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E-raamat: Exceptional Potential of General Practice: Making a Difference in Primary Care

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  • Formaat: 301 pages
  • Ilmumisaeg: 07-Dec-2018
  • Kirjastus: Radcliffe Publishing Ltd
  • Keel: eng
  • ISBN-13: 9780429764608
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  • Formaat: 301 pages
  • Ilmumisaeg: 07-Dec-2018
  • Kirjastus: Radcliffe Publishing Ltd
  • Keel: eng
  • ISBN-13: 9780429764608
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This innovative and timely book draws on pioneering precedents, basic principles, current examples and international experience to capture the narratives, examples and ideas that underlie and demonstrate the exceptional potential of general practice:

"If health care is not at is best where it is needed most, health inequalities will widen."

"The unworried unwell are not hard to reach but they are easy to ignore and are often ignored."

"With patient contact, population coverage, continuity, coordination, flexibility, long term relationships and trust, general practices are the natural hubs of local health systems."

"… practitioners … are not only scientists but also responsible citizens and if they did not raise their voice who else should?"

Written for family doctors looking to strengthen local collaboration, it brings together the traditional strengths of consultations, caring, continuity, coordination and coverage with the current and future challenges of building capacity, community, creativity, consistency, collegiality and campaigning. It highlights the critical importance of working with patients, maximising the use of serial encounters, integrating care, joint working between practices, social prescribing, community development and advocacy based on patient and practitioner experience.

Drawing on the highly-regarded work of Deep End GPs serving the poorest communities in Scotland ? www.gla.ac.uk/deepend ? the book is an invaluable handbook for all primary care doctors, irrespective of health care system or country, seeking to provide unconditional continuity of personalised care for all patients, whatever problem or combination of problems a patient may have.

Arvustused

"The Exceptional Potential of General Practice is a book that I will certainly use for academic resources and to bolster the arguments I can make when once again the local Clinical Commissioning Group cuts funding to the sort of deprived area that I work in. But I suspect its Bergers book that I will still give to my students to inspire them about general practice, even though it was written over 50 years ago."

Aneez Esmail- The Lancet

"The book itself serves to keep the torch of general practice burning bright and strong. Rather than provide another overarching academic critique of the value of general practice (community-based primary medical care), Watt provides us with a more illuminating constellation of contributions from GPs at the frontline, academics, and other health professionals who are seeking, through a variety of methods, to realise the exceptional potential that high-quality general practice can provide for those who it serves. For those already engaged in similar work in whatever form, it provides a useful summary of the founding principles that underpin their efforts, some examples of work elsewhere, and a reminder that they are very much part of a whole." Ben Jackson - British Journal of General Practice

