Primary Care Knowledge Boost

This is another episode in the series looking at all of the different roles that exist within primary care. Doctors Lisa and Sara speak to Charlotte Cockman who is a Dietician working in Primary Care in South Manchester. They discuss what a Dietician is and what the role can look like in Primary Care. It’s a new role and can be tailored to best suit the community. They also cover what the training consists of, what the day job looks like and advice for clinicians in Primary care around brief discussions with patients on nutrition. The discussion ends with some quick fire questions around supervision, opportunities for further professional development and registration requirements
Useful resources: 
Greater Manchester Primary Care Careers: https://gmprimarycarecareers.org.uk/jobs/
Greater Manchester Training Hub: https://www.gmthub.co.uk
A Roadmap to Practice: https://www.hee.nhs.uk/sites/default/files/documents/A%20Roadmap%20to%20Practice.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 Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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.

Drs Sara and Lisa tackle another urology topic today - recurrent urinary tract infections (UTIs) in non-pregnant women. They speak to Ian Pearce who is a consultant urologist at Manchester Royal Infirmary. They discuss what UTIs are, and what makes them recurrent vs relapsing. They also chat through how to assess someone with recurrent UTIs and highlight some of the risk factors, before talking about the red flags for more sinister causes.
The management options for recurrent UTIs are also covered, from conservative options to medications, including a detailed dive into antibiotic prophylaxis. They also get Ian’s opinions on who to refer to urology.
Useful resources: 
Conservative management tips: Bladder and Bowel Community UK: https://www.bladderandbowel.org/bladder/bladder-treatments/urinary-tract-infection-treatments/
NICE Recurrent UTI Guidelines (Published Oct 2018): https://www.nice.org.uk/guidance/ng112
Guidelines in Practice: The diagnosis and management of uncomplicated recurrent urinary tract infection (March 2019): https://www.guidelines.co.uk/urology/uncomplicated-recurrent-uti-guideline/454623.article
GMMMG Antibiotic Prescribing Guidelines (last updated Oct 2021): https://gmmmg.nhs.uk/wp-content/uploads/2021/10/GM-Antimicrobial-guidelines-OCT-2021-v10.0.pdf
BMJ article: Methenamine hippurate for recurrent urinary tract infections, published on 9/3/22 (after episode was recorded): https://www.bmj.com/content/376/bmj.o533
___
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 Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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.

****DISCLAIMER - CONTAINS STRONG LANGUAGE****
Doctors Lisa and Sara talk with GP Dr Austin O'Carroll. Austin works in Inner-City Dublin with marginalised and homeless/rough sleeping communities. He is co-founder of Safetynet Ireland, North Dublin City GP Training, and GPCareForAll. He talks to us about his take on how unhelpful the label of personality disorder is for patients in his care, about his take on the situation: the Triple F**k syndrome, and how medicine contributes to the systemic oppression of people born into poverty. We talk about trauma informed care and examples of outcomes for patients in his care. 
Useful resources: 
Dr Austin O'Carroll's TED talk about developing health services for homeless people (July 2017): https://www.youtube.com/watch?v=GiwRSPY_JqI
Safetynet Ireland Charity: https://www.primarycaresafetynet.ie/
GPCareForAll: https://www.gpcareforall.org/our-story
BJGP Article: The Triple F**k Syndrome: How medicine contributes to the systemic oppression of people born into poverty (Jan 2022): https://bjgplife.com/the-triple-fk-syndrome-how-medicine-contributes-to-the-systemic-oppression-of-people-born-into-poverty/
___
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 Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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 with Consultant Urologist Dan Burke about Lower Urinary Tract Symptoms in Men. We start with how to divide symptoms into voiding and storage. Red flags to consider are discussed, before tackling cases that lead us to talk about bladder diaries, tips for assessing the prostate and how PSA discussions have changed since the introduction of MRI scans and transperineal prostate biopsies. In discussing the thorny subject of prostate cancer and best treatment choices for individuals, we talk about radical treatment, advanced disease and the difference between watchful waiting and active surveillance. Though we talk about men, it is well worth mentioning these symptoms will apply to all people with a prostate including trans women and some non-binary people.
Useful resources: 
NICE Clinical Knowledge Summaries (Updated March 2019): https://cks.nice.org.uk/topics/luts-in-men/
Guidelines in Practice (2014): Full assessment is key for men with lower urinary tract symptoms: https://www.guidelinesinpractice.co.uk/mens-health/full-assessment-is-key-for-men-with-lower-urinary-tract-symptoms/341437.article
Urinary Frequency Charts to assess bladder volume, polyuria and nocturia: https://bladdermatters.co.uk/downloads/85923fchart.pdf
LUTS in Men Tower Hamlets NHS guidelines (2012) includes patient information sheets: https://www.qmul.ac.uk/blizard/ceg/media/blizard/images/documents/Lower-Urinary-Tract-Symptoms-in-Men,-Care-Pathway,-January-2012.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 Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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.

