eGPlearning Podblast
How to use email in General Practice

How to use email in General Practice

February 28, 2019

How to use email in General Practice

After Matt Hancock announced that email should be used over faxes and even post for communication with patients, some practices may be struggling to understand how to make these changes. This video post will highlight some of the areas to consider and tips on how to do this.

Set up
What system will you use- currently approved are and office365. Criteria for other providers can be found here.
It is worth having a patient facing inbox/address and a practice-based one for different communication routes. Consider different ones for results/ prescribing etc.
Suggest a generic email address for each to manage with a clear description as part of the email address ie or as examples.
Consider who and how often you will monitor the inboxes
Establish as a practice how the additional time needed to run emails will be used, especially if clinically based
If this is a system change, make this public. Use waiting room displays, footers on letters, social media platforms and patient participation groups (PPG) to advocate the use. Even consider a link on the prescription counterfoil.
Test wording of standard letters to make sure the practice is happy, even agree with indemnity provider or PPG if appropriate.
Email communication is part of the clinical record. Look at how this will be stored or transferred. If standard letters are used these may not need adding directly, but a clear system for recordings like templates or autoconsultations/macros should be used.
Consider using mailing list providers to help make this process easier, however, discuss with your local IT department on governance of providers.

Sign up
Abide by the data protection guidelines like GDPR, collecting information for what you need. Use either sign up sheet or confirmation via SMS/email with a link to your rules. A key tip is make this public ie on your website and use the link to share- easy via email, SMS or other. Make this the central governance hub for all your documents so you only have to update one place.
I would recommend adding a box that the patient agrees to all disclaimers as per below. This should be repeated in the confirmation message.
In this sheet/link be clear about how the practice will use the communication ie - sharing results, clinic letters, appointment information etc. If unsure or starting, try areas you are comfortable with and progress from there.
Use a template or autoconsultation/ macro to make this process easier for staff to support patients.
On sign up, instill a test email or SMS is sent at that time to confirm the identity and accuracy of the information given.
In this test email or message include a link to whitelisting emails. This is where a user confirms this is an email they want to receive. Include this in the footer of your emails as well which will help to ensure the messages do not end up in the junk folder. The following is an excellent link which shows this information
An additional option to help patients is to guide them to use folders to sort their emails from the practice.



Also, include a disclaimer about patients protecting their data once they have received it. A practice is not responsible for onwards use or transmission of email or text message once it has been received by the patient/service user
Include also that maintaining the integrity of the contact method ie correct number is the responsibility of the patient.
Commercial email providers are not as secure as those systems used in the NHS so include a line about being aware (and accept) that there is a risk (however small) of the email being intercepted or ‘hacked’.
Also include a line about which staff will access this data, ie admin, reception etc. This may help to prevent complaints at a later stage.
Recommend that the email or mobile number used is a personal one, not business or family one to support confidentiality. This is still the patient’s choice but an added disclaimer on the above would be prudent.

No-reply inboxes

One concern many clinicians have is being emailed about a critical symptom which may not be picked up till later and a negative impact. This also includes inappropriate clinical contact ie sending a prescription request but also asking a clinical question. One method to tackle this is with an automated no-reply message from the designated inbox.
Consider using a name rather than ‘’ This may help engagement ie or
Have a standard automated response. This may need tailoring for the time of day. Software exists to support this.
Use appropriate wording. Some examples are:
Thank you for getting in touch, unfortunately, this email is an automated notification, which is unable to receive replies. We’re happy to help you with any questions or concerns you may have. Please contact us directly at…..
If you wish to contact us, please do not reply to this message but instead contact the practice. For services like requesting your medications, booking appointments or viewing your records it may be easier to sign up to online access here. Replies to this message will not be read or responded to.
Please do not reply to this message. Replies to this message are sent to an unmonitored mailbox. If you have any questions or health concerns contact the practice at:

Clinical use of emails:
As the above look at your processes.
Remember that email can be effective for service information sharing, review of patients already seen and delivery of resources but may not be effective for new problem consultations.
Ensure an auto-response email is sent outlining the timeframe clinical emails will be reviewed in. NHS England recommends 24 hours. I would further clarify this to include a standard working day ie not including weekends or bank holidays.
This receipt email should also have a disclaimer about clinical direction ie this service is not regularly monitored. Any urgent health issues contact the practice at: or contact 111 if between these times…..
Ensure all reply emails have standard footers with disclaimer information and contact information.

For any comments or feedback contact me directly below or @drgandalf52 or @egplearning.






to change your user preferences in SystmOne

to change your user preferences in SystmOne

February 21, 2019

Do you get frustrated with not knowing how to make TPP SystmOne work better for you?

Watch this video as part of the eGPlearning #TipThursday to see my personal recommendations on how to tweak it to your needs including reducing excessive notifications and making tasks and letter workflow work smarter.

Commented as an avid user and admin of S1 FBUG (unofficial but awesome user group for S1) which you can join too.

(pssstt...remember to answer BOTH compulsory questions. Feel free to join the mailing list too for more resources.)

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Is Clockify the time tracking tool for primary care?

Is Clockify the time tracking tool for primary care?

February 14, 2019

How can you easily track all those time sinks in primary care without resorting to the limited method of pen and paper?

What is the best way to track the time your staff and peers use in practice?

Clockify is a tool that allows you to track time and do it easily, effectively and for free across the entire team.

Watch this video to see the whole review.

At the time of filming it is even more pertinent as the GP news magazine PulseToday has launched their GP workload survey. If you are a GP and watching this before the 15.2.19 please fill in this survey.:

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Tech to enhance CPD collection

Tech to enhance CPD collection

February 8, 2019

Watch Andy and Gandhi discuss how to use technology to enhance your collection of CPD (CME) for your appraisal and revalidation.

