable Angina (updated July 2016): https://www.nice.org.uk/guidance/cg126
European Society of Cardiology 2019 Guideline on Chronic Coronary Syndromes: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Chronic-Coronary-Syndromes
Life in the Fast Lane (ECG interpretations etc): https://litfl.com/library/
Traffic Light System for Primary Care Prescribing in Greater Manchester (contains information on what should be started by Specialists etc): https://gmmmg.nhs.uk/rag-category/adult/
___
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://pckb.org/feedback
___
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.

Doctors Sara and Lisa talk to talk to Dr Mary Cheshire who is the GP lead on the NHS England Fellowships for Greater Manchester GPs. As she explains, this is a fairly informal fellowship done over 2 years offering different types of courses and support that essentially consists of a paid CPD session a week and a range of CPD events to facilitate this. The course runs a qualification in coaching people can sign up for and are offered Mentors. Completing a quality improvement project is encouraged, whether that is small or large and there are opportunities for support for this along the way. At the moment this is available for newly qualified GPs and those up to 2 years after CCT who are in Salaried or Partnership posts. 
There are other types of Fellowships - we mention the Health Education England GP Fellowships and GP Nurses Fellowships briefly, see details below. 
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
The Greater Manchester Training Hub GP Fellowship Information: https://www.gmthub.co.uk/our-programmes/gp-fellowship
Links to information about the GP Fellowship, the GP Nurse Fellowship, Primary Care Mentoring and a course for clinicians New to Primary Care:https://www.gmthub.co.uk/our-programmes
For Questions about the Fellowship and how it works that aren’t answered in the links above: [email protected]
Health Education England GP Fellowships: https://www.nwpgmd.nhs.uk/post-cct-gp-fellowship-programme-hee-nw
___
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://pckb.org/feedback
___
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.

Doctors Sara and Lisa talk to talk to GP and Professor of General Practice Research Dr Carolyn Chew-Graham about the current landscape of Long COVID three years on. She spoke to us on the topic back in August 2021, but what we know and some of the treatments have moved on from then. In this talk we discuss why the patient-preferred term is Long COVID rather than Post COVID Syndrome, symptoms, how many people are living with the condition in the UK to date and some of the types of management and help that are available. 
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
Your COVID Recovery Website: https://www.yourcovidrecovery.nhs.uk/
Interviews with Patients with Long COVID: https://healthtalk.org/Long-Covid-In-Adults/overview
Postural Orthostatic Tachycardia Syndrome:
https://www.potsuk.org
 https://www.potsuk.org/gp_guide
BMJ Article on Orthostatic Tachycardia with Infographic Mentioned (March 2023): https://www.bmj.com/content/378/bmj-2022-072117
Information on Mastocytosis and Mast Cell Activation Syndrome:
https://ukmasto.org/#gsc.tab=0
https://www.potsuk.org/about-pots/associated-conditions/mcas/
Greater Manchester Long COVID Support Group: https://hsm.manchester.gov.uk/kb5/manchester/directory/service.page?id=Rn19N5XSimc
UK Long COVID Support Group: https://www.longcovid.org/
Support Groups for Families with a Child with Long COVID: https://www.longcovidkids.org/
Advice for Supporting a Child with Long COVID: https://theconversation.com/supporting-a-child-with-long-covid-tips-from-parents-of-children-living-with-the-condition-195153
Research on Impact of Long COVID on Racially Minoritised Groups: https://blog.westminster.ac.uk/hicovestudy/
Research on whether existing Medications have any Impact on Long COVID ‘STIMULATE ICP’: https://www.stimulate-icp.org/
LOCOMOTION Study looking at Optimising Treatments in Long COVID: https://bmjopen.bmj.com/content/12/5/e063505
Be Part of Research: What Trials are available (here for people with Long COVID): https://bepartofresearch.nihr.ac.uk/results/search-results?query=long%20covid&location=
National Institute for Health and Care Research: https://www.nihr.ac.uk/patients-carers-and-the-public/i-want-to-take-part-in-a-study.htm
Resources around advice for Returning to Work:
https://www.som.org.uk/take-planned-approach-managing-long-covid-workforce-new-som-guide
 https://www.fom.ac.uk/wp-content/uploads/longCOVID_guidance_04.pdf
 https://bjgp.org/content/71/712/508
NICE RCGP SIGN Guidance on Managing Patients with Long COVID (Last Updated Nov 2021): https://www.nice.org.uk/guidance/ng188
RCGP Online eLearning Module on Long COVID: https://elearning.rcgp.org.uk/course/view.php?id=492
___
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://pckb.org/feedback
___
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.

