Primary Care Knowledge Boost

Doctors Lisa and Sara talk to Consultant Endocrinologist Dr Rupinder Kochhar about patients with Type 2 Diabetes. Using hypothetical cases, we talk a little bit about diagnosis, but spend most of the time discussing the details of management in younger patients as well as how to de-escalate treatment and what the goals might be in a more frail elderly patient. Disclaimer: All educational content in this podcast was developed as part of the Circulation Health collaborative working project between Boehringer Ingelheim Limited, Greater Manchester Primary Care Provider Board and Health Innovation Manchester. Content has been created by Circulation Health Clinical Leads for educational purposes, reflecting NHS Clinical Lead and guideline-based recommendations. Boehringer Ingelheim had no input into content development. They have provided financial resources to support Podcast recordings related to this project. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Resources: NICE draft guideline - Type 2 diabetes in adults: management: https://www.nice.org.uk/guidance/gid-ng10336/documents/450 Managing Heart Failure, CKD and T2DM in Primary Care: https://pckb.org/e/managing-heart-faiure-ckd-and-t2dm-in-primary-care/ Essential steps in primary care management of older people with Type 2 diabetes: an executive summary on behalf of the European geriatric medicine society (EuGMS) and the European diabetes working party for older people (EDWPOP) collaboration: https://pmc.ncbi.nlm.nih.gov/articles/PMC10628003/ Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes: https://diabetesjournals.org/care/article/45/11/2753/147671/Management-of-Hyperglycemia-in-Type-Diabetes Diabetes UK: https://www.diabetes.org.uk/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara are back with Consultant Neurologist Dr Antonella Macerollo for this episode about Parkinson’s disease. We look at a typical case and discuss what Parkinson’s is, the differentials, the need for time to discern between these, and the options for treatment. Links include information on Clinical Trials and Parkinson’s UK which is an active Charity linking resources together for patients and professionals. Thanks to Alison Day at Parkinson’s UK for making the connection between ourselves and Antonella to make these episodes possible. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Resources: Parkinson’s UK: https://www.parkinsons.org.uk/ The epidemiological link between Essential Tremor and Parkinson’s Disease: https://www.nature.com/articles/s41531-023-00577-y PD Frontline (clinical trial in Parkinson's disease): https://pdfrontline.com/en Cure Parkinson’s: https://cureparkinsons.org.uk/ Parkinson’s Europe Charity (good resources): https://parkinsonseurope.org/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara speak to Consultant Neurologist Dr Antonella Macerollo about Essential Tremor (ET). We take a case and go through what ET is, how it might present, differentials and the differences between other conditions, how it might affect people and what management options there are. This is the first of two Episodes with Dr Antonella Macerollo, our next one is about Parkinson’s Disease. Thanks to Alison Day at Parkison’s UK for making the connection between ourselves and Antonella to make these episodes possible. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Resources: More Differentials and details of clinical assessment of Tremors: https://patient.info/doctor/history-examination/tremor-pro?utm_source=gpoptin Revisiting the assessment of tremor: clinical review. Vijiaratnam N, Wirth T and Morris HR. British Journal of General Practice 2020; 70 (701): 611-614. https://bjgp.org/content/70/701/611 Treatment for essential tremor: a systematic review and Bayesian Model-based Network Meta-analysis of RCTs. Zhang, Junjiao et al. eClinicalMedicine, Volume 77, 102889: https://www.thelancet.com/action/showCitFormats?doi=10.1016%2Fj.eclinm.2024.102889&pii=S2589-5370%2824%2900468-1 Parkinson’s UK: https://www.parkinsons.org.uk/ The epidemiological link between Essential Tremor and Parkinson’s Disease: https://www.nature.com/articles/s41531-023-00577-y ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara are joined by Dr Cheryl Fitzgerald who is a retired gynaecologist with an extensive background in subfertility. Using a hypothetical case we discuss the definition of subfertility, important components of a history with this presenting complaint, and comorbidities to be aware of. We talk about who should be referred to secondary care, and what patients can expect from that referral. We also think about useful investigations in primary care before referral. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Resources: Human Fertilisation and Embryology Authority (HFEA): https://www.hfea.gov.uk/ NICE Fertility problems: assessment and treatment: https://www.nice.org.uk/guidance/cg156 Green Top Guidelines: https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/ RCGP Infertility: https://elearning.rcgp.org.uk/mod/book/view.php?id=12534&chapterid=82 ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

