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International Primary Care Association

Clinical Focus Volume 1 N1

IPCA Admin

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Friendly, non-judgmental ‘one-stop’ services enable young people to access sexual and reproductive healthcare. Contraceptive advice should be comprehensive, addressing the young person’s needs and priorities with appropriate follow-up. Evaluating competence to consent and discussing confidentiality are core aspects of the adolescent sexual health consultation, in addition to identifying any safeguarding concerns.


Many people, especially non-Causcasians, have difficulty breaking down lactose (the sugar in milk) after early childhood. It results in gastrointestinal symptoms such as bloating, abdominal pain and diarrhoea following ingestion of milk and milk products, known as lactose intolerance. Lactose intolerance is easily managed by simple dietary modification.

The festive season would be over by the time this issue reaches you. We certainly need glad tidings. There are national and international calamities disrupting our economic and health related wellbeing. The Greek economic crisis may well have enveloped Italy and other Eurozone countries with the detrimental effect on the EU economy. As about 40% of UK exports are to Europe this will undoubtedly have a major negative impact on our GDP and therefore on public services. The austerity measures introduced by the government have prevented a financial UK meltdown but at what cost? The NHS will lose £20 billion over 5 years and all other public key sectors are similarly affected, education, welfare, police, councils. However, let us not forget the less obvious targets for reductions in support, such as children’s services, domestic violence….


I have had an interest in cardiology for some time, which developed during my time in anaesthesia and I felt that primary care had more to offer in this area. Some brief research (and a few emails) encouraged me to further develop my interest when I heard what others were doing in primary care. I was particularly interested in developing a local echocardiography service due to my personal interest in ultrasound and the pressures on our secondary care provider. A quick audit revealed a turn around time of almost four months from our local open access echo service (from dictation of referral to the typed report landing on my desk). The final catalyst was my desire to work as a GP with a special interest as the daily grind of full time partnership was adversely affecting my quality of life.


Hospital medicine has undergone considerable changes over the past decade. One of these changes has been the appearance of the term ‘acute medicine’ in the vocabulary of clinicians and managers working within the NHS. Since its first mention in a Royal College of Physicians document in 1996, the development of acute medicine has been a ‘roller-coaster’ ride, culminating in the establishment of subspecialty status in July 2003. The field now has its own journal, a specialist society and over 150 consultants across the UK. So what have been the catalysts for these rapid and dramatic changes, and what opportunities does the field of acute medicine offer for general practitioners with special interests?

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