Five Minutes to Change Your Practice

Meaningful learning which provides deep understanding of a topic is difficult to achieve in modern general practice. While we used to be able to utilise the lunch or coffee break or a rare CPD session for some uninterrupted learning, the current reality of time between patients is more likely one of getting to grips with hundreds of unanswered emails, urgent referrals, checking of results and DES and NIS audits. So a major challenge for general practitioners remains to find time to stay up to date when their temporal resources are severely limited. For those weeks when you’re not able to sit down and do a full RCGP e-learning module on its own, the Online Learning Environment Team has devised a 5 minute, bite sized presentation that will take a current topic – often debated in the popular press and therefore familiar to patients – and give you just one or two ideas how to change your practice and improve patient outcomes.

The eLearning Team.

Latest Five Minutes

This 5 minutes to change your practice screencast looks at the initial presentation of dementia and why an early diagnosis is beneficial. Screening tools are discussed and groups who present particular diagnostic challenges are considered.

While disease modifying agents are effective and mostly safe drugs used in the treatment of a wide spectrum of inflammatory conditions, they need careful monitoring of haematological and biochemical side-effects. This screencast will introduce you to the current guidance around shared care, monitoring schedules, vaccinations and teratogenicity.p>

Viral meningitis is now the most common cause of central nervous system infections in children. Believed to be underreported due to its often mild natural history, it is particular prevalent in infants under one year of age. This short screencast introduces the pathophysiology, epidemiology and symptoms of this potential life-threatening presentation and suggests how to take an appropriate history and examine these patients.

This screencast is on the topic of multiple sclerosis. It particularly looks at the changes in practice in recognising and managing relapses of MS in primary care.

Autistic spectrum conditions (ASCs) are lifelong neurodevelopmental conditions. The prevalence is about 1%, so a medium sized practice with 10,000 patients will have around 100 patients with an autistic spectrum disorder. This short screencast introduces some simple methods that can improve the experience for these patients and their families when visiting their general practitioners.

Tinnitus is a common presentation in general practice. This module discusses epidemiology of the presentation, its varied pathophysiology, how to take a good history and its management in primary care.

The incidence of cervical cancer has decreased dramatically since the advent of cervical screening. This module discusses the controversy surrounding the decision to screen from 25 rather than at a younger age, the addition of HPV to the screening programme and which women should have smear testing more often than the standard schedule.

A person is in fuel poverty if they are unable to afford to keep their home adequately heated – this will apply to many of our patients and is largely a social rather than a medical issue. This screencast describes a scheme whereby GPs who identify patients in fuel poverty can quickly and efficiently record this fact and, with a few clicks of the mouse, refer them to a local service who can provide help and advice.

Prostate cancer is the commonest male cancer and yet we have no validated screening programme. The PSA test has been in use for 30 years and there is increasing public interest in getting a “prostate test”, but it isn’t as simple as ticking the box on the blood form. This module explains why PSA doesn’t meet the criteria for a successful screening programme and helps GPs to counsel patients who ask for a test, as well as linking to a useful patient information leaflet.

Systemic lupus erythematosus (SLE) is a rare condition, although certain population demographics are more commonly affected than others. To coincide with Lupus Awareness Month, this screencast reviews some clinical presentations that may prompt consideration of SLE, and the primary care investigations which may be useful in detecting the disease.

This screencast launch follows migraine awareness week, which aims to highlight the facts about migraine and reduce the stigma which is felt by many migraine sufferers. This is something that is reflected in the work of the main migraine charities in the UK, and may not be on the radar of medical professionals. In this screencast we hope to raise your awareness of the diagnostic possibility of migraine in a wider range of clinical presentations.

Over the last few months the population of the United Kingdom has witnessed an unusually high number of national tragedies in quick succession: the terror attacks in Manchester, Westminster, London Bridge and Finsbury Park and the devastating fire at Grenfell Tower. There is clear evidence that traumatic events such as these can lead to the development of a range of psychological and mental health issues, such as adjustment and anxiety disorders, depression and post - traumatic stress disorder (PTSD). While the spectrum of responses to these traumatic events is broad, they will nevertheless impact on the ability of the persons affected to function, on their relationships and their ability to contribute to social and economic life.

In this ‘extended’ screencast (just under 10 minutes) Dr Jonathan Leach talks about the normal response to psychological trauma, the prevalence and diagnosis of PTSD and what we can do if we have been exposed to psychological trauma ourselves.

Hepatitis continues to be one of the leading causes of death globally, accounting for 1.34 million deaths per year and responsible for 80% of liver cancers in the world. World Hepatitis Day aims to achieve elimination by raising awareness, increase detection and facilitate treatment of viral hepatitis. This screencast focuses on how to increase detection rate of viral hepatitis in primary care.