We’ve got something a little bit different for you today, instead of our summer rewind. Some people may remember the wonderful episode about dealing with Uncertainty we did way back in 2020 with GP, Primary Care Educator and Author Dr Avril Danczak. It was such an important episode in our careers and I know helped many others. We wanted to share the news that Avril is doing brilliant podcasting work with the ever pragmatic Professor James McCormack. Their podcast Contented clinician, people may have already found, but we thought it would be useful to post one here to signpost listeners to their good work. Welcome to Episode 6 of The Contented Clinician Podcast! Dr Avril Danczak and Professor James McCormack created The Contented Clinician Podcast to help clinicians find more joy and satisfaction in your practice by blending a collective of real-world experience, common sense, and the best available evidence. So, if you’re looking to make your clinical practice more fulfilling and sustainable, join us and our inspiring network of clinicians as we explore new perspectives and effective strategies to reshape the way you think about your work. The Case: Dr. Ashville is currently training to become a family physician. One day, they receive a phone call from a frustrated patient named Jane Brown. Jane had received a message stating: “As your cardiovascular risk is now 10%, it is recommended you take a statin medication.” She is upset because no one had a proper conversation with her about starting a new prescription. Her main concern is: “How likely am I to actually benefit from this treatment? Is it really worth it?” Dr. Ashville realizes they had simply been following a protocol and isn't entirely sure how to answer Jane's question. Wanting to better understand how to provide more balanced information, Dr. Ashville decides to discuss the issue with the clinician supervising their medical education. Resources: GP Evidence: https://gpevidence.org/ James McCormack: Doing statistics can be difficult but understanding them can be fairly simple: https://www.sensible-med.com/p/doing-statistics-can-be-difficult ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general publ

Doctors Lisa and Sara take a deep dive into the recent combined asthma guidelines with Dr Murugesan Raja who is a GP and clinical lead for respiratory medicine for NHS Greater Manchester Strategic Clinical Network. We go through the new asthma recommendations for the different age groups, starting with a reminder of what symptoms make up a typical asthma history, moving on to the new pathway of investigations, and ending with a chat about management covering AIR and MART. We also touch on green prescribing, steroid cards and other important areas of management such as adherence and inhaler technique. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Resources: Joint asthma guideline: https://www.nice.org.uk/guidance/ng244 GMMMG asthma guidelines: https://gmmmg.nhs.uk/guidance/clinical-guidance-and-pathways/gm-asthma-guideline-2024-for-web/ Asthma and Lung UK: https://www.asthmaandlung.org.uk/ Right Breathe: https://www.rightbreathe.com/ Asthma and Lung UK explainer videos: https://www.asthmaandlung.org.uk/living-with/inhaler-videos ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Episode three of four on Paediatric ENT. Doctors Lisa and Sara are back with Paediatric Ear Nose and Throat Consultant Dr Simone Schaefer for this episode on Recurrent Epistaxis in Children. We discuss important differentials, including a rare condition that can present in predominantly teenage boys not to be missed, before moving on to discuss options for management and why the vast majority of these patients can often be safely managed in the community. We discuss cases that would be useful to be seen by the ENT team. Short and sweet, full of useful resources. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Resources: Success Rates of Naseptin (Chlorhexidine dihydrochloride and neomycin sulfate) in reducing Epistaxis: Garry S, Wauchope J, Hintze J, Ryan E, O'Cathain E, Heffernan C. Factors affecting Naseptin treatment success – A prospective cohort study. International Journal of Pediatric Otorhinolaryngology. Volume 171. 