Publications
47 results found
Douglas-Pannett L, Gnani S, 2015, Will Having a Named General Practitioner for Older People Improve Care and Reduce Hospital Admissions in England?, JOURNAL OF AMBULATORY CARE MANAGEMENT, Vol: 38, Pages: 10-15, ISSN: 0148-9917
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- Citations: 1
Ismail SA, Gibbons DC, Gnani S, 2013, Reducing inappropriate accident and emergency department attendances: a systematic review of primary care service interventions, BRITISH JOURNAL OF GENERAL PRACTICE, Vol: 63, Pages: E813-E820, ISSN: 0960-1643
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- Citations: 94
Cowling TE, Ramzan F, Majeed A, et al., 2013, Attendances at Charing Cross and Hammersmith Hospitals’ urgent care centres, 2009-12, BMJ, Vol: 347
Gnani S, Ladbrooke T, Millington H, et al., 2012, Evaluation of a general practitioner-led urgent care centre in an urban setting: description of service model and plan of analysis
Estimates of patients attending with conditions deemed non-urgent or inappropriate for accident and emergency services vary widely, from 6% to 80%. Previous research suggests that general practitioners working in emergency departments can reduce referral rates, diagnostic testing, the proportion of patients who become emergency hospital admissions, and inappropriate attendances. However, none of this previous research is recent and new models of care for general practitioners working in emergency departments have now been developed, which remain to be evaluated. In this paper, we describe an integrated urgent care model, which was commissioned by NHS Hammersmith and Fulham in 2009 to manage the rising number of urgent attendances at local hospitals and its associated evaluation. The evaluation will include examining the effect of the system on outcomes such as utilisation of diagnostic tests and effect on unplanned hospital admissions. If the new model of care is shown to be both clinically effective and cost-effective, the model and the proposed plan of evaluation will also be helpful to other areas that are considering the introduction of similar models of general practitioner-led urgent care.
Gnani S, McDonald H, Islam AFMS, et al., 2012, Patterns of healthcare use among adolescents attending an urban general practitioner led urgent care centre, Emergency Medical Journal
Adolescence is a time of increasing health and peak fitness, but also of increasing health risks. In the UK, primary care is free at the point of access, yet adolescents aged 10 to 19 years are the lowest users of primary care services, and disproportionately high users of emergency services. The effect of new general practitioner (GP) led urgent care centres in meeting the needs of adolescents are unknown.
Amiel C, Williams B, Ramzan F, et al., 2012, Reasons for attending an urban urgent care centre with minor illness: a questionnaire study, Emergency Medical Journal
The demand for urgent care is increasing and the pressure on emergency departments is of significant concern. General Practitioner (GP) led urgent care centres are a new model of care developed to divert patients to more appropriate primary care environments. This study explores why patients with minor illness choose to attend an urban urgent care centre for their health care needs.
Thomas P, Gnani S, 2012, A tale of two specialties: primary care and public health., London J Prim Care (Abingdon), Vol: 4, Pages: 89-91, ISSN: 1757-1472
Gnani S, Spicer J, 2012, Editorial response to Nigel Crisp: Is there consensus to re-design professional medical education?, London J Prim Care (Abingdon), Vol: 4, Pages: 120-121, ISSN: 1757-1472
Thomas P, Spicer J, Gnani S, 2012, University-linked localities., London J Prim Care (Abingdon), Vol: 4, Pages: 104-106, ISSN: 1757-1472
In this article, we propose that reframing the old concept of 'academic general practices' as 'university-linked localities' will help to integrate the work of those leading commissioning, education, research and public health. It will provide a 'playground' for different disciplines to creatively interact for the benefit of all.
Ashby J, Braithewaite B, Walsh J, et al., 2012, HIV testing uptake and acceptability in an inner city polyclinic, AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV, Vol: 24, Pages: 905-909, ISSN: 0954-0121
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- Citations: 8
Gnani S, 2010, London's children: more than mini adults., London J Prim Care (Abingdon), Vol: 3, ISSN: 1757-1472
Verma A, Birger R, Bhatt H, et al., 2010, Ethnic disparities in diabetes management: a 10-year population-based repeated cross-sectional study in UK primary care, JOURNAL OF PUBLIC HEALTH, Vol: 32, Pages: 250-258, ISSN: 1741-3842
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- Citations: 18
Ashby J, Braithwaite B, Gnani S, et al., 2010, HIV testing in a polyclinic setting can reach untested "at-risk'' groups, HIV MEDICINE, Vol: 11, Pages: 115-116, ISSN: 1464-2662
Tsang C, Majeed A, Banarsee R, et al., 2010, Recording of adverse events in English general practice: analysis of data from electronic patient records., Inform Prim Care, Vol: 18, Pages: 117-124, ISSN: 1476-0320
BACKGROUND: Although the majority of patient contact within the UK's National Health Service (NHS) occurs in primary care, relatively little is known about the safety of care in this setting compared to the safety of hospital care. Measurement methods to detect iatrogenic diseases in primary care require extensive development. Routinely collected data have been successfully applied to develop patient safety indicators in secondary care. Given the availability of electronic health data in primary care, we explored the potential to build adverse event screening tools using computerised medical record systems. OBJECTIVE: To identify the rate and types of adverse events that might be recorded in primary care through routinely collected data. The findings will inform the development of administrative data-based indicators to screen for patient harm arising from primary care contact. METHOD: Descriptive analyses were performed on data extracted from the clinical information management systems (CIMS) at NHS Brent. The data were explored according to age, sex and ethnicity of patients. Potential or actual adverse events were identified by mapping to three Read code chapters. RESULTS: Records from the calendar year 2007 were available for 69 682 registered patients from 25 practices, consisting of 680 866 consultations. A number of adverse events could be detected through terms contained in certain chapters of the Read code system. These events include injuries due to surgical and medical care (0.72 cases of per 1000 consultations) and adverse drug reactions (1.26 reactions per 1000 consultations). Patterns in the rate of harm among patients from different ethnic groups tended to reflect the proportion of the respective groups in the overall Brent population, with more injuries occurring among patients of white and Asian ethnicities. CONCLUSION: These findings suggest that there is scope to develop more accurate and reliable means of safety surveillance in general practice u
Bottle A, Gnani S, Saxena S, et al., 2008, Association between quality of primary care and hospitalization for coronary heart disease in England: National cross-sectional study, JOURNAL OF GENERAL INTERNAL MEDICINE, Vol: 23, Pages: 135-141, ISSN: 0884-8734
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- Citations: 43
Gnani S, Gray J, Khunti K, et al., 2004, Managing heart failure in primary care: first steps in implementing the National Service Framework, JOURNAL OF PUBLIC HEALTH, Vol: 26, Pages: 42-47, ISSN: 1741-3842
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- Citations: 8
Goldfield N, Gnani S, Majeed A, 2003, Primary care in the United States - Profiling performance in primary care in the United States, BRITISH MEDICAL JOURNAL, Vol: 326, Pages: 744-747, ISSN: 0959-535X
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- Citations: 16
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