Tagged: primary care

joined 3 years, 11 months ago

Dr. Vidya Kanthi qualified at UCL in 2007 and entered the Specialist GP Register in 2012, subsequently joining the Hertfordshire Performer’s List in 2016. Dr. Kanthi is a Clinical Diabetes Lead in her Clinical Commissioning Group (CCG) and is also a Project Lead for Herts Valleys Integrated Diabetes Service.

In her role as an NHS GP Appraiser, Vidya is responsible for assessing the quality of care provided by a myriad of GP’s across the South East. Dr. Kanthi is also an Educational Supervisor for the national Physician Associate training programme.

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joined 3 years, 11 months ago

Dr. Shabana Chaudhari is an expert Private Doctor with over twenty years’ clinical experience.

Following several years as a specialist hospital doctor, as well as having held a number of teaching positions, Shabana obtained her MRCGP (specialist GP Registration) in 2002.

With post-graduate qualifications in Female and Family Health, Dermatology and Occupational Medicine, Shabana is able to diagnose, treat and manage the most challenging of conditions.

Noted for her empathy and understanding, Shabana is rightly one of the most popular Private Doctors in London.

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Melita Fernandez

Urgent Care Clinic

At Urgent Care of Texas, We provide a wide range of urgent care services whether its non-life threatening injuries or sickness that is keeping you from your daily routine. No appointment needed, most insurances accepted and wait time is always minimal.

For decades health care facilities have been categorized based on health problems, Expecare Family Care & Urgent Care of Texas strives to change that and bring the focus back to the patient. We promise to serve and care for you, any age or gender, with health problems mild or severe, injury or chronic issues. It is about your convenience and comfort.

Specialty Services - Primary Care, Urgent Care, Occupational Health Care, Diagnostic Services, Physical Therapy, IV Infusion, Auto Accident Treatment, Podiatry Treatment, Prep, Iv Nutritional Therapy, Travel Medicine

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The convenient quality healthcare revolution

  • Demand for primary care services outstrips supply
  • People want affordable convenient, quality healthcare
  • The retailization of healthcare is large and growing fast
  • US Minute Clinics in CVS retail outlets expect 6 million visits in 2015
  • Traditional health providers can’t stop the convenience healthcare revolution, but they can encourage it 

“It” is larger, and growing faster than most people think. “It” is driven by the combined burdens of heightened patient expectations, disproportionate growing and ageing populations, and finite resources. “It” will significantly impact healthcare systems throughout the world. “It” . . . . is the ‘retailization of healthcare’, which uses pharmacists, and nurse practitioners to provide a range of healthcare services in diverse retail locations.

A convenience revolution

In 2010, Rite Aid, the US retail pharmacist, partnered with American Well, a company providing online access to doctors 24-7; 365 days a year, to test a service, which allows consumers to interact directly with Rite Aid pharmacies for medication advice, and results in an electronic record, which is shared with primary care doctors.

Larry Merlo, the CEO of CVS, the second largest drugstore chain in the US, which has 100 million customers each year, is leading the charge to create more healthcare services in CVS stores. Already, CVS has 960 walk-in Minute Clinics staffed by pharmacists and nurse practitioners. The clinics are open on nights and weekends with no appointments. Prices are between 40% to 60% lower than traditional US doctors, and a fraction of the cost of A&E. This year, Minute Clinics expect some six million visits, and CVS plans to open a further 500 such clinics by 2017. In 2014, at CVS stores, more than 700 million prescriptions and five million flu injections were administered. 

Walgreens, the largest drug chain in the US with 8,217 stores in 50 states, has also set-up healthcare clinics, and similar initiatives, are afoot in the UK. These, together with other retail initiatives, constitute a convenience revolution in healthcare. 

“US and UK healthcare systems will go bankrupt if they don’t change their current healthcare delivery models,” says Devi Shetty, world renowned heart surgeon, founder and chairman of Narayana Health, India, which provides affordable quality healthcare. 