This episode is part 2 of our focus on Quality Improvement. This time Drs Lisa and Sara are joined by Dr Varshini Rajakulendran alongside Dr Joanna Bircher. Varshini is a GP who is on the NHS England fellowship, and she talks to us about a quality improvement example that she is currently working on around weight management. Joanna (our resident QI expert) has a passion for the subject and has been involved in writing guidelines and teaching for QI. 
We hear why Varshini chose this particular project, and the context to it including enablers and barriers. Joanna then helps us break it down further, thinking about the tool used, considering the aim of the project, what was and could be measured and what ideas were implemented and tested during the project. 
If you haven’t already, we recommend listening to “An Introduction to Quality Improvement” which provides some great initial theoretical knowledge about QI.
Useful resources: 
Quality Improvement Resources by the Royal College of General Practitioners: https://www.rcgp.org.uk/clinical-and-research/our-programmes/quality-improvement/quality-improvement-guide-for-general-practice.aspx
RCGP QI Ready: https://qiready.rcgp.org.uk/
Domains of Healthcare Quality: http://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities/DefiningQualityAimingforaBetterHealthCareSystem.aspx
Public Health England National General Practice Profiles: https://fingertips.phe.org.uk/profile/general-practice/data#page/8/gid/2000005/pat/166/par/E38000220/ati/7/are/M85736/yrr/1/cid/4/tbm/1 
GP Patient Survey data: https://www.gp-patient.co.uk/
Prescribing data: https://openprescribing.net/
Institute for Healthcare Improvement (IHI) Model for Improvement: http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx 
The Health Foundation booklet: Quality Improvement made simple, written by Bryan Jones, Esther Kwong and Will Warburton: https://www.health.org.uk/sites/default/files/QualityImprovementMadeSimple.pdf
RCGP Quality Improvement Webcast with Dr Joanna Bircher Aug 2019: https://youtu.be/BJSbvu3j0cE
The Q Community Webcast: ‘Can QI help us to match capacity and demand in General Practice with Dr Joanna Bircher’: https://www.youtube.com/watch?v=RS-GMMZgbfw
Run Chart Tool: https://www.england.nhs.uk/improvement-hub/wp-content/uploads/sites/44/2017/11/A-guide-to-creating-and-interpreting-run-and-control-charts.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 Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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.

This is another episode in the series looking at all of the different roles that exist within primary care. Lisa and Sara speak to Heidi West who is a nursing associate as well as an apprenticeship facilitator for nursing associates, and Marina Khan who is a trainee nursing associate. 
They discuss what a nursing associate is and how they differ from health care assistants and nurses. They also cover what the training consists of, and the day job and remit of a nursing associate. The discussion ends with some quick fire questions around supervision, opportunities for further professional development and registration requirements.
Useful resources: 
Greater Manchester Primary Care Careers: https://gmprimarycarecareers.org.uk/jobs/
Greater Manchester Training Hub: https://www.gmthub.co.uk
University of Salford Nursing Associate Programme: https://www.salford.ac.uk/courses/degree-apprenticeship/nursing-associate-nursing-associate-higher-apprenticeship
A Roadmap to Practice: https://www.hee.nhs.uk/sites/default/files/documents/A%20Roadmap%20to%20Practice.pdf
Nursing and Midwifery Council: Nursing Associates Information: https://www.nmc.org.uk/about-us/our-role/who-we-regulate/nursing-associates/
Information on Career Development for Nursing Associates: https://www.healthcareers.nhs.uk/explore-roles/nursing/roles-nursing/nursing-associate
___
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 Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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.

