Imperial College London Primary Care

Dr Sonia Kumar has been appointed as the new Head of Undergraduate Primary Care Teaching the Department of Primary Care and Public Health at Imperial College London. She will take up her post in February 2013. Dr Kumar has worked as a GP in South London for the past 11 years. Her academic interests started about the same time, whilst working as a GP Assistant, at GKT Medical School where she taught on a number of undergraduate courses. This led her to study for a Masters in Primary Care at Kings College, which she completed in 2004 with a Distinction. Her Masters dissertation looked at the effectiveness of PBL as a teaching tool in medical schools. She then joined the London Deanery 8 years ago working as a local Programme Director for Kings and then 3 years ago was appointed as a Pan London Director for Quality and Innovation. She has been involved in teaching for the Deanery's Faculty Development Unit and with GP recruitment and assessment Panels. In November 2012, she join...

There are significant variations in the quality of primary care in London, according to a new report commissioned by NHS London from The King’s Fund and Imperial College London . The report was featured by a number of media outlets, including the BBC and Pulse . General practice in London faces unique challenges - its population is more transient and diverse, with hundreds of different first languages spoken. It is also growing faster than elsewhere in England. While on some measures Londoners are healthier than people from other parts of the country, widespread inequalities exist, with life expectancy varying by up to nine years and infant mortality three years between different parts of the capital. The report highlights some examples of excellent performance - for example, some deprived parts of the capital have the highest rates of child immunisation in the country, and London practices have made good progress in adopting new information technology. However, Londoners also repo...

Lizzie Cecil, who has been working within PCPH since October 2010, joined the Child Health Unit in September and has embarked on a PhD. Her research will look at reducing unplanned hospital admissions in children. The aim of the project is to investigate the factors associated with the rise in admissions: I s need, a rise in chronic and/or infectious disease dictating the trend or have other factors such as access and health seeking behaviour increased in influence over time?

Year 3 has seen an increase in intake which means it now has over 400 students compared to around 340 in Year 1. This increase in student numbers has meant recruiting even more GP tutors to teach, adding to the many already in use, some of whom are stationed as far as Shetland. More patients have been recruited for Year 1’s First Clinical Attachment which gives first year students the opportunity to meet patients and hear their experiences with long term care. We publicised the programme through flyers/posters, which were sent to contacts and advertised in healthcare publications/magazines and so far the response has been excellent. On another, sadder note, Kate Woodhouse, our Primary Care Undergraduate Education Manager, will be leaving the department in October. Kate has worked for Imperial College for 12 years and has been here with us at the department for 8 of those, racking up a colossal amount of knowledge and experience which has been an invaluable asset to our department....

Milagros Ruiz has joined the Unit as a Research Associate. Originally an astrophysicist, Milagros has recently completed a Master’s degree at the University of Essex on Statistics and Data Analysis with a focus on Statistical Quality Control. Within the Unit, she will initially be looking at comparing out of hospital mortality rates in the UK, USA and other European countries. The aim is to shed light on the relationship between in-hospital mortality rates and lengths of stay. Carmen Tsang attended the LINNEAUS EURO-PC conference at the Johann Wolfgang Goethe University of Frankfurt on the 18 and 19 of September. Having attended a LINNEAUS project start-up meeting in 2009, this was an opportunity to learn about the final results of the 12 partner collaboration on patient safety in primary care, which is funded by the European Union Framework 7 Programme. The conference was led by Professor Aneez Esmail at University of Manchester who is the Director of one of the two newly funded N...

A study led by William Palmer on access to treatments, and outcomes, for stroke patients admitted at the weekend appeared on the front page of the Telegraph and was also featured on Radio 4 in July. William is a part-time PhD student based at the Dr Foster Unit, and his research focuses on the feasibility of using administrative data to evaluate the quality and safety of hospital care. The paper confirmed previous international studies which suggested poorer outcomes for patients admitted at weekends but extended the existing analyses by providing explanations for why this might be happening, including access to specialist staff and urgent treatments. He hopes that the results will help accelerate the shift towards providing a more consistent level of NHS care to emergency patients across all days of the week. 