Acknowledgements xv
Contributors xvii
Introduction xxiii
1 The exceptional potential of general practice
1(4)
References
3(2)
2 Three horizons of general practice
5(4)
Andrew Lyon
References
7(2)
3 Traditional strengths
9(22)
3.1 Gatekeeping
9(1)
3.2 Tolerating uncertainty
10(1)
3.3 Knowing the patient
11(1)
3.4 Consultations
12(3)
Stewart W. Mercer
3.5 Caring
15(2)
3.6 Continuity
17(3)
3.7 Coordination
20(1)
3.8 Coverage
20(2)
3.9 Clinical generalism in Scotland
22(2)
John Gillies
3.10 39 Years in practice
24(7)
James D. M. Douglas
3.10.1 Practice reflections
24(2)
3.10.2 Personal reflections
26(1)
References
27(4)
4 Pioneers
31(16)
4.1 Pioneers in research
31(4)
4.1.1 Edward Jenner (1749--1823)
31(1)
4.1.2 Sir James Mackenzie (1853--1925)
32(1)
4.1.3 William Pickles (1885--1969)
32(1)
4.1.4 Seizing opportunities
33(2)
4.1.5 University-based research
35(1)
4.2 Population medicine
35(2)
4.2.1 Career advice for medical students
35(2)
4.2.2 The example of Julian Tudor Hart
37(1)
4.3 Advocacy
37(10)
4.3.1 Dr Lachlan Grant (1871--1945)
38(1)
James D. M. Douglas
4.3.2 Direct action for public health
39(1)
4.3.3 Advocating for a National Health Service
40(1)
4.3.4 Welfare reform
41(2)
4.3.5 Alcohol in general practice
43(1)
References
44(3)
5 Challenges
47(24)
5.1 Confusing terminology
47(2)
5.2 Multimorbidity
49(2)
Stewart W. Mercer
5.3 The challenges of multimorbidity
51(5)
5.3.1 Defining multimorbidity
52(1)
5.3.2 Listen to the patient
52(1)
5.3.3 Patient experience
53(1)
5.3.4 Machines that do the work of two people
53(1)
5.3.5 The worried doctor
54(1)
5.3.6 Leadership
55(1)
5.3.7 Information
55(1)
5.3.8 Conclusion
56(1)
5.4 Assessing the quality of generalist clinical care
56(2)
Ken McLean
5.5 Competing for power and resource
58(3)
5.6 Maintaining sufficient numbers of clinical generalists
61(2)
5.7 The Inverse Care Law
63(3)
5.8 GP views on health inequalities
66(5)
Breannon Babbel
References
68(3)
6 Practices working together in the Deep End
71(20)
6.1 General Practitioners at the Deep End
71(7)
6.1.1 The Deep End
72(1)
6.1.2 The challenge
72(1)
6.1.3 The practices
72(1)
6.1.4 The meeting
73(1)
6.1.5 What next?
74(1)
6.1.6 The Deep End logo
74(1)
6.1.6.1 A brief history of the Deep End Project
74(1)
6.1.7 Link worker programme
75(1)
6.1.8 Govan SHIP (Social and Health Integration Partnership)
75(1)
6.1.9 Deep End GP Pioneer Scheme
76(1)
6.1.10 Parkhead Financial Advisor Project
76(1)
6.1.11 Attached alcohol nurses
77(1)
6.2 Deep End Ireland
78(3)
Susan Smith
Patrick O'Donnell
6.3 General practice at the Deep End in Yorkshire and Humber
81(4)
Tom Ratcliffe
Elizabeth Walton
Benjamin Jackson
Dominic Patterson
6.4 Deep End Greater Manchester
85(6)
John Patterson
References
89(2)
7 Addressing the Inverse Care Law
91(14)
7.1 The Govan SHIP Project
91(8)
John Montgomery
7.1.1 Monitoring progress
93(1)
7.1.2 Overall GP demand and comparison with other practices
94(1)
7.1.3 Project activity and social care
94(1)
7.1.4 GP recruitment and retention
94(1)
7.1.5 Conclusion
94(3)
7.1.6 GP use of protected time -- 1
97(1)
Amanda Connelly
7.1.7 GP use of protected time -- 2
98(1)
Brian Milmore
7.1.8 GP use of protected time -- 3
98(1)
John Montgomery
7.2 The Deep End GP Pioneer Scheme
99(6)
Petra Sambale
7.2.1 GP use of protected time -- 4
101(1)
John Goldie
7.2.2 GP use of protected time -- 5
101(1)
Deborah Morrison
7.2.3 GP use of protected time -- 6
102(1)
Douglas Rigg
References
103(2)
8 Link workers in general practice
105(8)
8.1 Best arrangements for link workers
105(2)
8.2 Experience as a programme director
107(2)
Mark Kelvin
8.3 Experience as a host practice
109(2)
Maria Duffy
8.4 Experience as a GP lead
111(2)
Peter Cawston
9 Community practice
113(16)
9.1 Drumchapel, Scotland
113(4)
Peter Cawston
9.2 Dublin, Ireland
117(3)
Tom O'Dowd
9.3 Brisbane, Australia
120(3)
Tracey Johnson
Suzanne Williams
9.4 Pittsburgh, Pennsylvania
123(2)
Andrea Fox
Kenneth Thompson
9.5 Ghent, Belgium
125(4)
Jan De Maeseneer
References
128(1)