Joining doctors Lisa and Sara on today’s episode are GP and Perinatal Mental Health Champion Dr Carrie Ladd and Perinatal Psychiatrist Dr Sarah Jones. We discuss types of mental illness that can be experienced in the perinatal period and the challenges in primary care when helping patients and families. We cover tips for addressing these challenges, focusing on communication, resources and managing medications. We also talk about the impact of the pandemic and the Spotlight programme for disseminating perinatal mental health teaching and training trainers.
Useful resources: 
RCGP Perinatal Mental Health toolkit: https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/perinatal-mental-health-toolkit.aspx 
Best Use of Medicines in Pregnancy ‘Bumps’ website: https://www.medicinesinpregnancy.org/
The Lancet Series on Perinatal Mental Health (2014): https://www.thelancet.com/series/perinatal-mental-health
NICE Guidance on antenatal and postnatal mental health: clinical management and service guidance: https://www.nice.org.uk/guidance/cg192
Proud 2 b Parents Organisation: https://www.proud2bparents.co.uk/
Dad Matters Organisation: https://dadmatters.org.uk/
The Dad Pad, advice for new fathers: https://thedadpad.co.uk/
First 1001 days movement: https://parentinfantfoundation.org.uk/1001-days/
Action on Postpartum Psychosis Charity: https://www.app-network.org/
Maternal Mental Health Alliance Charity: https://maternalmentalhealthalliance.org/
Tommy's Trust: https://www.tommys.org/
Maternal OCD Organisation: https://maternalocd.org/
___
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 Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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.

Drs Lisa and Sara are joined by GP Dr Nikesh Vallabh, Consultant Cardiologist Dr Karthikeyan and Consultant Gastroenterologist Dr Bliss to discuss advice and guidance.
For those unfamiliar, the advice and guidance system came about to try to ease pressure on the long outpatient waiting lists, providing a different way of managing some cases. It is in place for a number of specialties for primary care clinicians to ask questions to consultants, getting an answer that will help guide patient care within a matter of short weeks at most. We talk about the system and where it can fit in to make a difference to patient care. We take the opportunity to go through some common themes and glean learning points from these to help our own practice.
Useful resources: 
Wigan, Wrightington and Leigh have their own LFTs guideline that should be available on the intranet or contact the local CCG
BMJ LFTs Algorithm 2017: https://www.bsg.org.uk/wp-content/uploads/2019/12/Guidelines-on-the-management-of-abnormal-liver-blood-tests.pdf
Greater Manchester Guidelines for managing patients with dyspepsia in primary care: https://gpexcellencegm.org.uk/resources/guidelines-for-managing-patients-with-dyspepsia-in-primary-care/#.YFEP4C2l23U
NICE guidelines Chronic Heart Failure in Adults: Diagnosis and Management (2018) https://www.nice.org.uk/guidance/ng106
___
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 Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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.

