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Showing posts from 2017

Improving the health of young children in Malawi

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

Addressing polypharmacy in older people

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…

New 'gene silencer' drug injections reduce cholesterol by 50% in clinical trial

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…

5 Minutes With...Nadine Engineer, Faculty Development Manager

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…

Primary Care Education Research update

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…

Year 6 GPSA update

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…

Year 5 GPPHC update

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…

Year 3 MICA (Medicine in the Community Apprenticeship) course update

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…

SAPC Madingley Hall Conference 2017 - Primary Care at the Coalface: Mining for Diamonds

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…

Complementary medicine – A Clinician’s Tale of Pride and Prejudice

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…

Professor Mitch Blair - Inaugural Lecture

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 …

Introducing the WATCCH Project - Widening Access to Careers in Community Healthcare

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…

Say hello, wave goodbye...

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…

The status of the patient safety culture in Arab countries

A recent study from the Department of Primary Care and Public Health at Imperial College London, published in the journal BMJ Open, explored the status of the patient safety culture in Arab countries. We identified that non-punitive response to error is seen as a serious issue which needs to be improved. Healthcare professionals in the Arab countries tend to think that a ‘culture of blame’ still exists that prevents them from reporting incidents. We found an overall similarity between the reported composite score for dimension of teamwork within units in all of the reviewed studies. Teamwork within units was found to be better than teamwork across hospital units. We concluded that there is a need to promote patient safety culture as a strategy for improving the patient safety in the Arab world. Improving patient safety culture should include all stakeholders, like policymakers, healthcare providers and those responsible for medical education.

http://dx.doi.org/10.1136/bmjopen-2016-013…

Why I became the mental health champion for the School of Public Health

Azeem Majeed is Professor of Primary Care and Head of the Department of Primary Care and Public Health at Imperial College London. He explains why he became the mental health champion for the School of Public Health.

As a doctor with over 30 years’ experience of working in the NHS, I am aware of the impact that mental health problems can have on people’s health, well-being and quality of life, as well as on their family and friends. Mental health problems are also important for employers, and result in considerable financial costs in lost production and in staff absences from the work-place due to ill-health. However, even though mental health problems are very common, many people find it difficult to talk about them. Encouraging a supportive environment in the workplace that reduces the risk of mental health problems developing – and in supporting staff to seek help when mental health problems do arise – is very important for employers. It improves employees’ health and well-being, a…

NIHR CLAHRC: Deprescribing initiative

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…

Dr Filippos Filippidis speaks on tobacco control to the Slovenian National Council

Dr Filippos Filippidis, Lecturer of Public Health at PCPH, was invited to speak at the Slovenian National Council in Ljubljana, Slovenia, on the 21st of October 2016. The Slovenian parliament is currently discussing new tobacco control legislation and European tobacco control experts were invited to support the decision making process. The event was organised by the European Respiratory Society (ERS) and the European Network for Smoking Prevention (ENSP) and provided a discussion forum between scientists, tobacco control advocates and Slovenian MPs and government officials. Dr Filippidis’ presentation focused on the importance of tobacco taxation and the option of earmarking tobacco taxes for health promotion and tobacco control activities. Closing the event, Mrs Milojka Kolar Celarc, Health Minister of Slovenia expressed her firm support for tobacco control in Slovenia, which is preparing to enter a new era in its tobacco control efforts.

Self-Care Academic and Research Unit (SCARU)

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 England, 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 selfcare 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 Hea…

Impact of the organisation and performance of health systems on the control of the Ebola outbreak in West Africa

An Ebola outbreak started in December 2013 in Guinea and spread to Liberia and Sierra Leone in 2014. The health systems in place in the three countries lacked the infrastructure and the preparation to respond to the outbreak quickly and the World Health Organisation (WHO) declared a public health emergency of international concern on August 8 2014. We conducted a study to determine the effects of health systems’ organisation and performance on the West African Ebola outbreak in Guinea, Liberia and Sierra Leone and lessons learned. The WHO health system building blocks were used to evaluate the performance of the health systems in these countries.

A systematic review of articles published from inception until July 2015 was conducted following the PRISMA guidelines. The review was supplemented with expert interviews where participants were identified from reference lists and using the snowball method.  Ensuring an adequate and efficient health workforce is of the utmost importance to e…

ICCDP awarded million pound grant

The Imperial Centre for Cardiovascular Disease Prevention (PI Prof Kausik Ray) was awarded a million pound grant to study the patterns of care around cholesterol control among those with established vascular diseases or at very high risk of vascular disease. The study will be coordinated through the Imperial Clinical Trials Unit across 18 European countries involving 6000 participants. This study will compare the patterns of care across Europe, between primary and secondary care, rural and urban settings. The impact of drug cost, guideline knowledge and clinical setting on achievement of cholesterol targets and the predicted risk of cardiovascular disease will be assessed. The findings are expected in 2018.

What makes a good placement?

In the New Year, Dr Kevin Patel a GP ST3 on the Imperial VTS, takes a reflective look at the factors that go into making a good clinical attachment for trainees.
As GP trainees we are ‘encouraged’ to reflect; challenging encounters with patients, conversations with colleagues that could have gone better, moments when you felt like you were born to do this job. All of this is good fodder for your ePortfolio.
Not one to miss out on a reflective opportunity, I took a step back from a discussion that was taking place about difficult rotations, a conversation I imagine that is oft-repeated amongst GPs and hospital doctors up and down the country, and thought about how we could use our experience as GP trainees to feed into this.
As trainees we rotate into diverse placements, from paediatrics to public health to care of the elderly. I counted at least 15 distinct departments I have worked in since finishing medical school just over 5 years ago. This is more than any other specialty trainee…