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Adherence to medication

People like the fact that pharmacists are accessible friendly health professionals, and over time grow trusting, personal and valued healthcare relationships with them, which enhance adherence to medications. Non adherence is costly, and can lead to increased visits to A&E, unnecessary complications, and sometimes death. According to a New England Healthcare Institute report, Thinking Beyond the Pillbox, failure to take medication correctly, costs the US healthcare system $300 billion, and results in 125,000 deaths every year. 

Rajiv Dhir a senior prescribing pharmacist working for NHS England describes the importance of patients being able to discuss their drug regimens with pharmacists:

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Primary care environment 

In the UK and elsewhere the demand for rapid and convenient primary care, outstrips it's supply. For instance, the UK is experiencing an exodus of GPs. In just five years, 40% have left to work abroad, and around 22,400 GPs – more than half of England’s 40,200 family doctors – want to retire before the usual age of 60. Younger doctors are not filling the gaps, with up to one in eight GP training posts unfilled. They are instead either choosing careers as hospital specialists or going to work abroad. Today, some 1,063 GPs are needed in England just to return to the patient-doctor ratio of 2009.

Coordination between primary and secondary healthcare

Walk-in retail clinics can provide a valuable link between primary and secondary care. CVS has partnered with over 50 secondary health providers including the Cleveland Clinic, which offer their Minute Clinics follow-up services, and answer questions a nurse practitioner might have over the telephone. Such relationships are well positioned to be enhanced by increased electronic sharing of patient data.


Traditional health providers can’t stop the convenience healthcare revolution, but they can encourage it.

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Expanding the role of community pharmacists

As efforts to integrate community healthcare falter, access to primary care becomes more difficult, and A&E departments become over-burdened with minor aliments, increasing attention is being paid to innovative ways to mine the vast, and easily accessible clinical expertise of pharmacists in order to increase the quality of healthcare and reduce costs.
An untapped reservoir of clinical excellence
Various reports describe how patients are increasingly tapping into the professional expertise of community retail pharmacists. However, the vast reservoir of pharmacists’ clinical knowhow and expertise is not optimally utilized in the provision of healthcare, and is not fully appreciated by the general public and healthcare providers. 
An underutilized clinical knowledge bank
Pharmacy is the third largest health profession in the UK, with universally available and accessible community services. In England about 6,000 pharmacists work in hospitals, some 3,000 are employed in the pharmaceutical industry, and about 32,000 work in 13,000 community retail pharmacies. All are highly trained graduates, who have undergone competency training, and a registration examination, which enables them to practice. 
In contrast to GPs, pharmacists have a significant high street presence, and long opening hours. They are also open at weekends, and no appointment is required for their services. According to a 2014 Royal Pharmaceutical Society report, 99% of the UK population can reach a pharmacy within 20 minutes by car, and 96% by walking or using public transport. Community retail pharmacists help people stay well, and use their medicines effectively. Each year, the NHS spends some £12bn on medicines; £100m of which is wasted on their ineffective use.
A 2014 Care Quality Commission review of 8,000 GP surgeries in England, uncovered overly long wait-times for appointments, and poor care of the elderly. Forty per cent of GPs questioned in England by the magazine PULSE, said that they expected two-week wait-times for non-urgent appointments in 2015.
Expanded role of pharmacists
Pharmacies are extending their services to patients’ homes, residential care, hospices, and primary care offices. This provides a significant opportunity for healthcare systems.
Pharmacists can play an expanded role in out-of-hours primary and urgent healthcare, and are well positioned to raise disease awareness, deliver educational information at multiple points of contact, and offer sexual health services. In 2013, more than 16,000 free Chlamydia tests were carried out in pharmacies. In 2010 NICE recommended that pharmacists should offer a full range of contraceptive services to tackle the exceptionally high under 18 conception rate in England.  
However, the core business for 21st century healthcare systems is to meet the large and growing needs of people with life-long chronic conditions, such as diabetes, cancer, heart disease, and respiratory conditions. Community retail pharmacists are well positioned to monitor and manage such conditions to alleviate their symptoms, and reduce the need for invasive, costly and disruptive interventions. This role would be significantly enhanced if pharmacists had access to patient records. 
There is an urgent need for community retail pharmacists to expand their range of clinical services. Working with other health professionals, pharmacists have an expanding role in optimizing the use of medicines, providing a national minor ailment service, and playing a larger role in the on-going management of patients with long-term chronic conditions.  
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joined 8 years, 7 months ago

