Reflections at a challenging time…..
I’m sure we’ll agree that it is a strange time for all of us.
Last week was ‘Mental Health Awareness week’ and members of the MH Special Interest group would have been attending the Primary Care Mental Health conference at the University of York on 21st May. You can find the submitted abstracts on the SAPC website
The focus of MH Awareness week was kindness, and, for me, the importance of being kind both to ourselves as well as each other is even more important during the pandemic restrictions. ‘Zoom fatigue’ (other platforms are available) is being described and I have found the need for venturing out of the house into ‘green spaces’ is vital to maintain my wellbeing.
As a result of COVID-19, our work – clinicians in their practices, educationalists delivering teaching online, and health service researchers trying to keep previous studies on track – is needing to adapt and respond almost daily to changes in external factors.
A number of colleagues are at the forefront of COVID-19 related research. The School for Primary Care Research (SPCR) has funded Mairead Murphy, University of Bristol, who is leading the “Rapid COVID-19 intelligence to improve primary care response” (RAPCI) study, which is investigating the current demands on GP practices, the challenges, and the creative solutions practices have developed in response to the COVID-19 pandemic. This information will be used to support general practices more effectively. The research team will collect quantitative data on 111 calls and GP appointments for the one million patients in Bristol North Somerset and South Gloucestershire to examine the impact COVID-19 is having on the nature of workload, delivery of primary care and patients’ health-seeking behaviour. The research team will also conduct brief regular interviews with staff at selected GP practices to understand the challenges, the innovations practices have put in place and what can be done to support practices further to meet demand during the pandemic.
Mairead commented “Since mid-March 2020 practices have implemented new ways of managing workload and repurposed their physical environments to safeguard staff and patients. It is essential that we examine how practices are coping with these changes to share challenges and innovations and support GP practices to continue safely delivering care to patients who need it.”
A COVID-19 primary care database consortium was established in April 2020 across seven academic departments (including five within the SPCR). Collectively, its researchers have ongoing COVID-19 projects in overlapping datasets with millions of primary care records representing 30% of the UK population, that are variously linked to public health, secondary care and vital status records.
SPCR is supporting projects within this database consortium which will link routine health data recorded in general practice, to public health and secondary care records. A consensus agreement has been developed which aims to facilitate transparency and rigour in methodological approaches, as well as consistency in defining and reporting cases, exposures, confounders, stratification variables and outcomes in relation to the pharmacoepidemiology of COVID-19. Hajira Dambha-Miller, University of Southampton, states that “This work will facilitate comparison, validation and pooling of research during and after the pandemic. The document is available as a pre-print in the Annals of Family Medicine COVID-19 collection.”
Another study will link primary care records with the records of the most severely ill patients admitted to hospital intensive care units. Knowing more about who is most at risk of harm will enable health care professionals to advise patients on how to minimise their exposure to the virus, make decisions about when to treat people – earlier for those most at risk - and prioritise treatments for those who are most likely to benefit. Data will be drawn for this study from the Clinical Practice Research Datalink (CPRD) and the Intensive Care National Audit and Research Centre (ICNARC). Rupert Payne, University of Bristol says “As well as answering initial questions on risk stratification, the new linked data has the potential to serve as an invaluable resource for future academic primary care research looking at the wider impact of the pandemic on primary care health services.”
Meanwhile, Joanne Reeve, Hull/York Medical School, has been working hard to launch the WISE GP website, supported by SAPC, RCGP and SPCR. WISE GP aims to help all GPs understand more about the everyday knowledge work of general practice, develop the clinical scholarship skills needed, and connect with others doing similar work. Do take a look at the website - which is still under development, and will be launches with some publicity in July, when we would have been meeting for the ASM - and contact Joanne if you wish to contribute a GEM.
I do hope we continue to be kind to ourselves and each other. Do contact any of the members of the SAPC Executive team if we you feel we can help you.