68: Physical health needs of Armed Forces veterans

Health inequalities, the differences in health levels and outcomes between individuals and groups of individuals, are an issue of fundamental importance for general practice. For the RCGP's chair, Professor Kamila Hawthorne, tackling health inequalities is an integral part of general practice: because GPs are expert medical generalists at the heart of their community, general practice has a pivotal role to play in combatting the causes of health inequalities and dealing with their effects. In this podcast, Professor Margaret Ikpoh, GP in Hull and vice-chair for professional development and standards discusses the impact of health inequalities on deprived communities with Professor Dom Patterson, GP in Doncaster, chair of the RCGP’s health inequalities group and founder and CEO of Fairhealth. They highlight solutions that can be implemented on individual, practice and ICB level. This podcast was produced by RCGP Learning. Editorial and content decisions were made solely by the RCGP. 

More than 1 in 4 women aged 16 to 24 years report having self-harmed at some point, compared to around 1 in 10 men of the same age. Research suggests as many as two thirds of people who self-harm will have seen their GP in the month before or after an episode of self-harm. In this podcast Dr Thomas Round, a GP and EKU Clinical Lead, talks to Professor Carolyn Chew-Graham, a Professor of General Practice Research at Keele University and a GP in Manchester, about assessment, management and prevention of self-harm.

Colorectal cancer is the fourth most common type of cancer in the UK, with over 40,000 new cases each year. The positive predictive value of Faecal immunochemical testing (FIT) far exceeds that of symptoms and makes FIT an important tool for triaging patients with symptoms suggestive of colorectal cancer to the right diagnostic pathway. In this podcast Dr Thomas Round, a GP and EKU Clinical Lead, talks to Dr Kevin Barrett, a GP in Hertfordshire with a special interest in gastroenterology, about faecal immunochemical testing in patients with signs or symptoms of suspected colorectal cancer (CRC)

In this series of two podcasts, Dr Dirk Pilat, the medical director for professional development of the RCGP, discusses the resurgence of measles in the United Kingdom. In the first part, Dr Michael Mulholland, the honorary secretary of the RCGP, reminds us of the severity of the disease, the efficacy of the MMR vaccine and how to prepare for a potential increase of cases in the community. In the second part, Dr Tehseen Khan, a GP in North East London, the Population Health & Health Inequalities Lead at North East London ICS and a Clinical Advisor for NHS England, shares his experiences on how to increase immunisation coverage within communities where coverage has traditionally been below average and how to address lack of vaccine confidence in the consultation. This podcast was produced by RCGP Learning. Editorial and content decisions were made solely by the RCGP.

In this series of two podcasts, Dr Dirk Pilat, the medical director for professional development of the RCGP, discusses the resurgence of measles in the United Kingdom. In the first part, Dr Michael Mulholland, the honorary secretary of the RCGP, reminds us of the severity of the disease, the efficacy of the MMR vaccine and how to prepare for a potential increase of cases in the community. In the second part, Dr Tehseen Khan, a GP in North East London, the Population Health & Health Inequalities Lead at North East London ICS and a Clinical Advisor for NHS England, shares his experiences on how to increase immunisation coverage within communities where coverage has traditionally been below average and how to address lack of vaccine confidence in the consultation. This podcast was produced by RCGP Learning. Editorial and content decisions were made solely by the RCGP.

In this podcast, RCGP Clinical Champion for veterans' healthcare Dr Emily Brookes talks with Beth Lambert, National Service Lead for Op RESTORE, and Mr Shehan Hettiaratchy, National Clinical Director for Op RESTORE, about their specialist service designed to improve physical healthcare for Armed Forces veterans. Become veteran friendly at rcgp.org.uk/veterans Services mentioned in the podcast: Blesma - charity that supports limbless veterans Blind Veterans UK - charity that supports vision-impaired ex-Servicemen and women to rebuild their lives after sight loss Op RESTORE - the NHS Veterans Physical Health and Wellbeing Service (formerly the Veterans Trauma Network)

Depression is both under-recognised and under-treated. Only 60% of people with symptoms of depression consult a GP and of these only 60% are diagnosed. It causes significant morbidity and mortality. Mental health problems are the cause of 10% of all certified sickness episodes and depression leads to more than 3,000 deaths by suicide each year in the UK. In this podcast Dr Thomas Round, a GP and EKU Clinical Lead, talks to Professor Carolyn Chew-Graham, a Professor of General Practice Research at Keele University and a GP in Manchester, about the treatment and management of depression in adults.

In the second podcast in this series, Dr Emma Ryan discussed how a GP might notice that a patient is experiencing gambling harms, and what they could do about it. The podcast covers the four tiers of treatment, from local voluntary services up to residential care, as well as the rating scales which are used in both primary and secondary care, and the issues to consider if a patient who is being treated for gambling disorder suffers a relapse. The podcast goes on to talk about how practices could develop their knowledge in this area, if it was something that they wanted to learn more about, and what services they could offer, including how to obtain RCGP accreditation. An educational grant was received from GambleAware for the production of the podcast. Editorial and content decisions were made solely by the RCGP. 

In this podcast, Dr Emma Ryan introduces the concept of gambling related harms, starting with background information on gambling in the UK and how it affects adults and children. She goes on to discuss the definition of gambling disorder, which populations are at particularly high risk, and the recent gambling white paper. The second podcast in this series will deal with the issue in more detail, giving practical information about how a GP can spot a patient who is affected by gambling, and what to do about it. An educational grant was received from GambleAware for the production of the podcast. Editorial and content decisions were made solely by the RCGP. 

In this podcast, Dr. Anne Connolly discussed endometrial and cervical cancers, with a focus on early diagnosis. The podcast covers the different risk factors for the two cancers and how knowledge of these risk factors can help with diagnosis and prevention. As part of this the cervical screening programme is discussed, including the recent change to primary HPV screening and the possibility of a future in which the first test is a self-taken HPV swab. The symptoms that should raise concern about endometrial cancer are discussed, as well as the referral pathways and what to do when you are concerned about someone but they don’t exactly meet referral criteria.