This screencast looks at the updated NICE guidance on the early pharmacological management of diabetes. It also considers when metformin may not be suitable as first line treatment, and what the new spectrum of alternatives are.

The RCGP eLibrary provides a wide variety of electronic resources to its members, including specifically selected primary care journals, a growing collection of ebooks and Medline; one of the most comprehensive medical databases. This video is designed to show how to get the best out of the Library: how to create an OpenAthens account, searching for journals, articles and ebooks and how to optimize search results.

Mental health problems affect up to 20% of women during pregnancy and the first post-natal year. This screencast looks at how we can better identify these women in primary care, and the steps that we can take to ensure they get the support and treatment they need.

Malaria is a serious infection, transmitted by mosquitoes. Although the UK is malaria free, cases are still seen in travellers from endemic areas. In 2015, 85% of patients who had travelled abroad from the UK and contracted malaria had not taken chemoprophylaxis. This screencast looks at which areas are the highest risk for malaria, issues with prevention, and the approach to possible malaria in primary care.

Tuberculosis is common – England has the second highest prevalence in Western Europe. It is more common among migrants, with 73% of new cases in 2015 being in those who were born abroad, but many of those patients had lived in the UK for years and so we should always have a high index of suspicion. This module covers latent TB and is a reminder of who might benefit from a BCG.

Obsessive Compulsive Disorder is common, but patients are often embarrassed to tell us about their symptoms. The risk of OCD is high in patients with eating disorders and also in the perinatal period. This 5 minutes to change your practice will provide useful information to detect and manage OCD.

Obesity rates in the UK are the highest in Europe. It costs the NHS £3 billion per year to treat obesity and its complications, which include diabetes, cardiovascular disease, liver disease and cancer. This screencast gives an outline of how we can help patients to lose weight and describes available treatments.

Antibiotic prescribing has increased drastically since 2000 and it is estimated that antibiotic resistance causes 700,000 deaths worldwide each year. This screencast looks at evidence based options for the treatment of some common primary care conditions and provides written information that can be given to patients who don’t need antibiotics.

It is not uncommon for patients to wait anxiously for an appointment for days before they can consult their GP. They may have to take time off work to attend this appointment and may, in desperation/frustration turn to out of hours or emergency services to seek help and advice. In many cases, patients may have been able to self care, if they had the appropriate resources and confidence to do this. Promoting self care in patients has a multitude of benefits for patients, individual practices, the NHS and the economy! This screen cast gives an outline of some ways that individuals and practices can support patients self care. It highlights resources that may help and how a practice can work together to promote self care.

Moderate to severe visual loss affects nearly three quarters of million people in the UK. This screencast offers advice on promoting good eye health and considers identification and immediate management of the main threats to vision. The module was written by Dr Emma Nash and is presented by Dr Khyati Bakhai.

Every year primary care organises influenza vaccination for large numbers of patients. Many myths about the "flu jab" exist and this "5 minutes" module will explain the evidence on flu vaccination, particularly thinking about the routine roll out of the programme to pre-school children and pregnant women. The module was written by Dr Jo MacIver and is presented by Dr Sally Higginbottom.

Superficial thrombophlebitis is a reasonably common presentation in primary care. This screencast looks at the evidence based treatment options and considers how concerned we need to be about the risk of concurrent deep vein thrombosis.

The government has set targets to reduce salt intake to just 3g/day by 2025, from the current average of 8g. This screencast will highlight the evidence driving this target, and help you guide your patients towards the cardiovascular benefit which can be achieved through this reduction.

Traditionally, inhaler therapy for asthma is a combination of "preventer" and "reliever" medications. There is, however, an alternative: Single Inhaler Therapy. This module will explain what this is and how to use it.

Increasingly, patients are being diagnosed with non-alcoholic fatty liver disease. This module aims to change your practice on monitoring and management for these patients based on their risk of disease progression. It outlines the need to calculate a "fibrosis score" and offers specific guidance on lifestyle changes these patients can be supported to make in order to avoid complications.

HIV has a much better prognosis when it is diagnosed early. Testing can be done in primary care with no need for extensive pre-test counselling. This module aims to change practice by increasing the number of HIV tests requested in primary care and also gives a brief update on issues relating to patients who have already been diagnosed.

Recent research indicates that abstaining from alcohol for even one month has significant health benefits - for weight, blood pressure, insulin resistance and liver fibrosis.

Last modified: Monday, 2 July 2018, 1:22 PM