2023: https://www.sciencedirect.com/science/article/abs/pii/S0165587623001878#:~:text=80.8%25%20(n%20%3D%20101),effects%20(skin%20irritation%20etc.) ENT UK: How to use a Nasal Spray: https://www.entuk.org/patients/conditions/79/how_to_use_nasal_sprays/ Asthma and Lung UK, How to use a Nasal Spray useful Video for patients: https://www.youtube.com/watch?v=S31maomo1xQ Alder Hey Children’s Hospital Patient leaflet: Nosebleeds: https://www.alderhey.nhs.uk/conditions/symptoms-checker/nosebleeds/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Episode one of four on Paediatric ENT conditions. Doctors Lisa and Sara are joined by Paediatric Ear Nose and Throat Consultant Dr Simone Schaefer for this episode on Recurrent Acute Otitis Media (AOM) in Children. A common problem, we take a classic presentation and work through getting the diagnosis right, red flags and differentials before discussing management and which children may need referrals. We then discuss the limited options of what might be done in an ENT clinic and helpful resources for families. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful Resources: NICE Clinical Knowledge Summaries on Acute Otitis Media (including initial presentation, persistent infections and recurrent infections (updated August 2024): https://cks.nice.org.uk/topics/otitis-media-acute/ Hoberman et al. 2021 NEJM Tympanostomy tube placement or medical management for recurrent acute otitis media: https://www.nejm.org/doi/full/10.1056/NEJMoa2027278 Resource for Patients: https://www.nhs.uk/conditions/ear-infections/ https://www.hopkinsmedicine.org/health/conditions-and-diseases/ear-infections-in-babies-and-toddlers ENT UK: Decision making aid for parents re Grommets: https://www.entuk.org/patients/conditions/5/grommets_a_decisionmaking_aid_for_parents ENT UK: Explainer leaflets, How to use ear drops or sprays: https://www.entuk.org/patients/conditions/74/how_to_use_ear_drops_or_sprays The Royal Children’s Hospital Melbourne. Clinical Paediatric Guideline (good algorithm, pictures of erythematous Tympanic Membranes versus Acute Otitis Media with bulging/effusion): https://www.rch.org.au/clinicalguide/guideline_index/acute_otitis_media/ ENT Guidelines for Derbyshire (includes details of Topical Drops in specific cases: https://www.derbyshiremedicinesmanagement.nhs.uk/assets/Clinical_Guidelines/Formulary_by_BNF_chapter_prescribing_guidelines/BNF_chapter_12/Chapter_12_Ear_nose_and_oropharynx.pdf ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical conditio

Doctors Lisa and Sara were delighted to interview Dr Sylvia Kama-Kieghe, a GP based in Sheffield with an interest in Women’s Health. She is the Chair of the Royal College of General Practice North of England International Medical Graduates Group. We start with what the group does, why it was set up and look at issues International Medical Graduates might face when working and training in the UK. We consider what practices, staff and supervisors can do to help make International Medical Graduates feel welcome and supported so that the experiences for all can be positive. A useful listen for all working in Primary Care and specifically those new to Practice in the UK and to Educational and Clinical GP Supervisors. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources: Dr Sylvia Kama-Kieghe’s YouTube Channel for Women’s Health: https://www.youtube.com/c/AskAwayHealth GMC Welcome to the UK pack for International Medical Graduates and Supervisors: https://www.gmc-uk.org/about/what-we-do-and-why/learning-and-support/workshops-for-doctors/welcome-to-uk-practice Royal College of General Practitioners Resources for International Medical Graduates: https://www.rcgp.org.uk/blog/international-medical-graduates-support Royal College of General Practitioners Guide for Overseas Doctors: https://www.rcgp.org.uk/your-career/overseas-doctors-guide Royal College of General Practitioners International Medical Graduates Forum: https://forum.rcgp.org.uk/login Guide on How the NHS works (2021): https://www.nhsemployers.org/system/files/media/Working-and-training-in-NHS-2021_0.pdf International Medical Graduates Podcasts with Raykal Simm: https://open.spotify.com/episode/5ZB88fc9X1tKftnYLhRytb?si=7c906c86bee34fbf Our Episode on How General Practice is Funded (2024): https://www.podbean.com/ew/pb-84rq4-15bc17f ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to Hepatitis C GP Champion Dr Lindsey Kent and Greater Manchester Peer Programme Manager Tony Horrocks for an overview of Hepatitis C. We cover the basics around the virus and prevalence, potential symptoms and at risk groups to consider when offering testing. We discuss the great work being done to eradicate Hepatitis C in Manchester (and around the UK) including Tony’s personal story as well as his work as a Peer Programme Manager. Wonderful to hear the success rate for cure with medications and how the team ‘leave no one behind’. Great listening for all of us working in General Practice. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources: NICE Clinical Knowledge Summaries Hepatitis C (last revised Sept 2022): https://cks.nice.org.uk/topics/hepatitis-c/ The Hepatitis C Trust UK Online Risk Checker: https://www.hepctrust.org.uk/hepatitis-c-risk-checker/ Order free Hepatitis C test UK: https://hepctest.nhs.uk/ Liverpool Hepatitis Interaction Checker: https://hep-druginteractions.org/checker Greater Manchester and East Cheshire Hepatitis C Operational Delivery Network: https://research.cmft.nhs.uk/innovation-at-mft/hepatitis-c-operational-delivery-network-for-greater-manchester-and-east-cheshire Aneesha Noonan’s podcast on Expanding hepatitis C elimination into Primary Care settings: https://youtu.be/U5TdLJdAGrI?si=Woy1nkVxfCztXaJY Hep C U Later Primary Care Toolkit: https://www.hepculater.com/wp-content/uploads/2024/05/Primary-Care-Toolkit-Final-with-links-v2-with-updated-date.pdf Hep C U Later’s ‘Hep C Elimination Successes’: https://www.hepculater.com/hepatitis-c-elimination-successes/ Hep C U Later: GP practices can run a case finding tools (these are already installed on systems within general practice). If you’re interested in running these tools with support from other organisations email connect.HepCULater@mpft.nhs.uk so we can link you to the right people. NHS England » NHS set to eliminate Hepatitis C ahead of rest of the world: https://www.england.nhs.uk/2022/12/nhs-set-to-eliminate-hepatitis-c/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not

Doctors Lisa and Sara talk to Locum Consultant Dr Caitriona MacDermott about assessing and managing constipation in Palliative Patients. A common symptom with a significant impact on people’s quality of life, the episode aims to get across the importance of the topic, the often multifactorial nature of clinical scenarios, the red flags not to miss and arm you with a logical and holistic approach to management. We discuss how management might differ for patients with certain conditions such as partial bowel obstruction, neurological causes, or liver disease. An important listen for those of us in the community looking after palliative patients. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources: Greater Manchester Palliative Care Symptom Control Guidelines for Adults (2019): https://www.england.nhs.uk/north-west/wp-content/uploads/sites/48/2020/01/Palliative-Care-Pain-and-Symptom-Control-Guidelines.pdf Clinical Knowledge Summaries from NICE: Palliative Care - Constipation (Updated Feb 2024): https://cks.nice.org.uk/topics/palliative-care-constipation/ NICE CKS Table of Doses of Laxatives that can be used for Palliative Patients: https://cks.nice.org.uk/topics/palliative-care-constipation/prescribing-information/doses-of-laxatives/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to Respiratory Physiotherapist Thomas James about COPD. We start with what COPD is, when to suspect it, a standard work up, pitfalls and points of consideration about spirometry, before moving on to an overview of management. We then cover some changes in the way COPD exacerbations are managed in South Manchester and the role of Eosinophils in both acute and chronic management. Understanding the role of Pulmonary rehabilitation, prednisolone and exercise in management are particular highlights. We cover our learning points from the episode at the end. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :) Useful resources: NICE COPD in adults (last updated Sept 2023): https://www.nice.org.uk/guidance/QS10 The Global Initiative for Chronic Obstructive Lung Disease (GOLD) Spirometry Guide: https://goldcopd.org/gold-spirometry-guide/ Association for Respiratory Technology and Physiology (ARTP) advice on Spirometry Interpretation: https://www.artp.org.uk/en/spirometry Greater Manchester Medicines Management Group (GMMMG) COPD Management Plan Guideline (2021): https://gmmmg.nhs.uk/wp-content/uploads/2021/11/COPD-Treatment-Guideline-Nov-2021-V7.1.pdf Greater Manchester Medicines Management Group (GMMMG) COPD Inhaler Guide (2021): https://gmmmg.nhs.uk/wp-content/uploads/2023/05/GMMMG-COPD-Inhaler-Guide-update-Mar-2023.pdf Greater Manchester CURE Project for Smoking Cessation: https://gmcancer.org.uk/programmes-of-work/treatment/the-cure-project/ Greater Manchester Change, Grow, Live Services including Smoking Cessation: https://www.changegrowlive.org/ Primary Care Respiratory Society MRC Breathlessness scale: https://www.pcrs-uk.org/mrc-dyspnoea-scale Our podcast with Dr Lesley Henson and Dr Caitriona MacDermott on Breathlessness in Palliative Care (May 2024): https://pckb.org/e/breathlessness-in-palliative-care/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professi