10 Learning health systems
129(28)
10.1 Learning health systems
129(4)
John Robson
Kambiz Boomla
Sally Hull
10.2 Achievements in East London
133(11)
John Robson
Kambiz Boomla
Sally Hull
10.3 Development in East London
144(13)
John Robson
Kambiz Boomla
Sally Hull
Acknowledgement
151(1)
References
151(6)
11 Core topics
157(22)
11.1 The dynamics of family life
157(1)
11.2 The child in the consulting room - What does the future hold?
158(4)
Phil Wilson
11.3 Levelling up in Deep End practices
162(4)
Anne Mullin
11.4 Mental health
166(3)
Andrea Williamson
11.5 End-of-life care
169(10)
Euan Paterson
References
171(8)
12 Learning from medicine at the margins
179(6)
12.1 Working with refugees in general practice
179(3)
Becky Macfarlane
12.2 Homeless general practice
182(3)
John Budd
References
184(1)
13 International perspectives
185(14)
13.1 Key components of a well-functioning health system
185(2)
13.2 A general practitioner for every person in the world
187(2)
Iona Heath
13.3 Perspective from China
189(3)
Harry Hao-Xiang Wang
Stewart W. Mercer
13.4 Perspective from Lebanon
192(2)
Khairat Al Habbal
Mona Osman
13.5 Perspective from sub-Saharan Africa
194(5)
Vincent Cubaka
Phil Cotton
References
196(3)
14 Working to produce evidence of change
199(10)
14.1 Rules of engagement
200(3)
Bridie Fitzpatrick
14.2 The Deep End Advice Worker Project
203(6)
Jamie Sinclair
References
207(2)
15 Evaluation
209(12)
15.1 Learnings from the Deep End
210(5)
Sanjeev Sridharan
15.2 Towards a framework of learning
215(6)
Sanjeev Sridharan
References
220(1)
16 Education and training
221(20)
16.1 Correction of social ignorance
221(1)
16.2 A lifeline for a drowning man
222(2)
John Frey
16.3 The special needs of practitioners working in deprived areas
224(1)
Austin O'Carroll
16.4 GP training in the Deep End
225(2)
David Blane
16.5 The North Dublin City GP Training Scheme (NDCGP)
227(3)
Austin O'Carroll
16.6 The South Wales GP Academic Fellowship Scheme
230(2)
Megan Blyth
Harry Ahmed
Kevin Thompson
16.7 The Deep End GP Pioneer Scheme
232(9)
David Blane
16.7.1 A journey to the Deep End
235(1)
Lisa Robins
References
236(5)
17 Preparations ahead of time
241(4)
18 Reflection
245(4)
References
248(1)
19 Postscript
249(4)
19.1 The virtues of the race
249(1)
19.2 A philosophy of general practice
250(3)
References
252(1)
20 Biographies
253(14)
In Memoriam: Dr. Julian Tudor Hart (1927--2018)
263(4)
Index 267
Professor Watt is Professor of General Practice and Primary Care at the University of Glasgow, where he served as Head of Department of General Practice from 1994-2009.After hospital posts in Shetland, Leicester, Aberdeen and Nottingham, Professor Watt sought to combine training in epidemiology and general practice, moving to work with Dr Julian Tudor Hart at Glyncorrwg in South Wales, where they carried out a challenging series of community studies on the effect of dietary salt intake on blood pressure.Moving to the community paediatrics scheme in Edinburgh, Professor Watt completed vocational training at Townhead Health Centre in Glasgow. During the next decade, he established the Glasgow WHO MONICA Project Centre, gained accreditation in public health medicine and worked first as a research manager for health services research in the Scottish Chief Scientist Office and then as a senior lecturer in public health at Glasgow University.Since 1994, he has been Professor of General Practice and Primary Care at University of Glasgow combining and requiring experience in medical education, clinical medicine, epidemiology, research management and public health advocacy.Professor Watt is Lead Coordinator of the Deep End Project, involving the 100 most deprived general practices in Scotland. He also served as Elected Chair, Heads of Departments Group, UK University Departments of General Practice and Primary Care (2001-2004), and has been the Fellowship Panel for Public Health, Primary Care, Epidemiology, Statistics and Psychiatry, UK Academy of Medical Sciences (2004-2006).