Sachin Patel

General Practitioner

Dr Patel is a GP Principal in West Wandsworth. He looks after a large and diverse diabetic population in Putney & Roehampton and is the lead GP for diabetes at Mayfield Surgery.

He has completed post graduate training in diabetes and is the Clinical Diabetic lead for West Wandsworth on the clinical reference group for Wandsworth CCG.

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Evidence from a recent survey of people with diabetes, suggests patient outcomes will improve if GPs provide healthcare information in video clips rather than paper pamphlets.

Traditional patient information is failing
"An indication that the current paper and web-based diabetes information is failing to improve patient outcomes is the fact that the incidence rates of diabetes in the UK are escalating. Currently, a plethora of diabetes information is provided either in paper pamphlets or as digitalized text on websites, but patients want healthcare information in video clips, and greater connectivity with their health providers," says Dr Seth Rankin, managing partner, Wandsworth Medical Centre, who conducted the survey.

Despite the NHS spending £10 billion each year on diabetes care, between 2006 and 2011 the number of people diagnosed with diabetes in England increased by 25%: from 1.9 million to 2.5 million. Today, 3.8 million people have diabetes, and this number is expected to increase to 6.2 million by 2035. In 2013 there were 163,000 new diagnoses of diabetes in the UK, the biggest annual increase since 2008, and the five-year recurrence rates of diabetic foot ulcers are as high as 70%. The population increase over the past decade only explains some of these increases.
Improving outcomes
Organizations treat the distribution of diabetes information as ends in themselves, and report the quantity of information distributed, but not the impact it has on outcomes.
By simply asking patients with diabetes how, when and where they would like to receive information to help them manage their condition provides an important missing social link between health professionals and patients, and can help to improve outcomes.
Patients' views neither sought nor acted upon
"When we ask patients living with diabetes," says Rankin, "we get a clear picture of what patients want. The fact that patients' opinions are rarely sought, and even more rarely acted upon, might help to explain why the incidence rates of diabetes are escalating. There's no shortage of resources and technical competences in the UK to treat and manage diabetes. However, communications between doctors and their patients living with diabetes throughout their therapeutic journeys are weak. This inhibits patient education, slows self management and quickens the onset of complications," says Rankin. 
Patient survey 
In 2014, 140 people living with diabetes from two London primary care practices participated in a six-week project to improve doctor-patient communications. Patients received regular video clips via email from their health professionals and fellow patients to help them improve the management of their condition. At the end of the project patients' opinions were sought in an email survey, which yielded 51 responses: a response rate of 36%.
  • 65% found video information about diabetes helpful
  • 72% prefer diabetes information from GPs via email
  • 70% want access to healthcare information anytime, anywhere and anyhow 
  • 52% prefer healthcare information in video format to paper pamphlets
  • 68% want more information about their condition
  • 14% visit Diabetes UK's website
  • 53% regularly search the Internet for information about diabetes care
  • Only 19% can distinguish between good and bogus Internet healthcare information
"Providing diabetes information in short video clips featuring local health professionals, which can be easily browsed by patients, creates greater connectivity between doctors and patients.
Unlike health professionals and paper pamphlets, video clips never wear out, and are available 24-7, 365 days a year. Further, any number of people can access them at the same time, from anywhere, on any device.
Our survey suggests that videos clipsare effective in increasing patients' knowledge of diabetes, and propelling them towards self-management. Video clips could be used for all manner of patient information on all manner of conditions," says Rankin.
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