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2017 Annual GP Teachers Conference

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The Annual GP Teachers’ Conference took place on Friday 9 June 2017 Celebrating the Student and Teacher Partnership. About 100 delegates joined together to network, offer peer support and learn through conversation, lectures and a series of workshops. A brief overview of the key themes and reflections from the day follows.

A story
Dr Sonia Kumar, Director of Undergraduate Primary Care Education, opened by sharing a story of coming across an old man with a bike puncture while out with her husband. While her husband repaired the puncture they got to know a little of his life; how his wife had died and he now lived in sheltered accommodation with cycling being an important way for him to get out and about. Later that day Sonia was reflecting on how hearing his story had made her feel sad and sorry for his changed circumstances, whereas Dev, Sonia’s husband, had taken away a different impression – a wonderful life where he continued to be cared for, maintaining his independence and a life…
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WHO Europe Primary Health Care Advisory Group

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Professor Rawaf was appointed by WHO Europe as a member of the newly formed Advisory Group on Primary Health Care. The first meeting of all Members was attended by the Regional Director Dr Zsuzanna Jakab and Kazakhstan’s Minister of Health, Dr Alexey Tsoy. Professor Rawaf gave a presentation on integration of public health and primary care services and highlighted the role of Healthy Living Centres in the UK. He also described some possible models for the integration using the experience of countries around the globe. The WHO European Centre for Primary Health is leading the work across the 53 member states of WHO Europe.
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Introduction to Leadership and Communication in Medicine, Dubrovnik

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This course was developed and run jointly between the Zagreb Institute of Culture of Health and the WHO Collaborating Centre, at the Centre for Advanced Academic Studies in Dubrovnik. More than 40 health professionals from across Croatia took part in this intensive course over 5 days. The modular format of the course allowed participants to choose the sessions which are relevant to their needs. The course was organised and led by Professor Rawaf from Imperial College London, and Professor Marijana Bras and Professor Velijko Dordevic of University of Zagreb. It is planned to run the course on annual basis at the Centre for Advanced Academic Studies.
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Advanced Leadership and Management for Healthcare Course

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This summer, the WHO Collaborating Centre delivered the well-established Advanced Leadership and Health Management course in London for delegations from China and the Gulf Region. The participants came from various health professional background with responsibilities to lead in their health systems.

Colleagues from China are mainly from hospital management, some from hospitals with over 4000 beds. The WHO Collaborating Centre Advanced Leadership and Management for healthcare course is a one-week intensive training addressed to health professionals. The content of the course is built around the WHO framework and aims to help participants become more successful leaders in complex knowledge-based health systems around the world.
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President’s Awards for Excellence in Teaching

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Dr Andy McKeown, Co-Course Director (Year5  MB BS Course Lead) and Dr Shivani Tanna (Year 3 GP Course Lead) have both received President’s Awards for Excellence in Teaching for 2017. These awards follow three similar awards received by our academic GPs in 2016 and showcase the fantastic teaching being delivered by the Department of Primary Care and Public Health.
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Dr Javier Salerno wins a 2017 Lifetime Teaching Award

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Dr Javier Salerno won a 2017 Lifetime Teaching Award for his contribution to teaching medical students from Imperial College London. Dr Salerno accepted his award by sharing some reflections of what students have said to him over the years.

“I like this rotation as we do hands on medicine: it gives students the experience of seeing patients from very early days in their illness and the opportunity to see a lot of different patients. 

I learned more medicine in this practice than in hospitals. I did not have a clue what I was going to do as a post graduate studies however after this rotation I am considering general practice very seriously. I will read my BMJ, NEJM, Lancet, JAMA on a weekly basis! 

After diagnosing 3 melanomas on young people, they asked how did I find them if they had come for a flu like illness and chest infections. I asked them to remove their tops and melanomas were in rear dorsal areas and behind the arms. But why did you do that.....? Because of a 4 letter word wh…
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Imperial College GP Tutor Dr Christine Scott wins a 2017 Lifetime Teaching Award

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Imperial College GP Tutor, Dr Christine Scott, won a 2017 Lifetime Teaching Award for her contribution to teaching medical students from Imperial College London. Here, she reflects on her experiences of teaching medical students.