We are delighted to report that Dr Roger Neighbour, past President of the RCGP and author of The Inner Consultation, has been working with the department both as a tutor for Year 5 departmental teaching sessions, and to help support and develop our departmental tutors for the Year 5 consultation skills sessions. So far we have had an interesting workshop exploring a new model of feedback for video consultations; the “windows method” originally described by Professor Colin Coles from University of Winchester and subsequently developed by a Scandinavian group led by Danish GP Jan-Helge Larsen. We are now testing it out with students to see how it works in practice. Roger will be holding further workshops in the department, and we hope to make some available to community GP teachers too.

Congratulations to Dr Sonia Saxena and Dr Josip Car. Both were nominated in Pulse’s annual poll of Top 50 GPs. The poll seeks to name those GPs who are considered to be amongst the most influential GPs in the profession, the NHS and Government policy.

The number of children admitted to hospital in England for acute throat infections increased by 76 per cent between 1999 and 2010, according to new research published by Elizabeth Koshy and colleagues in the journal  Archives of Disease in Childhood . The article was covered by a number of media outlets, including the BBC . Acute throat infection (ATI), which includes acute tonsillitis and acute pharyngitis, is one of the most common reasons for consulting a GP. The majority of ATIs are self-limiting and can be managed at home or by the GP, but a small proportion may require hospital admission. This study investigated admission rates for children up to age 17 with ATI alongside trends in tonsillectomy rates, between 1999 and 2010.  The study was motivated by concerns that the decline in tonsillectomy rates in recent years has led to an increase in hospital admissions for tonsillitis of increased severity. It also investigated whether performing fewer tonsillectomies is as...

Enquiries from prospective PhD students are welcome in any of the  areas of research  carried out in the  Department of Primary Care and Public Health  at Imperial College London. The department is part of the  School of Public Health . We have a highly active and wide-ranging research programmes in public health and primary care. This includes collaborative work with UK and international organisations. Current and past PhD students have undertaken studies on a wide range of projects, including prescribing policy in Thailand; health care equity; deaths from drug overdose; the impact of pay for performance schemes on quality of care; ethnic and socio-economic differences in the management of diabetes and its complications; screening for diabetes and other chronic diseases; the use of new technology to improve health care; the epidemiology and management of diabetes in the countries of the Gulf Cooperation Council; medical ethics; and the epidemiology of c...

The Medical Education Specialist Interest Group ( MESIG ) is a support group and discussion forum for anyone involved in teaching, curriculum development or education research across the medical faculty at Imperial College. MESIG meets once a month to hear from expert speakers, share experiences and offer support and advice for your educational projects. The group meets in an informal atmosphere where participants can discuss the latest thinking in education, ask for advice on ethics approval or funding for their research project, or listen to expert speakers.

Tomorrow's Doctors 2009 highlighted the importance of undergraduates acquiring leadership skills and set out learning outcomes required of medical students. The medical leadership competency framework was commissioned in 2006 by the Department of Health and jointly compiled by the NHS Institute for Innovation and Improvement, and the Academy for Medical Royal Colleges as part of a wider UK project called ‘enhancing engagement in leadership’. This framework lists the key competences that medical students require to become involved in improving and delivering future health services. It also maps these competences to the learning outcomes. In a paper published in JRSM Short Reports , Sian Powell and Graham Easton design online questionnaire to explore current leadership teaching in an undergraduate curriculum, using the medical leadership competency framework (MLCF). Sixty-nine course leads were invited to participate in the questionnaire study. Course leads were asked whether they...