They explore useful resources and tools that can help make the collection of continuous professional development units easy and effective, including their own hints and tips.

This is recorded as part of the HTN Digital week.



Contact Andy:

Contact Gandhi:


A brief summary of hardware and system options to enhance your CPD collection.

A comprehensive list and guide of clinical resources

How to create systems using the above resources to enhance your CPD collection.

A summary of advanced methods to help automate and share your learning experience.

Our hints and tips to make it all manageable

Other sessions in this series

Bullet Journal:

Dingbats book

Frixion pen
Rocketbook Wave:

Clarity Appraisal toolkit walkthrough



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Which foods have FODMAPS? Can FastFODMAP help?

Which foods have FODMAPS? Can FastFODMAP help?

February 7, 2019

FODMAPS are complex carbohydrate chains with some evidence linked as triggers for irritable bowel syndrome (IBS).

Avoiding FODMAPS can help a patient experience fewer symptoms such as bloating, abdominal pain and changes in bowel habits.

Understanding which foods have FODMAPS, however, is complex. This episode looks at how using an app this can be supported, including some extra information about games in the app and cautions on using it.

Click the image below to see the full video.

To download the app click the link here for iTunes or Google Play

Subscribe to or follow the eGPlearning platform for more videos, app reviews and content to support technology-enhanced primary care and learning.

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The best primary care paediatric resource: Paediatric Pearls?

The best primary care paediatric resource: Paediatric Pearls?

January 31, 2019

What do you think is the best primary care paediatric resources?

In my experience, I have yet to find a complete resource that beats the paediatric pearls website.

The best primary care paediatric resource: Paediatric Pearls? Click image to watch the video

Created by Dr Julia Thompson and her team, based in London working for the NHS, paediatric pearls regularly produce and update paediatric newsletters for both primary care (general practice) and emergency medicine. In addition, they collate guidelines for condition management and referral guidance for most paediatric conditions.

As a result, paediatric pearls is an excellent resource for helping with your continuous professional development (CPD/ CME) especially for GP trainees (AiT).

Check out the site above or find it on our eGPlearning Paediatric resource page.


Alternately, contact them on Twitter: @Paedspearls on Twitter


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Top 5 GP apps eGPlearning Podblast

Top 5 GP apps eGPlearning Podblast

January 25, 2019

Watch this session as Andy and Gandhi of the eGPlearning Podblast discuss their top 5 GP apps.


Covering a variety of apps that you may want to use in general practice either for yourself or the benefit of your patients. This session also includes some honourable mentions.


This session is created as part of the HTN Digital week.

 To watch the video click here:

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Honourable Mention:



5: NHS Quicker

4: Headspace

3: Wysa

2: MyfitnessPal

1 Onenote


Honourable mention

5: MDcalc

4: BNF

3: Camscanner

2: Nottinghamshire LMC

1: Evernote:


Other sessions in this series

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CPD Certificate of engagement:


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Best Facebook groups for GPs and primary care

Best Facebook groups for GPs and primary care

January 24, 2019

This video showcases the variety of Facebook groups for GPs, primary care, and doctors.


It explains the reason for wanting to join the various groups and the importance of each.


Finally, the video shows how to get the most out of a Facebook group.


For links to the groups see the post below as shown in the video:


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Primary Care and Health Tech News Blast ep 3

Primary Care and Health Tech News Blast ep 3

January 19, 2019

Hello eGPlearners,  in this news update- covering the big stories for primary care over the past week….

lets tech-enhance your primary care

If the first time we are meeting Im Dr Gandalf of eGPlearning where I look at supporting you with technology-enhanced primary care and learning so don't forget to subscribe and ring the bell to be the first to get notified of all these updates.

Let us start

GP partnership review

This piece of the future of General practice was released on Monday 14.1.19 as led by Nigel Watson with seven recommendations at the heart of the review.

Recommendation 1: There are significant opportunities that should be taken forward to reduce the personal risk and unlimited liability currently associated with GP partnerships.

Recommendation 2: The number of General Practitioners who work in practices, and in roles that support the delivery of direct patient care, should be increased and funded.

Recommendation 3: The capacity and range of healthcare professionals available to support patients in the community should be increased, through services embedded in partnership with general practice.

Recommendation 4: Medical training should be refocused to increase the time spent in general practice, to develop a better understanding of the strengths and opportunities of primary care partnerships and how they fit into the wider health system.

Recommendation 5: Primary Care Networks should be established and operate in a way that makes constituent practices more sustainable and enables partners to address workload and safe working capacity, while continuing to support continuity of high quality, personalised, holistic care.

Recommendation 6: General practice must have a strong, consistent and fully representative voice at system level.

Recommendation 7: There are opportunities that should be taken to enable practices to use resources more efficiently by ensuring access to both essential IT equipment and innovative digital services.

From a digital perspective recommendation 7 is key. Updating systems and allowing innovation must happen, Digitising records would be a major support to practices and help to tackle another uncosted area on subject access requests. Taking this burden away from partners would be very useful. Also working better with statutory organisations for reports for DWP and DVLA would be helpful and reduce considerable administrative burdens on practices. In this past week I have done three reports for the same patient all relating to the DWP- one unified system would reduce unnecessary workload.

Updating our IT infrastructure and policies more in line with consumer tech is also a must. Tackling the ‘computer says no’ mentality due to a reliance on legacy IT would allow primary care to truly innovate, and I eagerly await the day I do not have to use internet explorer 8 in practice.

Many will know I have been critical of the interim review which was published last year. The final review is, however, a good document that identifies the challenges facing partnership and also commends the positive impact the partnership model has in primary care.

Several of the recommendations are high quality and call on other pieces of work to deliver an improvement for partnership in practice- particularly the call for a sort out of indemnity and the premises review.