Were you aware you were students’ inspiration and role model?
I think we often underestimate our impact on students. Now, as I read my feedback I recognise once again how extremely influential we are. What a great privilege, and what a great responsibility!

How long have you been teaching Imperial Medical Students for?
A lot of my embarrassment in receiving a lifetime teaching award is that I've only really been teaching at Imperial for about eight years. In a former era, I taught undergraduates from my alma mater, Newcastle University.

Why so long?
It hasn't really been a very long time but I have been privileged to teach a number of different courses from first-year communication skills and First Clinical Attachment (FCA), doing some lecturing and tea…
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Recent Imperial College paper highlighted on the Facebook page of Senator Bernie Sanders

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US Senator Bernie Sanders shared a recent paper on Facebook highlighting the importance of expanding universal health coverage to reduce ‘avoidable’ deaths among Brazil’s black and mixed-race populations. The paper was published in the journal PLoS Medicine.

Dr Thomas Hone, Professor Christopher Millett, Professor Azeem Majeed and their colleagues from Fiocruz in Brazil, have analysed mortality data from 2000-2013 to determine the effect of the FHS on avoidable deaths in black and mixed-race Brazilians compared to white Brazilians.

They found rates of avoidable deaths were between 17 and 23% higher in black and mixed-race populations than in the white population during 2000-2013.

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Grenfell Tower survivors in fear of immigration checks

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Volunteer doctors and lawyers providing support to survivors of the Grenfell Tower disaster have spoken of residents who escaped from the fire but remain, they believe, too frightened to seek medical and legal help for fear of being reported to the Home Office because of their irregular immigration status.

Dr Paquita de Zulueta, a London GP and Honorary Senior Lecturer in Primary Care in the School of Public Health at Imperial College London who has been volunteering to help survivors in the Westway, said she and colleagues were aware of at least three patients who were reluctant to go to hospital because of concerns about their immigration status.

The full story can be read on the Guardian Website.
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Health, economic and social costs of china’s tobacco epidemic

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Professor Christopher Millett and Dr Anthony Laverty contributed to a ground-breaking WHO report which provides an analysis of the current health, social and economic costs and impacts of tobacco use and policies in China. The report highlights the impact of tobacco use on development, with special emphasis on poverty and inequality and the tremendous burden tobacco represents for the poorest and most vulnerable.

China is the epicentre of this epidemic, and thus lies at the heart of global efforts to stop it. China is the world’s largest producer and consumer of tobacco. A staggering 44% of the world’s cigarettes are smoked in China. One million people die of tobacco-related diseases in China every year, many of them in the prime of their productive years.

The report can be viewed on the WHO Website.
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Understanding the challenges for GPs in managing overweight & obese children

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As part of a research project on the effectiveness of the NCMP (National Child Measurement Programme), a workshop was held in the School of Public Health to evaluate the current use of National Child Measurement Programme feedback by GPs. The aim was to investigate how GPs feel they could add further value to NCMP feedback in the future and any challenges they face incorporating National Child Measurement Programme feedback into their routine clinical work.

The workshop was facilitated by Dr Sonia Saxena & Prof Russell Viner, with participation from Dr Zoe Williams and Dr Rachel Pryke.

In the interactive 2-hour workshop, the audience discussed and came up with different ideas and solutions to overcome barriers faced in monitoring childhood obesity in Primary Care as well as the National Child Measurement Programme feedback. They specifically highlighted the importance of allocating more time for growth and weight checks, improving awareness of appropriate local weight management …
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Self Care R&D Priorities

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With the increasing pressure on the Welfare State in the UK and other European countries, policy makers are increasingly looking to Self-Care as a means to empower individuals to live longer and healthier lives, whilst helping curb unnecessary spending and over-reliance on health systems. Yet self-care remains a broad and somewhat nebulous concept to most as it covers a wide spectrum of ideas and activities ranging from cognition and health literacy, to empowerment and evidence-based decision making and rationing of resources.  This makes self-care an exciting but also a challenging area to study.
Self-care has been extensively defined and considered by various academic groups and conceptualised from several different perspectives. Paradoxically, the academic exercise of understanding self-care as a broad concept has not as yet resulted in a definitive canon of evidence that makes the absolute case for self-care and its realised benefits in the real-world setting. It is therefore nece…
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Releasing student potential: Widening access to opportunities in community healthcare

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This summer the Department of Primary Care and Public Health kicked off an exciting new programme: Widening Access to Careers in Community Healthcare (WATCCH). We hosted twenty 16-17 year olds who are aspiring to be the first in their families to go to university – at the Charing Cross campus for the inaugural WATCCH project. Our aim was to change perceptions of wider healthcare careers and provide vital work experience for their University applications. Competition was high and the team was very impressed by the number of high calibre students that applied for a place.