Free bus passes for over-60s may be encouraging older people to be more physically active, say the authors of a study published in the American Journal of Public Health by researchers from the Department of Public Health & Primary Care at Imperial College London. The researchers reached their conclusion by analysing four years of data from the UK National Travel Survey. They found that people with a bus pass are more likely to walk frequently and take more journeys by "active travel" - defined as walking, cycling or using public transport. These associations cut across socio-economic groups, suggesting that wealthier and poorer people are benefiting from the scheme equally. Keeping physically active helps to maintain mental wellbeing, mobility and muscle strength in older people and reduces their risk of cardiovascular disease, falls and fractures. Previous research has shown that 15 minutes of moderate daily exercise is associated with a 12 per cent lower risk of dea...

This is an exciting opportunity for an individual with a Master’s degree or equivalent in Health Services Management/research or a related field. The post holder will be a member of the London (North West) Comprehensive Local Research Network (CLRN) team, responsible for managing a wide variety of projects to support research activity in primary care. The aim of the post is to widen participation in research, particularly in North West London, and ensure that patients and healthcare professionals from primary care are able to participate, and benefit from, clinical research in all areas of disease and healthcare. The appointee will be based at the Charing Cross Hospital campus in Hammersmith, but the role will require frequent travel to general practices across NW London, the CLRN host organisation in Northwick Park Hospital, as well as other collaborating organisations in North West London. The post holder will have substantial experience of healthcare management, extensive knowl...

In a study published in JRSM Short Reports , Sian Powell and Graham Easton from the Department of Primary Care & Public Health at Imperial College evaluated medical students' perceptions of a new community-based surgical module being delivered as part of the third-year clinical methods teaching (CMT) course at Imperial College London. They carried out focus group interviews with medical students who had recently completed the surgical module. Two groups of fourth-year medical students were invited to participate in the focus groups. The first group consisted of seven students from the surgery and Anaesthesia BSc course. The second group consisted of a random sample of five students from other BSc courses at Imperial College. Students' opinions of surgical teaching delivered in the community compared favourably with the surgical teaching delivered in hospitals. Students identified the key benefits as: having protected time to learn regular access to suitable patient...

Michelle van Velthoven from the Department of  Primary Care & Public Health  has been offered a prestigious Santander Mobility Award to assist her in an overseas research trip. This Award was made on  academic merit and her strong personal statement about the value of the trip to her research. The Award is funded directly by Santander, who are committed to investing in University education globally. Imperial has joined the Santander Universities Network, which provides universities across the world with scholarships and other funding. At Imperial, Santander provide scholarships, mobility awards and entrepreneurship prizes. Mobility awards provide Imperial staff and students with the opportunity to further their studies abroad and in doing so, enhance international academic collaboration and boost their own cultural development.

Anthony Laverty’s work on patient choice has received attention in both The Guardian and on Radio 4. A research assistant with CLAHRC, Anthony’s paper, published in the March edition of Health Affairs , finds that although there was widespread media coverage of serious lapses of performance in three hospitals, this had no overall effect in patient numbers at those hospitals. The results of the study, a culmination of work Anthony begun before joining the department, are in line with what is known from other settings. Anthony hopes the results of this paper will lead to the recognition that patient choice alone cannot be relied upon to improve quality in the NHS. He plans to follow this up with other work on more specific clinical areas.

The summer 2012 seminar series has now ended. The seminars started on Wednesday 25 May and were compiled by Dr Felix Greaves. He has organised some very exciting speakers to visit the Department this term and explains the benefits of the seminars. Felix says: “ The seminar series is important because it gives us access to some of the other fascinating work being done in our department, in other parts of Imperial and beyond. A real highlight of the series so far has been Professor Atun talking about the real challenges of global health funding, with wonderful examples fresh from his experiences operating at the highest levels at the Global Fund in Geneva ”. If you would like to get involved and become a part of the Autumn Seminar Series, please contact Jenna Mollaney.

