All things General Practice! Join doctors Sara and Lisa as they interview specialists from around Greater Manchester with the aim of improving the confidence and knowledge of local primary care clinicians. The podcast has been made possible due to the support of Wigan CCG and GP Excellence in Greater Manchester.
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Doctors Sara and Lisa talk to GPs and Workforce Leads Dr Nikesh Vallabh and Dr Richard Bircher. They wanted to talk to us today to discuss a practical approach to some of the workforce issues we are all facing. This episode will be particularly useful for GP Partners, Practice Managers and anyone interested in workforce issues in General Practice. …
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Doctors Lisa and Sara talk to Dr Aseem Mishra to discuss changes in the guidelines for Hypertension. The discussion includes advice on how to get the most accurate diagnosis and measurements for blood pressures, the importance of counselling patients well, and advice on medications. We started with a poem from Aseem focusing around why this is such…
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Primary Care Knowledge Boost


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The Art of Stuck Cases: A Framework for Managing Complexity in Primary Care
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Doctors Lisa and Sara talk with Consultant Psychiatrist Dr Mark Spurrell about a framework that can be applied to the care of complex patients with multiple problems or difficulties. It is particularly useful at times where we feel stuck, we are struggling to help or move forward and care may be fragmented with lots of care professionals feeling si…
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Doctors Lisa and Sara talk to Optometrist Dharmesh Patel to get an understanding of Optometry as part of the Primary Care Team. We discuss how the service is set up, what can be done at the Opticians, different types of patient access and how GP practices can link in with services. We discuss the Community Urgent Eye Care Service (CUES), Minor Eye …
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Doctors Lisa and Sara talk to GP Dr Charlotte Bădescu about Ovarian Cancer. We focus on the important learning points about cardinal and other features of presentations to better understand this cancer as an abdominal cancer with symptoms that can and do often present much earlier than the diagnosis is often picked up. She talks us through the valu…
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Doctors Lisa and Sara are joined by Community Pharmacist and Director of Pharmacy Transformation for Greater Manchester Luvjit Kandula. We learn all about the Essential Services and Enhanced Services Community Pharmacies are engaged in and get an understanding of the pressures Community Pharmacies are under. We discuss the plans for upcoming transf…
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Doctors Lisa and Sara are joined this week by Dominic Anderson (Programme Director of the Health and Wellbeing Programme Greater Manchester), Lorna Laflin (Former Practice Manager who works with the GP Excellence team) and Joanna Bircher (GP and Programme Director for GP Excellence). We discuss the new QOF indicators around Workforce and Wellbeing …
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Doctors Lisa and Sara speak with Dr Uma Marthi who is a GP with a Specialist Interest in Gynaecology about red flags for gynaecological cancers. We discuss some cases based on real patients that involve cervical, vaginal and endometrial cancers. We’ll be recording a separate episode around the varied presentations of Ovarian cancer. You can use the…
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**Summer Rewind: This episode was first released on Nov 30th 2022** Doctors Lisa and Sara talk to Consultant Otolaryngologist Ms Emma Stapleton and Clinical Scientist David Jay about Vertigo. We discuss the definition, differentials, and how to use information around timing and triggers to differentiate between the likely causes of vertigo. We get …
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Doctors Lisa and Sara speak with GP Dr Allison Rees for her advice on how to approach GP Appraisals and Revalidation. We heard her talk about this in a Health Education England First Five talk a few years ago and found it so helpful. We cover why they can be useful, the practicalities of what needs to be done and how to make them work for you. You …
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Doctors Sara and Lisa talk to Dr Wasim Javed, ST6 in Cardiology, about the diagnosis and management of Angina. Taking a theoretical case we talk through symptoms, differentials, diagnosis, including the guidelines and practicalities of different types of functional and non-functional tests, as well types of angina and their management. It was usefu…
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Greater Manchester NHSE GP Fellowships - A Great Opportunity for New GPs
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Doctors Sara and Lisa talk to talk to Dr Mary Cheshire who is the GP lead on the NHS England Fellowships for Greater Manchester GPs. As she explains, this is a fairly informal fellowship done over 2 years offering different types of courses and support that essentially consists of a paid CPD session a week and a range of CPD events to facilitate th…
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Doctors Sara and Lisa talk to talk to GP and Professor of General Practice Research Dr Carolyn Chew-Graham about the current landscape of Long COVID three years on. She spoke to us on the topic back in August 2021, but what we know and some of the treatments have moved on from then. In this talk we discuss why the patient-preferred term is Long COV…