Year 12 Pupils from 19 London secondary schools attended an induction day in late July. During the workshop, an experienced multi-professional panel consisting of 5 professionals including an Imperial final year medical student, shared their career journeys with the pupils from their A level to postgraduate degrees. This was followed by pupils creating individual mind maps, which they thoroughly enjoyed, of where they…
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NIHR School for Public Health Research

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Imperial College London has joined a partnership of leading academic centres that demonstrate excellence in applied public health research. The NIHR School for Public Health Research aims to build the evidence base for effective public health practice including what works practically to improve population health and reduce health inequalities; and generate knowledge that can be applied across the country to better meet the needs of policymakers, practitioners and the public. Today, we held out first meeting of the key staff at Imperial College who will be collaborating on this project.
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The Self-Care Academic Research Unit (SCARU) at Imperial College London

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In a recent horizon scanning exercise, the School of Public Health recognised the rising importance of self-care as a means to empower patients and support an NHS fit for 21st Century Britain, identifying ‘self-care’ as an important area of academic interest. Further to participation in the annual Self-Care Conference, the Department of Primary & Public Health recently met with Dr Pete Smith OBE (Co-Chair of the Self Care Forum) and Dr David Webber (Head of the international Self Care Foundation) with a view to help establish Imperial College as an academic base of self-care in England.

The Self Care Forum is a national charity that seeks to develop and promote self-care throughout life and work, and encourages the recognition and embedding of self-care in all our lives. It defines self-care as the actions that individuals take for themselves and on behalf of or with others in order to develop, protect, maintain and improve their health, wellbeing or wellness. This includes Healt…
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Improving the health of young children in Malawi

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The department's Global eHealth Unit was in Malawi for two weeks as part of the Supporting LIFE project. From October 2016 to January 2017, the Supporting LIFE consortium ran a clinical trial in two districts in Northern Malawi to assess the added value of a mobile health version of Community Case Management on under-5 referral, re-consultation and hospitalization rates.

The team presented preliminary results from the trial during the Supporting LIFE Dissemination Workshop. The meeting was held in Lilongwe on 9 February 2017 and was attended by Ministry of Health officials, district health officers, health care professionals, WHO and other NGO officials
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Addressing polypharmacy in older people

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A major challenge for healthcare, particularly for older people, is that patients are ending up on many medicines, termed ‘polypharmacy’. Polypharmacy can be either ‘appropriate’ or ‘problematic.’ With the latter, prescribing professions are traditionally better at starting medicines than stopping them (for a variety of reasons), which means that patients are too often left with problematic polypharmacy that can lead to side effects, interactions, and an inability to manage to take them all.

The NIHR Collaboration for Leadership in Applied Health Research and Care for Northwest London (CLAHRC NWL) have an active Medicines Optimisation work stream. A lot of work has been done around the need for medication review and stopping unnecessary medicines when problematic polypharmacy occurs. The term ‘deprescribing’ has emerged strongly in the literature and CLAHRC NWL have put together what we think is the first journal issue devoted to the topic of deprescribing.

The themed issue is partic…
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New 'gene silencer' drug injections reduce cholesterol by 50% in clinical trial

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The first in a new class of gene-silencing drugs, known as inclisiran, has halved cholesterol levels in patients at risk of cardiovascular disease. The findings come from the largest trial yet to test the safety and effectiveness of this kind of therapy. The technique, known as RNA interference (RNAi) therapy, essentially ‘switches off’ one of the genes responsible for elevated cholesterol.

Researchers from Imperial College London and their colleagues, who conducted the trial, say the twice-a-year treatment could be safely given with or without statins, depending on individual patient needs. Eventually, inclisiran could help to reduce the risk of heart attacks and stroke related to high cholesterol.