In addition to receiving confirmation that the Dr Foster Unit’s patient safety work will continue within the Centre for Patient Safety and Service Quality , work continues on the Global Comparators project, led by DFI, which involves 30 leading hospitals in five countries sharing data and outcomes for mutual learning and improvement. In February this year, Rene Gaudoin joined as research associate to continue work on the three-year NIHR-funded project on risk adjustment methods. He is comparing the performance of traditional logistic regression and more specialist machine learning approaches, with an emphasis on adjusting patient risk for comorbidity.

Dr Sonia Saxena from the Child Health Unit in the Department of Primary Care & Public Health has been invited by the Royal College of Paediatrics and Child Health to join the Clinical Outcome Review Programme: Child Health Reviews-UK (CHR-UK) which systematically examines the incidence and associated features of mortality and serious morbidity in 1-18 year olds. More information can be found on the RCPH website .  Liz Koshy and Jo Murray have had abstracts accepted for presentation at the RCPH annual conference in Glasgow which took place in May.  Latest publications for the team include papers on a study on the rates of C-difficile infection, a comparative study on using small bowel contrast ultrasound tests to monitor disease complications in patients with C-difficile, and methods of improving IUD uptake.

Dr Paul Booton has been appointed as the Chair of General Practice and Primary Care at St George’s, University of London. Paul is currently the Head of Undergraduate Primary Care Teaching at Imperial College London. Paul studied as an undergraduate at the London Hospital Medical College. After medical registration he worked as medical officer for the UN High Commission For Refugees amongst the Vietnamese ‘boat people’ in Hong Kong.  He continued his training in hospital medicine as a physician, before pursuing a career in general practice.  After a year in general practice in rural Suffolk, he returned to London as lecturer at Guy's and St Thomas' Medical School Department of Primary Care. He moved to King’s College London to set up the first experiments in teaching general medicine in general practice.  Subsequently, as undergraduate dean, he led the development of the new medical undergraduate curriculum for the newly formed merged medical school of Guy's...

The Global eHealth Unit has organised a 3-month research internship experience for Michelle Bruggeling. Michelle arrives from Radboud University in Nijmegen, the Netherlands, where she is completing her final year of medical studies. She is currently working on a Cochrane review focused on interventions for recruiting smokers into cessation programs. The Unit has also been collaborating with researchers in China, and earlier this year Michelle van Velthoven (PhD student) presented an overview of some of the Global eHealth Unit’s projects and her own work on mobile health. Researchers from Beijing’s Capital Institute of Paediatrics (Department of Integrated Early Childhood Development) then visited the Department of Primary Care & Public Health and presented a forum to the unit on the Institute's current work, the Chinese health system, and their plans for eHealth.

Kate Woodhouse was awarded an MBE in the New Year Honours List for her work with the Mortlake community in southwest London. Kate is the Primary Care Undergraduate Education Manager in the Department of Public Health & Primary Care. Kate has been involved with the Mortlake Community Association for nearly 15 years, working with statutory and voluntary agencies like Age UK, Mind, NHS Richmond, and the Richmond Youth Services to bring small, important projects to local people. Examples of the work they do include offering a mental health drop-in service and support for young parents. She is also a Trustee for the Mortlake Hall which works with children in the area.  Kate says, “ It was a great day and I felt the whole community was recognised for its work ”.  Clearly Kate is pleased with her well-deserved award and we send her our congratulations on receiving such an honour.

Available in October 2012 A new textbook of general practice -  General Practice at a Glance  - from academics in the Department of Primary Care & Public Health at Imperial College London will be published in October 2012. The book provides an illustrated introduction to the full range of important primary care presentations. It includes sample questions to ask during history taking and examination and features ‘red flags’ to highlight symptoms or signs that must not be missed. The textbook is ideal for medical students on their general practice attachment and also for medical practitioners working  in primary care.

Dr Adrian Raby passed on his thanks to all the people who supported him for the London Marathon. He was delighted to finish in 2 hrs 59 minutes and was pleased to have had so many generous sponsors,. He raised a total of £2669 for the Teenage Cancer Trust.