Respiratory clinics and rural and Aboriginal health

Abstract

underestimating prevalence by up to 100%.PHE used a small study from 2010 in northern Sweden with a population of 76 000 to estimate the rates in an ethnically diverse population of 50 million people in England. Twenty per cent to 50% of people in some urban CCGs are from BAME groups with lower AF prevalence than white populations. Bradford AF prevalence was reduced by 70% in South Asians in comparison with the white population. 2 The Swedish study was conducted over 7 years and included all cases of AF, including all transient hospital inpatient cases that occurred in one in three cardiac operations. When the authors analysed cases identified in a single year rather than over 7 years, numbers were reduced by half. A Scottish study based on GP diagnoses showed that the annual prevalence was less than half that in Sweden. AF in people over 85 was 22% in Sweden and 7.1% in Scotland. 3 Comparing PHE estimates based on Sweden with the QOF 2018/2019 data from general practice in London boroughs shows overestimates of between 28% and 100% (Table 1), the higher figures being most pronounced in boroughs with large black or South Asian populations.These data from Sweden are not reliable for the estimation of annual AF prevalence as determined by GPs and substantially overestimate annual reports of prevalence in these populations. Commissioners and GPs should beware of the gap between flawed estimates and the reality of their local community prevalence.

Impact of COVID-19 on asthma management in general practice: A qualitative study

“…Presentations suggestive of an acute asthma flare during the pandemic were often redirected to the Federal Governmentfunded GP-led respiratory clinics where the review of COVID-19 undifferentiated patients with respiratory symptoms could be facilitated. 22,23 Participants who used their local respiratory clinics reported them as valuable and crucial in facilitating respiratory assessments, echoing a mixed-method evaluation of a similar clinic in the UK by Hibberd et al 24 The lack of communication and information sharing pathways between respiratory clinics and the patient's usual GP was noted. This might have contributed to the short-term fragmentation of asthma and other respiratory care in general practice 22 and is a barrier that should be addressed in developing models for GP-led clinics.…”

General Practice in the Time of COVID-19: A Mixed-Methods Service Evaluation of a Primary Care COVID-19 Service

“…These were not primary care led and, therefore, were a different model than that discussed in this paper. During the current pandemic, there have been GP-led COVID-19 respiratory clinics set up in rural Australia that are having some successes [ 36 , 37 ]. However, it is too early for any formal evaluation of these services to have been published.…”