“These initial results are hugely exciting for patients and clinicians,” said Professor Kausik Ray, lead author of the study from the Department of Primary Care and Public Health. “We appear to have found a versatile, easy-to-take, safe, treatment that provides sustained lowering of chole…
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5 Minutes With...Nadine Engineer, Faculty Development Manager

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Nadine joined our team in January as our new Faculty Development Manager. Her role involves recruiting new teachers, keeping records of existing teachers and arranging teacher training and the Annual Teachers' Conference.

We had a quick chat with Nadine to find out more about her.

·What is your role within the department and how long have you been here?
I have been here for 2 months now, my job title is Primary Care Faculty Development Manager and my role is to aid the Faculty Development lead to recruit and retain more GPs to teach medical students out in GP Practices across north west London.  
•        What does your role involve?
I organise the Imperial GP teacher training course, designed for GPs that are new to teaching for us, or as a refresher for more experienced teachers. I also organise the Imperial ASTIC course, which supports GPs teachers to update their skills over a variety of topics such as coaching/mentoring and feedback skills. In some cases I target GPs and Pract…
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Primary Care Education Research update

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The GP teaching team continue to be busy with a range of medical education research projects, working with both students and GP teachers to collect data in order to evaluate the educational innovations that are taking place in the department. A number of these projects were presented at the the Society for Academic Primary Care (SAPC) regional conference held on 26th & 27th January in Madingley Hall, Cambridge. These included the following presentations

* Dr Arti Maini and Dr Sonia Kumar - A health coaching training programme for medical students at Imperial College London.
* Dr Andy McKeown, Dr Ravi Parekh and Dr Sonia Kumar - Inspiring commissioners of the future: A unique teaching session for Year 5 medical students to learn about and experience commissioning in the NHS.
* Dr Maham Stanyon, Ms Lisa Carrier, Dr Noreen Ryan and Dr Sonia Kumar - Virtual reality as a tool for learning in medicine; exploring the perceptions of medical students.
* Dr Elizabeth Muir and Dr Melek Somai…
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Year 6 GPSA update

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Well it's been a busy year so far but now that the term has ended it's time once again to reflect on the successes and the challenges of the year that has passed, and start preparing for the next academic term starting in August. 

The students consistently feedback how much they value time spent consulting in their own clinics, under your expert supervision. Until now there hasn't been a requirement on how many of these clinics students should be doing, and as a result, the student experience is often quite varied across practices. This is why, for the next year, I have produced an 'Essential GPSA guide' that sets out minimum requirements for the attachment which includes a minimum number of independent clinics that students should have across the 3 weeks. If space is an issue in your practice, look out in the next Teacher's Guide for the 'Making teaching work for you and your student apprentice' guide which will contain creative tips to help you the mak…
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Year 5 GPPHC update

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As we near the end of the academic year, the year 5 students minds inevitably begin to focus on their upcoming PACES exams.  The GPPHC course is ideal preparation for this as it gives the students an opportunity to practice focused history taking, examination and implementing a management plan in a time-limited situation – something which we as GPs do every day we sit in out surgeries.
We hope to implement some exciting changes to the course in the next academic year, hopefully reducing the number of mandatory assignments the students have to complete during their placements to allow them to concentrate more on getting experience consulting independently.  A new course guide for GP tutors is currently being produced and we are also planning some changes to the departmental teaching with a new session on leadership and professionalism.
Thank you once again for hosting and teaching our students – your hard work and dedication to teaching is what makes the course successful.  To quote som…
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Year 3 MICA (Medicine in the Community Apprenticeship) course update

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The year 3 Medicine in the Community Apprenticeship pilot year is drawing to a close and the new cohort of 150 students have been selected and are ready and poised to start phase 2 in September 2017!
Our wonderful tutors have done an excellent job hosting students for 10 weeks at their surgeries. We have really seen our students thrive during this attachment. We have realised the value in giving the students true authentic roles where they begin seeing their own patients in clinic by week 3 and follow up their own patient case loads throughout. The student feedback has been overwhelmingly positive and they have really enjoyed feeling like integral members of the team.
Not only have we had involvement from excellent GP tutors, we have also had many specialists and other GPs hosting our students for their experience and clinical skills sessions. We are excited to be using more hospital sites and GP services to help us next term.
We would like to thank all the faculty involved in developing…
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SAPC Madingley Hall Conference 2017 - Primary Care at the Coalface: Mining for Diamonds

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This year the Imperial College GP teaching team were responsible for organising and hosting the Society for Academic Primary Care (SAPC) regional conference held on 26th & 27th January in Madingley Hall, Cambridge. Each year, one of the five London medical schools takes on this honour. We would like to share some of the highlights from mixture of workshops, prizes, speakers, dinner and a quiz with you.