I do still feel strongly that a key piece lacking is a direct request to increase the global sum funding for practices, as this would significantly and rapidly improve the partnership the workload impact for partners and attract more staff making it more viable and sustainable. I do still see this as a major omission of the review which is in the terms of reference. It should have been requested and using the long term plan as the vehicle to suggest increased funding does not directly help as this still requires increased work for new money, rather than offer a stabilising impact.

However, I do feel continuing to state the review is not fit for purpose is not true. The case studies are useful. I do maintain that much of the data collection could have been done rapidly online and not needed a UK wide roadshow to deliver on the review, but accept that the data and narrative is helpful. A key question moving forward is how much of this review will be implemented moving forward.

As an addition for those in Nottinghamshire, see this excellent summary by the Nottinghamshire LMC chief exec - Michael Wright with useful supportive links.

The difference in GP access across England is shocking

Speaking of Nottingham according to a breaking story today Rushcliffe (where I live) is the most well-covered GP area in the country. A stark contrast to where I work- St Anns which is in the second worse category for coverage- areas only 2 miles apart.

While many, especially will claim this is shocking news, to those who work in primary care it will be obvious. People work where there is a better work-life balance or income. The challenges of working in rural and inner-city areas in comparison to suburbia can be ignored and tackling health inequalities is paramount.

The patient who objected to 'Asian doctor' silenced by the receptionist

After a patient objected to seeing a Doctor because she was Asian this excellent reply by the reception team highlights the challenges many people still face.

See this tweet:

One area to consider is the institutionalised prejudice about choosing the gender of the clinician you may see. While there are many cultural and preference reasons for a woman to want to see a woman and similarly for a man to see a man, it can be argued this is still prejudiced that in some areas is supported by some CCGs and area teams insisting practices offer daily appointments with both male and female clinicians regardless of the organisation size.

Is this appropriate? As seen in this story when chosen by race it is abhorrent but choosing gender is more acceptable? What a confusing way to define prejudice.

Pharmacists warn of a 'surge' in shortage of common medicines

This has been a hot story over the week and likely to develop further. Anyone working in primary care will know about the challenges of obtaining certain medications, whether a doctor, nurse pharmacist and indeed patient. Last week I commented on the challenges about Rivaroxaban. Now this story has broken to the wider media.

The article shows some of the challenges such as:

increased global demand

the increasing cost of raw materials

new regulatory changes causing the closure of factories

fluctuations in exchange rates making it more attractive to supply Europe than the UK

generic companies unwilling to keep creating unprofitable items.

Part of the challenge is also created by the brand switching and use of branded generics by medicine management teams to bring down the costs for CCGs. While this has led to an ‘on the books’ reduction in cost, the opportunity cost to primary care is not factored in for the workload of GPs and pharmacists in dealing with switches and the potential health damage and costs caused by patients who have not had their medications on time. If this was to be factored in I would estimate it would obliterate the savings made, hence the cost to the system rather than individual pots may need addressing. This is potentially where PCNs may help, however, on a national stage there is little I feel the new changes will do.

There is also commentary by many pharmacists about the gaming of suppliers and warehouse companies who deliberately withhold stock to drive up prices, then release them with a short use-by date to increase profits. Much of this is caused by the poor way pharmacists are renumerated for the cost of items particularly with the drug tariff rates which are often out of date when published due to the rapid changes.

For this reason, I again state my challenge to our Secretary of State for Health and Social care @matthancock to work with organisations like the RCGP, BMA, GPC and RSPh to be bold and create clear guidelines for all how to manage these issues rather than pointless statements asking people not to stockpile, - given few seem to be listening and we are likely to be hit with challenges as Brexit progresses.

Don't forget to check out this week’s TipThursday on the best haematology app - Buku Haematology. I like this app and see why on the video below.


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The best haematology app? Buku Haematology

The best haematology app? Buku Haematology

January 17, 2019

What is the best haematology app?

Watch this review of Buku Haematology - a useful clinical reference resource that details how to manage haematological investigation results, work up for common haematological conditions and emergencies.

With a clean interface and clear explanations and reference to BMJ, CKS and national guidance it really is a valuable resource for anyone in primary care.

The highs and lows section covers individual test results and the implications of them to help clinicians understand how to manage the results in the context of each patient.

The coagulation section gives useful guides on problems with coagulation including FAQs on DOACs like Rivaroxaban.

The workup section explains common presentations and considerations for haematological conditions and how to manage from a primary care perspective and what point to refer.

The obstetric section has useful criteria for managing anaemia in pregnancy. The emergency section helps guide how to manage complex haematological emergencies.

Created by Dr Alex Langridge and Prof Steven O'Brian it really is a useful app that is updated in content on a regular basis.

Check out this app in detail use the link below to download it:

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NHS Long term plan - Primary Care and Health Tech News Blast ep 2

NHS Long term plan - Primary Care and Health Tech News Blast ep 2

January 13, 2019

Hello eGPlearners,  in this news update- covering the big stories for primary care over the past week….

lets tech-enhance your primary care

If the first time we are meeting Im Dr Gandalf of eGPlearning where I look at supporting you with technology-enhanced primary care and learning so don't forget to subscribe and ring the bell to be the first to get notified of all these updates.

Let us start

Long term plan

Called the 10year plan or 10YLTP released on 7.1.19. This video is a review of the executive summary, as the full document is 136 pages long as will take some time to digest.

What are the headline points?

Split into seven chapters.

Chapter 1

Spend an increased amount of funds on bringing successfully implemented changes to healthcare of care to other areas.

Right to digital GP consultations. (doesn't say video).

Focus on networks of practices (likely to be called either neighborhoods or PCNs) to deliver care in communities for primary, community and social care to prevent hospital admissions.

Focus on social prescribing, personal health budgets and the voluntary sector.

Guarantee of a greater rate of funding for the first time ever under a Tory government for primary care using the previously announced £4.5b for community care by 2023/4.