Doctors Sara and Lisa talk to GP Dr Adam Cliffe about how he and his practice went about changing the model by which patients access the practice. It is so far working very well for both staff and patients. It’s an interesting talk about change management and one example of how a difficult situation was changed for the better. 
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
House of Commons Committee Report: The Future of General Practice Oct 2022: https://publications.parliament.uk/pa/cm5803/cmselect/cmhealth/113/report.html#heading-0
The King’s Fund, Innovative Models for General Practice June 2018: https://www.kingsfund.org.uk/publications/innovative-models-general-practice
___
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://pckb.org/feedback
___
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.

Doctors Sara and Lisa talk to Dr Aseem Mishra, Academic GP trainee involved in helping produce the Guidelines for the Greater Manchester Lipid Pathway. Greater Manchester has very high levels of Major Adverse Cardiovascular Events (MACEs). The guidelines for how to treat hyperlipidaemia and what we’re aiming for have changed. Dr Mishra helps talk through these changes.  Towards the end of the episode, we discuss injectable treatments for secondary prevention including Inclisiran. The resource links are extensive, we hope you find the discussion and the links as useful as we do. 
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
NICE Clinical Knowledge Summaries for Lipid Modification Jan 2023 (links to both Primary and Secondary Prevention): https://cks.nice.org.uk/topics/lipid-modification-cvd-prevention/
Familial Hypercholesterolaemia Assessment Guidelines (links to Simon Broome and the Dutch Lipid Clinic Criteria): https://cks.nice.org.uk/topics/hypercholesterolaemia-familial/diagnosis/assessment-diagnosis/
Statins Prescribing Information, with risks of serious side effects and interactions: https://cks.nice.org.uk/topics/lipid-modification-cvd-prevention/prescribing-information/statins/#adverse-effects
National Statin Intolerance Pathway: https://www.england.nhs.uk/aac/publication/statin-intolerance-pathway/
Manchester Secondary Prevention Lipid Pathway: https://gmmmg.nhs.uk/wp-content/uploads/2023/02/Lipid-Management-Pathway-for-Secondary-Prevention-of-Cardiovascular-Disease-CVD-21.12.22.pdf
GMMMG Prescribing Information for Inclisiran: https://gmmmg.nhs.uk/wp-content/uploads/2022/11/Inclisiran-prescribers-information-leaflet-13.10.22-for-web.pdf
SPIRIT Trial on Inclisiran: https://clinicaltrials.gov/ct2/show/NCT04807400
NHS Accelerated Access Collaborative: https://www.england.nhs.uk/aac/what-we-do/innovation-for-healthcare-inequalities-programme/commercial-partnerships/
Health Innovation Manchester Lipid Webinar and Links to Prescribers and Patient Information for Inclisiran: https://healthinnovationmanchester.com/cvdprevention-lipidpathway-resources/
HeartUK resource on Statins: https://www.heartuk.org.uk/getting-treatment/statins
Reference for the discussion on Plaque Regression: Kalanuria A, Nyquist P and Ling G. (2012) The prevention and regression of atherosclerotic plaques: Emerging Treatments Vascular Health Risk Management: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459726/
Tool to Calculate Lifetime Cardiovascular Disease risk: https://u-prevent.com/
___
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://pckb.org/feedback
___
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.

