Promoting Mental Health and Preventing Mental Illness in General Practice

This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert ‘Think Tank’ convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your ‘cluster’ of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development

Protocol to evaluate the implementation of the royal college of general practitioners and Marie Curie Daffodil Standards in UK general practice

Introduction General Practitioners (GPs) provide a key role to facilitate end-of-life care. However, variable provision of palliative care in primary care settings may lead to both inequitable or suboptimal care. The Royal College of General Practitioners and Marie Curie launched the ‘GP Daffodil Standards for Advanced Serious Illness and End of Life Care’ in 2019 to improve and sustain practices delivering high-quality palliative and end-of-life care; we were commissioned to undertake an independent evaluation of the Standards. Aims To evaluate the implementation of the Daffodil Standards in general practice, and how they sustained or improved end-of-life care activities; To identify factors and processes which could lead to wider implementation of the Daffodil Standards. Methods A multi-method study comprising three phases, underpinned by the Normalisation Process Theory: Phase 1: online survey for UK GP practices (n=200 sample) to map end-of-life activities and levels of implementation of the Standards. Phase 2: semi-structured interviews with a sub-sample of survey respondents (n=20–26) to refine and provide further information from the survey. Phase 3: case studies (n=6–8), informed by Phases 1 and 2, to capture learning and identify exemplars of best practice to inform wider implementation of the Standards. Results The study has commenced, running from 2022 to 2024. We will share lessons learnt from implementing our protocol, and reflect on any required adaptations, within a community context. We will actively involve and engage with our research partner and Service Users for Primary and Emergency care Research (SUPER) group (PRIME Centre Wales). Conclusions We anticipate the learning will contribute a greater understanding of key enablers and barriers to implementing the Standards, capture lessons learnt, and build an evidence-base to encourage wider implementation across the UK. Impact To improve care for those affected by serious illness and end-of-life care with realistic and practical support for primary care teams

'Difficult Conversations':evaluation of multiprofessional training

ObjectivesEvidence-based communication skills training for health and social care professionals is essential to improve the care of seriously ill patients and their families. We aimed to evaluate the self-reported impact of ‘Difficult Conversations’, a multidisciplinary half-day interactive workshop, and gain feedback to inform future development and evaluation.MethodsService evaluation using questionnaire data collected before and immediately after workshops from February 2015 to August 2016 regarding participant self-assessed confidence, knowledge and skills. Qualitative free-text comments provided feedback about the workshop and were subjected to content analysis.ResultsOf 886 workshop participants, 655 completed baseline questionnaires and 714 postworkshop questionnaires; 550 were matched pairs. Participants were qualified or trainee general practitioners (34%), community nurses and care coordinators (32%), social care professionals (7%), care home staff (6%), advanced practice/specialist nurses (5%), care workers (5%) and allied health professionals (3%). All groups demonstrated significant increases in mean self-assessed confidence (2.46, 95% CI 2.41 to 2.51; to 3.20, 95% CI 3.17 to 3.24; P&lt;0.001), knowledge (2.22, 95% CI 2.17 to 2.27; to 3.18, 95% CI 3.14 to 3.22; P&lt;0.001) and skills (2.37, 95% CI 2.32 to 2.42; to 3.09, 95% CI 3.05 to 3.12; P&lt;0.001). Qualitative findings showed participants valued role play, the communication framework acronym and opportunities for discussion. They commended workshop facilitators’ skills, the safe atmosphere and interprofessional learning. Suggested improvements included more prepared role play and greater coverage of the taught topics.Conclusions‘Difficult Conversations’ workshops were associated with improvements in participants’ self-assessed confidence, knowledge, and skills. Our findings identify workshop characteristics that are acceptable to multidisciplinary trainees. Further testing is warranted to determine effectiveness and accurately identify workshop components leading to change.</jats:sec

Effect of Antiplatelet Therapy on Survival and Organ Support–Free Days in Critically Ill Patients With COVID-19

International audienc