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vrijdag 23 februari 2018

RCGP: Research should reassure patients, and GPs, that antidepressants are effective, says College

Research should reassure patients, and GPs, that antidepressants are effective, says College

She said: "Taking antidepressants is frequently portrayed as a negative thing or something done only when other therapies are not available or have failed, but this in itself can add to the unfortunate stigma that sometimes exists around people with mental health conditions.

"This research should reassure patients who are taking or are contemplating commencing antidepressants, and the doctors that prescribe them, that they are an effective treatment for depression in the short-term.

"Depression is a significant mental illness which, if left untreated or unmanaged, can cause a huge amount of distress for a patient, their family and friends. It should never be swept under the carpet or ignored.

"Although antidepressants are of proven benefit - as this study shows - no doctor wants their patients to become reliant on medication so where possible, GPs will explore alternative treatments, such as talking therapies or CBT, which can be of great benefit for some patients.

"However, these services are often hard to come by in the community and we need better, quicker access to them if we're able to deliver the level of care we want to for all NHS patients.

"NHS England's GP Forward View pledged that every GP practice in England will have access to one of 3,000 new mental health therapists.

"We need this, and its other promises, including an extra £2.4bn a year for general practice and 5,000 more GPs, to be delivered, in full, as a matter of urgency, with similar promises made and delivered in the devolved nations, so that we can continue to provide the best possible mental health services to our patients, regardless of where they live."

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Social prescribing can help give some patients a 'sense of purpose', says College

She said: "It's good news to hear about so many schemes across the country where primary and secondary care are working together to implement social prescribing initiatives that are benefitting patients, and having a positive impact on the NHS as a whole.

"Over 1m patients are seen in general practice each day, and GPs will always take into account a patient's physical, psychological and social factors potentially affecting their health when making a diagnosis and formulating a treatment plan.

"Sometimes, what our patients need isn't actually traditional medical care; it is encouragement to take an exercise class, or any activity that will get them out of the house and mixing with other people. GPs and other colleagues in their teams will readily recommend these initiatives if they are appropriate and available locally.

"Social prescribing is something that experienced GPs have always done – it just the actual term was not widely used until recently. Benefits we have seen can include prescribing less medication, fewer follow-up consultations, and engaging patients more with their own health. Linking patients with local voluntary organisations can also help to give people a sense of purpose.

"It's clear that for social prescribing schemes to work well, then different sectors of health and social care services must work together constructively, and input from local councils can really help. It is also imperative that there are enough community services that could have a positive impact on our patients' physical and mental health and wellbeing, to meet demand.

"Social prescribing initiatives can potentially help free up some GPs' time which can then be used caring for patients with the most complex health needs, and thus ease pressures on general practice and the wider NHS - but they must not be seen as an alternative to investing in our general practice service.

"Ultimately, we need NHS England's GP Forward View, pledging £2.4bn extra a year and 5,000 more full-time equivalent GPs by 2020, to be delivered urgently and in full, and for equivalent promises to be made and delivered in each of the devolved nations."

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College welcomes patient safety measures on prescribing

"GPs work hard to avoid making mistakes in the prescribing process, and our patients should be reassured that in the vast majority of cases, prescriptions are made appropriately and correctly. But as well as being highly-qualified medical professionals, doctors are also human, so medication mistakes can and occasionally do happen.

"GPs already use systems designed to help them prescribe safely, but the College would welcome any additional resources or technology that will help to further minimise the risks of making a medication error, such as those outlined by the Health and Social Care Secretary today. Systems better linking prescribing data in primary care to hospital admissions, sound like a particularly good and necessary step forward.

"What is essential, is that highlighting that prescribing errors do occasionally happen is not used to admonish hardworking NHS staff – including GPs – for making genuine mistakes, but to address the root cause, and in general practice that is intense resource and workforce pressures, meaning that workloads and working hours are often unsafe for GPs and our teams.

"New measures to help reduce prescribing risk are certainly helpful, but the long-lasting solution to this is a properly funded NHS with enough staff to deliver safe patient care.

"Ultimately, we need to see NHS England's GP Forward View, which promises an extra £2.4bn for general practice, 5,000 more GPs and 5,000 more members of the practice team, delivered, in full, as a matter of urgency."


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