Doctors Sara and Lisa talk to ENT Consultant Ms Sadie Khwaja about common throat symptoms we encounter in General Practice and get her take on how to assess and manage these. We cover Red Flag symptoms for the neck in detail as well as looking at three cases we commonly encounter; pain on swallowing, globus symptoms and hoarseness. We discuss a useful approach for assessing causes of throat problems, consider the triad of swallowing, breathing and voice difficulties and the importance of feeling for neck lumps amongst other interesting pearls of wisdom. 
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
NICE guidelines for Head and Neck Cancer Referrals: https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#head-and-neck-cancers
Greater Manchester Cancer: Head and Neck Cancer: Homepage: https://gmcancer.org.uk/head-and-neck/
Greater Manchester Cancer: Head and Neck Cancer: 2 week wait Proforma: https://gmcancer.org.uk/wp-content/uploads/2021/10/head-and-neck-referral-form.pdf
EAT-10 Swallowing Screening Tool Score: https://www.exservanhcp.com/assets/dist/pdfs/eat-10-screening-tool.pdf
Use of proton pump inhibitors to treat persistent throat symptoms: multicentre, double blind, randomised, placebo controlled trial. BMJ Jan 2021: https://www.bmj.com/content/372/bmj.m4903
British Voice Association (BVA) resources: https://www.britishvoiceassociation.org.uk/free.htm
British Voice Association (BVA) resources: General Voice Care Advice: https://www.britishvoiceassociation.org.uk/downloads/free-voice-care-literature/Take%20care%20of%20your%20voice.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://pckb.org/feedback
___
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.

Doctors Sara and Lisa talk to Dr Maiedha Raza to find out her take on issues of Equality and Diversity in General Practice. This is a gentle dive into the very complex world of diversity and inclusivity with messages of how we can improve our culture in the NHS. 
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
Talks by Nancy Kline: Time to Think: https://www.youtube.com/channel/UCNF-NcrXmaOHp1KmLxIuNOw
Pulse Article: Over one in five young GPs has experienced racism at work (Jan 2023): https://www.pulsetoday.co.uk/news/workforce/over-one-in-five-young-gps-has-experienced-racism-at-work/
Psychological Safety: https://psychsafety.co.uk/about-psychological-safety/
TED Talk by Amy Edmonson Building a Psychologically Safe Workplace (May 2014): https://www.youtube.com/watch?v=LhoLuui9gX8
British Medical Association Equality and Diversity Guidance: https://www.bma.org.uk/advice-and-support/equality-and-diversity-guidance
British Medical Association Delivering Racial Equality in Medicine Report (2020): https://www.bma.org.uk/advice-and-support/equality-and-diversity-guidance/race-equality-in-medicine/delivering-racial-equality-in-medicine
NHS leadership Academy Inclusion, Equality and Diversity Resources: https://www.leadershipacademy.nhs.uk/inclusion-equality-and-diversity/
NHS Leadership Inclusivity Course: https://www.leadershipacademy.nhs.uk/programme-course-1-inclusive-leadership-in-health-and-care/
Induction Resources for International Medical Graduates: https://www.e-lfh.org.uk/programmes/nhs-induction-programme-for-international-medical-graduates/#:~:text=The%20National%20Induction%20programme%20has,transition%20to%20UK%20clinical%20practice.
TED Talk By Tiffany Alvoid: Eliminating Microaggressions: The Next Level of Inclusion: https://www.ted.com/talks/tiffany_alvoid_eliminating_microaggressions_the_next_level_of_inclusion
Professor Camara Jones Talk on Anti-Racism and Health: Levels of Health Intervention (Nov 2022): https://www.youtube.com/watch?v=yEHXVUiUMtU
Toolkit: Being an Ally: https://www.imperial.nhs.uk/-/media/website/about-us/how-we-work/equality-and-diversity/allyship-toolkit_14_03.pdf?rev=ff58666cce764881ac223312733c4abb&hash=93DED6E338883958AD0176E3FC130E86
___
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://pckb.org/feedback
___
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.

Doctors Lisa and Sara talk to Dr Sarah Taylor about the changes being made to how Primary Care Clinicians refer patients for Suspected Lower Gastrointestinal Cancers. These changes are discussed in the context of referring in the Greater Manchester area, but you can view the  joint guideline from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology below. This will change the way we manage patients. To help, we go through some potential cases. Good tips for how to mitigate potential risks with the changes included. We hope you find this useful.
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
Faecal immunochemical testing (FIT) in patients with signs or symptoms of suspected colorectal cancer (CRC): a joint guideline from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG): https://www.bsg.org.uk/clinical-resource/faecal-immunochemical-testing-fit-in-patients-with-signs-or-symptoms-of-suspected-colorectal-cancer-crc-a-joint-guideline-from-the-acpgbi-and-the-bsg/
GatewayC FIT infographic: http://bit.ly/409mXUy
GatewayC Lower GI infographic: http://bit.ly/3XJpIKN
Raised Platelets and Cancer Risk: https://gpnotebook.com/en-au/simplepage.cfm?ID=x2019111783915921223
The Current NICE Guidelines last Updated December 2021: https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#lower-gastrointestinal-tract-cancers
___
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://pckb.org/feedback
___
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.