Shift away from hospital-based care for both outpatients (maybe video consultations for outpatient to reduce infrastructure costs like estates/parking etc).

Video Consultations in primary care:

Focus on urgent treatment centres instead of emergency departments and same day discharge from acute wards.

Chapter 2


Focus on prevention ie stop smoking, obesity programme, supporting reducing alcohol - much of this seems public health territory no longer funded by local councils - sharing the costs or shuffling the money?

Focus on deprived groups with outcomes like smoking rates in pregnancy, learning disabled /autistic patients and homeless patients to name a few based on locally supported programmes.

Chapter 3.

This identifies priorities for care quality and improvements, particularly on mental health. Focus on cancer survival, maternity-related deaths, increasing planned (elective surgery) and ring-fenced funds for mental health (2.3bn a year by 2023/4)

Chapter 4

Looking at Workforce, reintroducing training budgets for health education England (taken away in recent reforms) and a workforce implementation plan for later this year. Increased funding for nursing training and routes into training including recruitment from overseas. Also new roles with a focus on professional development especially in primary care based on networks.

Chapter 5

Details the focus on technology including digital access for all, interoperability of data and use of new technology like AI. This chapter will be covered in more detail in our in-depth look later in the month.

Chapter 6

Looks at changes to the financial structure of the NHS to maintain funding increases to prevent challenges in the future including various efficiencies ie saving £700m in administrative costs.

Chapter 7

The final chapter explained the implementation of the plan including legislative changes to enable rapid implementation. It recommends changes to: create publicly-accountable integrated care locally; to streamline the national administrative structures of the NHS, and remove the overly rigid competition and procurement regime applied to the NHS. This includes the shift to integrated care system models by 2021.

5y GP training

Straight from med school - pilot not really 5y as same time in training just different spread

Man shots GP with a crossbow

Lone worker risks - Zero Tolerance or not?

We provide a health care service but are not servants.

Rivaroxaban shortage

Furosemide, naproxen, most eye drops,

Impact on workload is unaccounted and risk to patient care being held by GPs and pharmacists.

Look at formal joint guidance from NHS England/RCGP/BMA/Royal Pharmaceutical Society for how clinicians can safeguard patients should further short or long term shortage supplies hit.

Don't forget to check out this week’s TipThursday on a must own GP app- Nottinghamshire LMC app, useful guidance, tools, and resources for any GP regardless of the stage of career or location.


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Must own GP app- Nottinghamshire LMC

Must own GP app- Nottinghamshire LMC

January 10, 2019

Must own GP app- Nottinghamshire LMC app

Hi #eGPlearners , with millions of apps out there how do you know which ones you should use. Try one of my top 5 apps as a must own GP app- the Nottinghamshire LMC app. 

Watch the video here and do not forget to subscribe to be the first to see future episodes. 


The Nottinghamshire LMC app in my view is a must own GP app. 

It contains multiple resources useful for any GP at any stage of their career.  Linking to BMA resources means that although Nottinghamshire centric, the app is relevant to GPs in any geographic location. This includes a guidance section which is kept up to date, resources for partners, trainees, practice managers, and sessional GPs. 

The app contains useful news links and contact details including local LMC events (Nottinghamshire focused). 

The SHOP library allows you to share experience and innovation while the services section links to valuable resources offered by the LMC. 

Finally, the Wellbeing section is diverse with multiple resources, tools, and links to financial, mental health, well-being, support and self-development help. 

I find this a truly useful app with multiple resources. One development could be to enhance reporting like the BEAM to LMC app offered by the Londonwide LMC. 

Take a look and download the app from the link here

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Primary Care and Health Tech Newsblast ep 1

Primary Care and Health Tech Newsblast ep 1

January 5, 2019

Hello eGPlearners,  in this news update- covering the big stories for primary care over the past week including a really valuable resource to analysing appointment usage at the end.


lets tech-enhance your primary care

If the first time we are meeting Im Dr Gandalf of eGPlearning where I look at supporting you with technology-enhanced primary care and learning so don't forget to subscribe and ring the bell to be the first to get notified of all these updates.


Let us start


GP IT shake-up by Matt Hancock - GP IT Futures framework
move data to cloud so by 2024 all patients can access GP services digitally, with
practices able to offer online or video consultations.
S1 and EMIS market leaders EMIS X already announced how will others respond?

Switching providers

Outdated IT - IE 8

Boots UK acquires Wiggly-Amps
- change in delivery and better tech interface
- take on Pharmacy2u

Test your breath to check cancer
Pilot at Owlstone Medical practice to use Breath Biopsy to check for unstable molecules as
part of 2y trial lung cancer a likely focus but possibly others.

GDPR - government rule out exempting GPs from SARs
MP Margot James feels would weaken the rights of patients
However the increase in the number of requests is fuelled by Lawyers who make a profit from fewer costs
Siginifcant workload increase- not mirrored by other organisations like gas/ banks etc
no guidance on excessive req no one wants to be the test case for ICO


Big story of the week possible £200m saved  1 in 20

Cost of £30 an apt  PSSRU- not paid by the individual but a cost to the system

Variety reasons, sometimes can't be helped

The overall cost to the system as a buffer sometimes it just nice- chaos and a break


NHS Digital GP practice data hub - area, time to apt, which healthcare professional, apt type ie f2f/tele


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Are you hoping for a Dry January?

Are you hoping for a Dry January?

January 3, 2019

Are you hoping for a Dry January?


Hi #eGPlearners - are you hoping for a Dry January? Check out this Dry January app review on how the app works and whether it is useful for individuals or patients. 

Click on the image below to see the full video or read below. 



It is reasonable to assume that alcohol drinking increases over December with Christmas parties, festive celebrations over the holiday period and New Years which also culminate in lesser-known occasions like Black eye Friday. 