Drs Lisa and Sara welcome Dr Joanna Bircher back to the podcast to speak about an area which she is very passionate about - Quality Improvement. 
We talk about what quality improvement is, how it differs from audits and why it’s so important within general practice. We also learn about the processes that can be followed when approaching quality improvement, and some helpful tools and tips to think about before you start. We hope it’s accessible for all within general practice, and think it provides a great starting point for those considering quality improvement within their setting.
Useful resources: 
Quality Improvement Resources by the Royal College of General Practitioners:https://www.rcgp.org.uk/clinical-and-research/our-programmes/quality-improvement/quality-improvement-guide-for-general-practice.aspx
RCGP QI Ready: https://qiready.rcgp.org.uk/ 
Domains of Healthcare Quality: http://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities/DefiningQualityAimingforaBetterHealthCareSystem.aspx
Public Health England National General Practice Profiles: https://fingertips.phe.org.uk/profile/general-practice/data#page/8/gid/2000005/pat/166/par/E38000220/ati/7/are/M85736/yrr/1/cid/4/tbm/1 
GP Patient Survey data: https://www.gp-patient.co.uk/ 
Prescribing data: https://openprescribing.net/ 
Institute for Healthcare Improvement (IHI) Model for Improvement: http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx 
The Health Foundation booklet: Quality Improvement made simple, written by Bryan Jones, Esther Kwong and Will Warburton:https://www.health.org.uk/sites/default/files/QualityImprovementMadeSimple.pdf
RCGP Quality Improvement Webcast with Dr Joanna Bircher Aug 2019:https://youtu.be/BJSbvu3j0cE
The Q Community Webcast: ‘Can QI help us to match capacity and demand in General Practice with Dr Joanna Bircher’:https://www.youtube.com/watch?v=RS-GMMZgbfw
Run Chart Tool: https://www.england.nhs.uk/improvement-hub/wp-content/uploads/sites/44/2017/11/A-guide-to-creating-and-interpreting-run-and-control-charts.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 Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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.
 

Drs Lisa and Sara talk to Dr Luke Wookey, Dr Joanna Bircher and Ava Bircher for an introduction to Trans and Non-Binary Health in General Practice.
We start with all important definitions, which leads us to talking about coding, healthcare records and a discussion about screening and health inequalities. We talk about how our practices and consultations can be welcoming, before considering Hormone Replacement Therapy and NHS funded surgical options which are potential options for people accessing Gender Clinics. We move onto health issues that disproportionately affect Trans and Non-Binary people, and discuss important resources for clinicians and patients. A lot more could be said but we hope you will find this a useful resource for the whole Primary Care Team to access. 
Useful resources: 
LGBT Foundation including links to Pride in Practice: https://lgbt.foundation/
GMC ethical guidelines: Your rights as lesbian, gay, bi and trans patients: https://www.gmc-uk.org/Ethical-guidance/Patient-guides-and-materials/LGBT-patient-guide?utm_source=press&utm_medium=press%20release&utm_campaign=LGBT
Royal College of General Practitioners Transgender Care: https://www.rcgp.org.uk/policy/rcgp-policy-areas/transgender-care.aspx
TransActual UK: Supporting trans patients: A brief guide for GP surgery staff (excellent resource and links): https://www.transactual.org.uk/gp-surgery-trans
Information for trans and non-binary patients seeking fertility treatment: https://www.hfea.gov.uk/treatments/fertility-preservation/information-for-trans-and-non-binary-people-seeking-fertility-treatment/
Changing Name Greater Manchester LMC Guidance: https://manchesterlmc.co.uk/wp-content/uploads/2016/06/LGBT-Foundation-changing-a-trans-persons-name.pdf
Changing Name and Gender, Primary Care Support England Flow Diagram: https://pcse.england.nhs.uk/media/1291/process-for-registering-a-patient-gender-re-assignment.pdf
Greater Manchester Indigo Gender Service: https://indigogenderservice.uk/
Gender Identity Research and Education Society (includes eLearning packages): https://www.gires.org.uk/
The World Professional Association of Transgender Health: https://www.wpath.org/
The Royal College of General Practitioners Gender Variance eLearning module: https://elearning.rcgp.org.uk/course/search.php?search=transgender
Mutual Aid Resource for trans and non binary people in Greater Manchester: https://www.consortium.lgbt/member-directory/trans-mutual-aid-manchester/
Information about Hate Crimes, reporting them and third party Hate Crime centres: https://www.report-it.org.uk/home
___
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
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This podcast has been made with the support of Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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.