Doctors Sara and Lisa talk to GP Dr David Bartlett who works with the Neuroendocrine Cancer UK charity and GP Dr Will Evans who is a researcher specialising in rare diseases. We wanted to discuss how they  approach finding rare diseases in General Practice whilst balancing this with the risk of over investigating. We start with definitions and classifications before discussing where neuroendocrine cancers fit into this landscape. Their pearls of wisdom could help us keep our antenae up, referrals helpful and resources for clinicians and patients well stocked. 
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
British Journal of General Practice Article: Rare diseases in General Practice: Recognising the Zebras among the Horses. Evans, W & Rafi I (Vol 66, 2016): https://bjgp.org/content/66/652/550
Rare Disease UK: https://www.raredisease.org.uk/
Neuroendocrine Cancer UK: https://www.neuroendocrinecancer.org.uk/
Royal College of GPs eLearning on Neuroendocrine Cancers (search here): https://www.rcgp.org.uk/learning-resources/courses-and-events/elearning-courses
Medics for Rare Diseases: https://www.m4rd.org/
Information on Beckwith Wiedemann Syndrome: https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/beckwith-wiedemann-syndrome-bws/
Inattentional Bias Studies with Radiology:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964612/
https://pubmed.ncbi.nlm.nih.gov/17412097/
Mnemonic Family GENES Reference: Genetic red flags: clues to thinking genetically in primary care practice. Whelan et al. Primary Care: Clinics in Office Practice (Sept 2006): https://pubmed.ncbi.nlm.nih.gov/15331244/
Resource with helpful leaflets for Chromosomal Diseases: https://rarechromo.org/
OMIM: An Online Catalogue of Human Genes and Genetic Disorders: https://www.omim.org/
Gene Reviews: https://www.ncbi.nlm.nih.gov/books/NBK1116/
Orphanet Rare Disease Platform with Search Engine: https://www.orpha.net
Rare Disease Search Engine: https://www.findzebra.com/https://www.ndr-uk.org/browse
___
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://pckb.org/feedback
___
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.

Doctors Sara and Lisa talk to Dietician Charlotte Cockman about managing weight for patients who are overweight or obese in General Practice. This includes a discussion around the definitions of overweight and obesity, risk factors, and what terms are less stigmatising when discussing weight with patients. Charlotte talks to us about her approach to weight, eating and health, and how this approach can encourage long term behavioural changes that focus on health and nutrition rather than weight. We discuss management options including what tier two and three NHS services do, as well as where some medications and surgery fit into this picture.
You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)
Useful resources: 
NICE Clinical Knowledge Summaries Obesity (Sept 2022): https://cks.nice.org.uk/topics/obesity/
Waist to Height Ratio: https://www.nice.org.uk/guidance/cg189/chapter/Recommendations
Greater Manchester Diabetes My Way: Healthy Living Support for People with Diabetes:https://diabetesmyway.nhs.uk/
The Association of UK Dieticians Resources: https://www.bda.uk.com/food-health/workplace-health-work-ready/what-we-do/resources.html
Giles Yeo Webinar: https://mynutriweb.com/why-calories-dont-count/
Giles Yeo ‘Why Calories don’t count’ Book: https://www.betterworldbooks.com/search/results?q=Giles%20Yeo
Giles Yeo: ‘Let’s consider the type of food we eat, not fixate on calories’ The Guardian. David Cox (Jun 2021): https://www.theguardian.com/science/2021/jun/20/giles-yeo-why-calories-dont-count-diet-interview
British Dietetic Association Food Resources: https://www.bda.uk.com/food-health/food-facts.html
Resources on Weight Stigma: https://www.bda.uk.com/news-campaigns/campaigns/managing-and-preventing-obesity/eliminating-weight-stigma-comms-guidelines.html
https://www.worldobesity.org/what-we-do/our-policy-priorities/weight-stigma
For Healthcare Professionals interested in more Nutritional Knowledge: https://mynutriweb.com/
Nutrition information leaflets: https://www.ndr-uk.org/browse
___
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://pckb.org/feedback
___
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.