But with a new year comes change and a slew of new years resolutions. Many may participate in Dry January - where you do not drink alcohol for the whole month. To support people,  the Alcohol Change UK charity has created the Dry January app, but is it any good?

The app is easy and free to download. It asks for your current drinking habits and lets you add this quickly and easily. Presenting you with an approximate unit intake, cost and calorie intake per week is also a good set of metrics to use. 

The app does ask if you want to contribute and savings you make as a pledge. I think this is reasonable as the Alcohol Charity UK have created this app for free and offer you the choice. Better yet- even if you pledge it is only a percentage of the savings you have made so technically you are not paying for it. 

Logging your habits is easy and customisable. The main dashboard provides clear information and some resources to support you. 

However, I think the app could be improved. while Dry January can be a useful idea, for those significantly high drinkers stopping suddenly can be dangerous and clearer warnings on this would be more ideal particularly when logging your intake. Also signposting to regional support services would be a more useful way to use the app. 

Overall, I like the app and think it works better than many of the tools in the patient health records I use. If it leads to a permanent change in drinking habits this can be really helpful, although it is important to remember that boom or bust methods to cut vices can sometimes lead to rebound use which can be just as damaging to a person's health. Subjectively many clinical colleagues mention higher admission rates for alcohol misuse in the first two weeks of February and Dry January may be the cause. 


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#TipThursday -

3 GPs in an eGPlearning Podblast

3 GPs in an eGPlearning Podblast

December 28, 2018

3 GPs in an eGPlearning Podblast


Welcome by Andy, Gandhi and…….Shubz


How did Shubz get into podcasting from his mygpevents journey to listening to inspirational speakers. This led to his podcast 2GPs in a pod and speaking with Zoe Williams, Rupy Aujla and others

‘You do not have to leave medicine to do all this other cool stuff’

Gandhi talks about having flux in your working week as recommended by notable people like Warren Buffet and Pat Flynn


We discuss how to utilise time as a locum for portfolio working and balance in your roles.

Andy talks about the ease of saying yes, but the importance of saying no occasionally


We then discuss the Next Gen GP programme created by Nishma Manek with amazing talks by Nikki Kanani (our Supreme leader- including how difficult it has been for both podcasts to pin her down for an interview given NHS England oversight).


Gandhi talks about the importance of teams around you and how they can support you ie his partners and working on the podblast with Andy as a team.

Shubz echoed this with a shout out to his MyGPevents partners Mehul and Max.


We did a recap of Andy and Gandhi’s year, starting with Gandhi which including being elected and attending his first RCGP Council meeting as a National Rep, and the importance of having your say- including his controversial comments on the partnership review by Nigel Watson.


We all talked about how the omission of a baseline increase in the global sum seemed confusing and the impact of indemnity funding and planned changes to pension regulations that may significantly impact the future of GP partnerships.


Gandhi finished off with talking about his continued efforts with the eGPlearning platform including TipThursday on YouTube, and his 84km Pilgrimage in Iraq in October.


Andy talks about his work with the NCGPA including signposting health- a project applicable to any locality to help with practice-based signposting, his video journey for patient information videos for the area:

Which has gone mainstream by being shown in the Broadway Cinema in Nottingham in the new year.

He also talked about the power as a partner being able to innovate in your own practice. HIs focus has been on creating a user-friendly website seen here: Parkside medical practice


Note Andy did all the illustrations, which is also on offer to your our listeners as part of the collaborator reward for supporting the eGPlearning Podblast on  Patreon account. At this limited reward, Andy will draw you into our new banner as a caricature.


We then move on to talk about health technology moving forward including the regulation of health tech by NHS England and NICE, RCGP, and the hype cycle on artificial intelligence (AI) and challenges off innovating in the NHS.


Andy then mentions his vision of the use of wet technology as discussed in our genomics podcast (with 23andMe) earlier in the year. Andy makes his 2019 prediction of the AI backlash in healthcare with examples like the Wysa app.

Gandhi predicts the rise of personalised medicine focusing on individual patient care vs condition-based care as patient focus shifts from wanting to know if they are unwell to wanting to know if they are healthy. He states in his view the NHS is designed to look after you when you are unwell, not to make you healthy.

Evidence of this direction is with our Secretary of state for health Matt Hancock and his focus.


We talk about how technology can help tackle health inequalities but also exacerbate them, particularly around access. We commented that much of the technology is based on improving access but not productivity.


We then discussed the impact technology can have on health with Gandhi using an example from the programme Criminal Minds about knowing your own family history and the impact that may have on your own health outlook. Does it create a healthier life or does it create health anxiety?


This led on to a discussion about overdiagnosis and overtreatment- key challenges in health care moving forward. This included a discussion on Martin Marshall Vice-chair of the RCGP and his article on rethinking medicine.


We moved on to talking about the use of data like Facebook and metrics to hyper-target health information a little Black Mirror-like,


We then ask the question,- how would you spend £100million on health tech


Gandhi mentioned his idea for a unified video consultation platform for primary and secondary care. Could the NHS app provide this?


Shubz talked about using technology to facilitate communication to provide bandwidth so we can be more effective in caring for patients.


Andy talked about creating a system to help physician productivity - Sherwood tech incubators. Gandhi then changed his idea to create an NHS approved a version of Asana - a project management tool.


We finished by creating a Christmas tradition of doing a roundup episode between the two podcasts each year.


Contacts Andy: @drawfoster and

Contact Gandhi: @drgandalf52, @egplearning, or subscribe to the eGPlearning Youtube channel.

Contact Shubz: @2GPs_in_a_Pod or myGPevents.


A shout out to our sponsors - The HTN (Health Technology Newspaper)

And join us for the digital week where we cover our top 5 apps, how to use technology to enhance your CPD and social media use as a clinician - all which contributes to your appraisal and revalidation in the comfort of your own PJs.