The first keynote address was by Associate Professor David Hirsh from Harvard Medical School, a world-renowned expert in educational transformation. He spoke passionately about the longitudinal integrated clerkships (LIC) he has been responsible for. He outlined research demonstrating erosion of medical student empathy over the course of a ‘traditional’ undergraduate curriculum, and offered LICs as a possible solution. Here, students learn from a panel of diverse patients, following them closely by attending hospital and GP appointments with them, developing meaningful relationship…
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Complementary medicine – A Clinician’s Tale of Pride and Prejudice

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GP ST1, Dr Cornelia Junghans discusses her experience during an open day at the Hospital for Integrated Medicine.
I frequently get asked by patients about homeopathy, acupuncture and reflexology and find myself admitting that I don’t know much about it. As a result, I recently attended an open day at the Hospital for Integrated Medicine in London to find out more about complementary medicine in order to have a better answer for patients who ask about it.
The day covered the use of a range of complementary medicine such as homeopathy, herbalism, acupuncture and hypnosis. I learnt that complementary medicine places a strong emphasis on restoring balance, focuses on the patient’s own healing powers and considers that mind and body are intrinsically linked. It made me realise that we as doctors learn about the concept of balance or homeostasis in pre-clinical years, but seem to forget about it to some degree in clinical practice. We also routinely separate body and mind for neatness of diag…
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Professor Mitch Blair - Inaugural Lecture

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Several members of the Department of Primary Care and Public Health attended the inaugural lecture of Professor Mitch Blair on 8 March 2017. Mitch Blair is Professor of Paediatrics and Child Public Health at Imperial College London; and a consultant paediatrician and specialist in child public health. Professor Blair is a long-standing colleague and academic collaborator, and a great proponent of primary care.

During his lecture, Professor Blair spoke on the topic of "How are the kids? Improving population child health and development". Professor Blair asked his audience to imagine a future where toddlers are given individual health programmes to optimise health and development based on the latest research into public health and personalised medicine. Would this help pick up and even prevent big areas of concern for modern paediatrics, from mental health to allergies he asked?

Preventive childcare dates back to the 19th century’s Boer War, where 40% of the recruits were unfit …
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Introducing the WATCCH Project - Widening Access to Careers in Community Healthcare

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The Undergraduate Primary Care Education team in the Department of Primary Care and Public Health at Imperial College London has kicked off an exciting new work experience programme called WATCCH – Widening Access to Careers in Community Healthcare.
There is a shortage of work experience in the health sector for pupils, particularly for those who have no connection to healthcare professionals. WATCCH aims to open up work experience opportunities in the healthcare sector by offering placements for sixth form pupils from disadvantaged backgrounds to shadow various allied healthcare professionals in general practices. These 16/17 year olds have completed their GCSEs with good grades, do not have placements elsewhere, and are the first in their family applying to university. 
Pupils will attend a pre-placement induction at Imperial College's Charing Cross Hospital Campus, and will then have a 3-day work experience session at a general practice where they will observe a variety of allie…
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Say hello, wave goodbye...

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Our GP Derm and Paeds Course Lead Dr Emma Metters sadly left us this month to take a new post at St George's. She reflects on her time at Imperial below:
My time as GP Derm and Paeds Course Lead has come to an end but the good news is the wonderful Senita Mountjoy is returning from her maternity leave to take up the post again.  She brings so much energy and enthusiasm for the courses that she was instrumental in the design of initial delivery of.  I am sure she has many ideas of where she wants to take them so watch this space for new and exciting teaching developments on the horizon.
This is not really goodbye as I will be continuing my involvement in Imperial in various ways so may well cross paths with some of you again.  I have really enjoyed my time at Imperial, in several different roles, and have gained a wealth of experience which I will be taking with me to my new role as Clinical Lecturer in Primary Care at St George’s University. 
I hope many of you continue your invo…
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