Do you need some Headspace?

Do you need some Headspace?

December 20, 2018

Hi #eGPlearners do you need some Headspace?

Working in healthcare whether as a GP, part of the primary care team or in hospitals can be emotionally stressful. There are many ways to manage stress and lately mindfulness is seen as an effective tool to support stress management. But access can be tricky – so let us look to technology to help in the form of Headspace.

  • Edit

Headspace was founded in 2010 by Rich Pierson and Andy Puddicombe (who wrote the Headspace guide to Mindfulness and Medication).  The Headspace platform offers unique content varying from guided meditations to animations and videos via the Headspace website and mobile app, teaching users the techniques of mindfulness.

The app is free to download and use with extra features behind a subscription paywall. These extra functions include modules to help deal with stress,  difficulties in focusing, sleep issues, chronic pain,  fear of flying and more. It also has dedicated sections to help with younger people such as settling the active child at night. 

The variable module length is useful with a minimum of 3 minutes meaning anyone can use at some point in the day. 

I love the animations which do draw me in, and the interface which is easy to use. The guided meditations work well and its simplicity is a key reason I do recommend this app to patients as well. With often limited timely access to mental health support, I have found this a useful tool for several patients as an adjunct to their treatment.  Just simply switch on the app, select your module and time length, audio or headphones on and go. 

The app also continues to work if you have to multi-task with your device. I accept this may defeat the object of guided mindfulness- but a useful feature to know about. 

Additionally, the app is resource packed including the obstacle section in the settings which are short free modules which offer advice on overcoming obstacles when trying to use the app such as worry, posture, stiffness, pain etc. 

With the rise of AI assistants like Google Home, Siri, and Alexa you can also set Headspace to run from these systems like using the Headspace Skill for your Amazon Echo

As mentioned the extra modules come at a cost. Last year Headspace was offered as part of the BMA membership at a reduced rate (as mentioned in a previous eGPlearning Podblast episode).

Currently, the app is on offer for £44 for a year compared to £9.99 a month or £72 a year if paid annually. 

Another option is to sign up at a reduced rate via Anxiety UK as part of their membership. 

I do like the interface and it is simple to use, however, I would like to change the voice if possible to customise it more, also I can see how social sharing of goals can be a valuable asset, much how many running apps use this method as a motivator. However, I can also appreciate this is not a feature all users would want given how physical health and mental health are viewed. 

Feel free to given Headspace a try either for yourself or for patients. 

Do not forget to subscribe to our various channels and feel free to comment below or on the various channels. 


(ps. I receive no benefit from eGPlearners signing up to Headspace, however, some affiliate links to other resources on this page). 

How to use Twitter as a clinician- hints and tips

How to use Twitter as a clinician- hints and tips

December 13, 2018

Hi #eGPlearners

Welcome to the weekly showcase of Technology-enhanced primary & learning resources from eGPlearning.

In this final part of the series on using Twitter as a clinician, I share my own personal hints and tips on using Twitter and how you can use it to collect and manage your continuous professional development (CPD). 

This episode contains hints on who to follow, how to engage in a twitter debate, which primary care and clinical hasthtags are worth following, and how to create your won CPD Twitter system. 

Subscribe on YouTube for the latest video or follow and share the eGPlearning Facebook page for more. 

As always, comment, share and keep eGPlearning. 


Anatomy of a Tweet

Anatomy of a Tweet

December 6, 2018

Anatomy of a Tweet

Hi #eGPlearners – Do you know the anatomy of a tweet?

In this episode of TipThursday we continue the series looking at how to use Twitter as a clinician by looking deeper at what I call the anatomy of a tweet.


This episode is a showcase of the Twitter interface including how to use the newsfeed, search, trending and moments, sections, notifications, personal messages, exploring your own and other’s profiles, retweeting, quoting and liking a tweet; and how to create a tweet including images, videos, gifs and more.

This video uses my own personal profile and references various others including @matthancock and @NikkiKF.

If you want to subscribe to the DrGandalf UK Primary care twitter list see here:

Next week we explore more specifically how Twitter may help you as a clinician, how you can use it for continuous professional development and a few of my personal tips.

Watch the full video below, or subscribe on our audio platforms:




Subscribe, comment, share and keep eGPlearning.


Are video consultations the future of primary care?

Are video consultations the future of primary care?

November 30, 2018

eGPLearning Podblast Video Consultations Nov 2018


Welcome & Thanks to our sponsor

  • HTN - Health Tech Newspaper, an innovative daily news and opinion website for the health tech network.
  • Recently had their HTN awards and sign up for the HTN week (£32 for the whole week) but we are on the afternoon of Thursday Jan 24th afternoon - sign up here:
  • Sign up here to our Patreon account:


Welcome to those watching us on youtube...

We are trying something new we are recording a behind the scenes video as special content for our youtube followers.


Thanks for your feedback and retweets...






@somedocs doctors on social media group - retweeted us- thanks

@annalise2406 - great feedback re the app and iplato

@orcha - app review organisation connected with NHS App Library - kindly retweeted us

@NikkiKF - acting Director of Primary care for NHS England


What have we been doing?


Today main Topic is Video Consultations…


Remember listeners - we are not experts, these are just our opinions


Is there demand?

  • Venture capital and investors are putting money behind it so there is believe in the technology and concept from investors.
  • @UNHS_Cripps Have experimented with
  • @MattHancock (Health Secretary) is a GP at Hand patient and advocate of technology and is behind the concept.


But what problem are we solving?

  • Low capacity or convenience?
  • Probably more for patient convenience than increase capacity - but maybe if replaces home visits?...


What happens in a typical video consultation?

Gandhi describes his experience of working with Babylon Health @babylonhealth


Discussion of video consultation business models…

Babylon / GP at Hand, LIVI, QDoctor, Push doctor, NOW Healthcare, GPDQ, Zoomdoc (listen to our interview with founder Kenny Livingstone )



What problems do we see with video consultations?

  • Reduced continuity?
  • Overprescribing of antibiotics? (but discussed later)
  • Do video consultations drive an increase in demand? Does making it easier to speak to the GP make people more likely to feel the need to contact their GP?
  • Destabilising traditional General Practice Partnership business model?
  • Destabilising the Primary Care workforce - pulling GPs that might otherwise work at practices into the “private” sector.


Potential positives of video consultations?

  • Does patient spend in the private sector taking pressure off NHS?
  • Some patients may self-select away from NHS services to private video providers, leaving NHS to meet needs.
  • More options and convenience for patients.
  • Options for using as part of innovative systems - perhaps true power comes when part of a system including eTriage, remote monitoring, video consult and face to face?


How can surgeries prepare for video consultations?

Work together with federations, neighbours. Benefits likely to come from handling patients at scale.


Our verdicts… Good or bad?


Thanks for listening - certificate of engagement.


Comments and feedback…


You can now support us on Patreon!

  • $1 just to support us if we doing a good job
  • $ 10 new banner drawn by Andy and you can be part of it
How to sign up to twitter as a doctor

How to sign up to twitter as a doctor

November 29, 2018

Hi #eGPlearners

I am a big fan of social media and often I get asked how can I use social media effectively as a clinician. In this series, we will look at how to use Twitter as a clinician. 

Twitter is a micro-blog site that lets you post (tweet) comments or re-port (retweet) comments of others to share information. Originally tweets were limited to 140 characters but this has now increased to 280 – however, you still have to be concise. 

Twitter allows the rapid sharing of information and can be an effective way of supporting learning and information discovery as well as networking. 

This TipThursday focuses on the basics of creating an account the first step to using Twitter. This includes creating your own profile and initial guidance on where to find medical tweeters (or twits if you want ;p) to follow (check out this twitter list for hints).  For information on creating safe passwords read the blog post here


Next week we will look at the anatomy of a tweet including common terms and how you can post, learn more about profiles and start on your journey to become a part of the Twitterati. The final week will cover more tips on using Twitter including specifically as a clinician and important considerations. 

Please comments and share any challenges you have, or if this TipThursday has made you take the leap into Twitter let me know. I am happy to help on @drgandalf52 or @egplearning

As always: 

Subscribe, comment, share and keep eGPlearning. 


NHS Digital resources to help you be safe using health technology

NHS Digital resources to help you be safe using health technology

November 22, 2018

Hi #eGPlearners

Welcome to the weekly showcase of Technology-enhanced primary & learning resources from eGPlearning.

This episode looks at NHS Digital resources and governance posted on the eGPlearning Facebook page ( or available here

This is pertinent guidance that talks about four key areas such as instant messaging apps, video conferencing, bring your own device (BYOD) and mobile device use in hospital. 

Listen to the video below or read our brief notes under for more details. 

Messaging apps:

This document outlines key aspects such as encryption, passcode use, notification issues, and remote wiping- key aspects with most of the following guidance. 

The guidance does not specify which apps to use despite mentioning a few and ignores apps specifically used for secure healthcare instant messaging like Siilo, Forward and Cupris to name a few. This was covered in our previous episodes of the eGPlearning Podblast about GDPR and our interview with Dr Aisha Malik

Video Conferencing:

This guidance offers information about the use of video conferencing as a service provider, clinician and aspects for patients to be aware. It also offers a template consent form citing that use should not be compulsory. These are interesting aspects which are covered in more detail in the upcoming eGPlearning Podblast episode out at the end of this month. Click the links below to make sure you subscribe for this episode which talks in depth about video conferencing in primary care. 


Increasingly BYOD is being considered for healthcare delivery given the lower cost to organisations and increasing in remote and part time working. This document does outline key issues to consider as both a provider and user. Particularly focusing on safety and responsibility such as two-factor authentication, sandboxing of software and remote wiping of data. 

Mobile device use in hospitals. 

How devices are used is changing. This document does outline key considerations and regulations that are applicable. The last sheet is an excellent summary. 

What are your thoughts on these NHS Digital resources?

Do not forget to subscribe to our various channels to be the first to hear more useful TipThursday bites, and as always:

Comment, share and keep eGPlearning. 


Podblast interview- Dr Aisha Malik - Doctors in Business

Podblast interview- Dr Aisha Malik - Doctors in Business

November 16, 2018

eGPlearning Podblast is the UK's leading primary care focussed health tech podcast by two Nottingham based GPs covering recent topics, useful clinical apps, interviews with primary care health tech innovators and in-depth perspectives on health tech.

Hosted by Dr Hussain Gandhi (@drGandalf52) and Dr Andrew Foster (@drawfoster).

In this episode, Dr Gandalf talks to Dr Aisha Malik owner of a website which is dedicated to getting doctors and medics more visible online.

We talk about her acceptance onto the Clinical entrepreneur fellowship led by Prof Tony Young (@DrTonyYoung).

We discuss if GPs are ideally placed to change the NHS.

I challenge Aisha to Make a video blog for all the eGPlearners to learn from regarding her experiences.

Aisha then explains her top 5 tips for using social media as a practice. See her Pulsetoday article here.

We then discuss the implications of consulting on social media including how that may differ from the work of Babylon, Pushdoctor and Doctor Care Anywhere.

I then ask Aisha her favourite work an non-work related apps. We talk about a project management app Asana and then discuss other methods like Siilo or Forward.

We then talk about her favourite non-clinical app- Audible - like the netflix of reading - ideal for any podcast listeners.




We finish off asking the perennial question. How would you spend £100 million on health tech with no red tape. 

To contact Dr Aisha Malik either on twitter or on the Doctorsinbusiness website. 

Here is your certificate of engagement.

In the next episode, we cover the implications of telemedicine in primary care- small topic ......honest. 

Should you stand as a GP?

Should you stand as a GP?

November 15, 2018

Sitting is the new smoking. Staying sedentary for several hours a day increases your risk of diabetes. So should you stand as a GP?

I remember visiting my GP as a child. Sit in the waiting room normally sullen and low because of yet another episode of tonsillitis. 

Then I was called into the doctor’s office. I would enter a room that CQC would now shut down in a heartbeat with mosaic rugs, plush furry chairs, and a beautiful mahogany desk.

And there was the GP….sitting behind his desk. I remember him moving in his chair to get some forms from a cabinet. I remember him asking me to stand as he examined me sitting in his executive chair, and I remember him always sitting behind a desk. 

Fast forward to a couple of years ago. I remember finishing work with my shoulders feeling tight, my lower back aching for a stretch, as I scooted in my chair to get a form from my cabinet next to my desk. It was at that point I realised I had been sitting in my chair for over four hours. 

I wanted to change this sedentary life. I had a chat with my partners and highlighted I would be changing my room. Shortly after I got a rising desk (Yoyo-90). 

I love it. The build quality is excellent with significant heft. The hydraulic risers are simple to clip and push my whole station upwards to allow me to stand. Initially I could only manage an hour or so before my legs tired out and I had to sit again. A further investment in a standing mat helped there. Within a month I was standing while doing all my admin. Then I took the plunge and stood while consulting with patients.



Should you stand as a GP?

Some will feel less happy about standing while consulting. I know in sharing my story I have heard several criticisms such as:

  • It means you are trying to rush the patient
  • To stand over a patient is to exert a power dynamic in the consultation
  • It means you are trying to hide the screen from the patient

Over the past year, I have not found any of these to be true. 

  • In my clinic, patients sit while I stand (see the chairs above). 
  • If a patient feels uncomfortable I will sit, however, I have only been asked this twice in the past 18 months.
  • When there is a need for additional empathy, I often sit next to the patient. 
  • I actively share my screens when needed with the patients. 
  • Patients often comment on the desk, about seeing similar in the media and how positive such changes are. 

Sounds encouraging and even our Secretary of State for Health and Social Care – Matt Hancock is very pro-standing desks. 

However, it is important to recognise that standing desks on their own is not enough.  This is a useful article and another here that comments on the opposing view. This includes complications of standing for long periods (tiredness, varicose veins, musculo-skeletal pain from adjusted positions of screens etc.)

Encouraging our patients to be more active is important. So for Self-care week, I am showing how it works in my practice.  Watch the video below and feedback your thoughts on should you stand as a GP?






When should I worry?

When should I worry?

November 8, 2018

Hi #eGPlearners

Welcome to the weekly showcase of Technology-enhanced primary & learning resources from eGPlearning.

When should I worry? This is a common question for parents when looking after an unwell child. In primary care, this can often be a challenge for clinicians to manage due to parental anxiety, the expectation of treatments like antibiotics, concerns about antibiotic resistance and growing demand. 

A helpful resource which can be used with and for patients is the When should I worry booklet found at

This short booklet provides clear and helpful advice on managing common conditions that can be self-managed by parents, with advice on self-care options, symptom management and importantly clear guidance on when to see further advice. 

The website even offers training on how to use the booklet effectively, and it is available in a variety of languages. Taking it one step further, you may choose to send parents the weblink for the booklet and for the English version: use this helpful case-sensitive shortlink:

For proactive practices, you could send this as a public information message to all registered parents or share via practice social media channels. 

Watch the video guide below and free to share your thoughts on this resource and as always:

Comments, share and keep eGPlearning. 


The NHS app - an eGPlearning Podblast perspective

The NHS app - an eGPlearning Podblast perspective

November 2, 2018

eGPlearning PodBlast - Introducing the NHS App

Welcome to our deep dive episode on the upcoming NHS app - which we cover multiple areas of primary care and patient care. A highly opinionated episode which we encourage your comments and feedback on. 

1.00 Thank you Sponsor - HTN The Health Tech Newspaper (HTN)- an innovative daily news and opinion website for the health tech network.

1.40 Thank you to our followers: @SonaliKinra  @NottsLMC @NCGPANottm @Jacey_Melody @JThambyrajah @KalindiKrishna  @RcgpFaculties @2GPs_in_a_Pod , @DME_Health, @BenXGowland , @EvilGP and @drNickHarvey -creator of Digitalis


2.25 Andy has had a cold and been on a cruise

2.40 Gandhi has also had a holiday, working on TipThursday especially the Kardia Alivekor episode with a free resource on the episode available here. 

3.30 Today we are talking about the upcoming NHS app


We are going to talk about the app. This was inspired by a great article by our friends at Gizmodo.


The intentions behind the app are exactly what you might expect: Make it easier for patients to access healthcare services, cut down on administrative burden, and eventually provide a means to connect with other health apps, like Fitbit and Apple’s Health app.


Jeremy Hunt set out “8 challenges” for the app

  • (7.20) Symptom checking and triage (i.e. figuring out if you’re just being a hypochondriac or whether you should be in an ambulance right now)- eConsultation, webGP, babylon AI
  • (13.00) Access to your medical records and security issues. 
  • (23.10) GP appointment booking
  • (28.20) Repeat prescription ordering
  • (29.50) Changing data sharing preferences
  • (31.38) Changing organ donation preferences
  • (33.38) Changing end of life care choices - DNAR medical decision
  • (38.50) Promoting “approved apps” to patients - see the NHS app library and @OrchaUK

(42.50) Summary of our views (including a compliment for Jeremy Hunt!!!!) including the issue of photo ID verification to use the app. 

These are discussed in turn during the show...

(49.00) Sign off and next episode spoilers

Do let us know what you think?


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