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Changing Access Models in General Practice - A Success Story
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Doctors Sara and Lisa talk to GP Dr Adam Cliffe about how he and his practice went about changing the model by which patients access the practice. It is so far working very well for both staff and patients. It’s an interesting talk about change management and one example of how a difficult situation was changed for the better. You can use these pod…
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Doctors Sara and Lisa talk to Dr Aseem Mishra, Academic GP trainee involved in helping produce the Guidelines for the Greater Manchester Lipid Pathway. Greater Manchester has very high levels of Major Adverse Cardiovascular Events (MACEs). The guidelines for how to treat hyperlipidaemia and what we’re aiming for have changed. Dr Mishra helps talk t…
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Doctors Sara and Lisa talk to ENT Consultant Ms Sadie Khwaja about common throat symptoms we encounter in General Practice and get her take on how to assess and manage these. We cover Red Flag symptoms for the neck in detail as well as looking at three cases we commonly encounter; pain on swallowing, globus symptoms and hoarseness. We discuss a use…
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Doctors Sara and Lisa talk to Dr Maiedha Raza to find out her take on issues of Equality and Diversity in General Practice. This is a gentle dive into the very complex world of diversity and inclusivity with messages of how we can improve our culture in the NHS. You can use these podcasts as part of your CPD - we don’t do certificates but they stil…
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Doctors Lisa and Sara talk to Dr Sarah Taylor about the changes being made to how Primary Care Clinicians refer patients for Suspected Lower Gastrointestinal Cancers. These changes are discussed in the context of referring in the Greater Manchester area, but you can view the joint guideline from the Association of Coloproctology of Great Britain an…
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Doctors Sara and Lisa talk to GP Dr David Bartlett who works with the Neuroendocrine Cancer UK charity and GP Dr Will Evans who is a researcher specialising in rare diseases. We wanted to discuss how they approach finding rare diseases in General Practice whilst balancing this with the risk of over investigating. We start with definitions and class…
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Doctors Sara and Lisa talk to Dietician Charlotte Cockman about managing weight for patients who are overweight or obese in General Practice. This includes a discussion around the definitions of overweight and obesity, risk factors, and what terms are less stigmatising when discussing weight with patients. Charlotte talks to us about her approach t…
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How Coaching and Mentoring can work in General Practice
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Doctors Sara and Lisa speak with Christopher Lewis, Operations Learning and Development Manager for Greater Manchester Training Hub. His non-pretentious, passionate approach to coaching and mentoring was infectious. We hope you get a flavour of how coaching and mentoring might help in General Practice. The episode was designed with GP fellows in mi…
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Doctors Lisa and Sara talk to Consultant Otolaryngologist Ms Emma Stapleton and Clinical Scientist David Jay about Vertigo. We discuss the definition, differentials, and how to use information around timing and triggers to differentiate between the likely causes of vertigo. We get their take on the important details in the examination that can help…
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Health Inequalities in General Practice with Dr John Patterson
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Doctors Sara and Lisa speak with Dr John Patterson about Health Inequalities. This is the second of our two talks on Health Inequalities, please check out Dr Laura Neilson’s talk before this one. Dr John Patterson is a GP and Medical Director of Hope Citadel, as well as their Focused Care Lead and the Chief Clinical Officer for Oldham CCG. We discu…
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Health Inequalities in General Practice with Dr Laura Neilson
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Doctors Sara and Lisa talk to Dr Laura Neilson the founder of Hope Citadel who is passionate about tackling Health Inequalities. She talks to us about the importance of addressing them, what the inverse care law is, and skills that people will find useful working in areas of deprivation. We ask her about her projects which include helping create Ho…
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Doctors Lisa and Sara speak with GP Dr Uma Marthi about Endometriosis; a topic she is passionate about due to the common delay in diagnosis, coupled with the impact this condition has on peoples’ lives. We talk through a hypothetical case and explore differential diagnoses for dysmenorrhoea, examination tips, investigations and management. We discu…
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How to use Consultation Skills to Improve Time Management
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Doctors Lisa and Sara are joined by Dr Avil Danczak to talk about how we can use consultation skills to improve our time management in General Practice. She takes us through first principles and core skills before talking about common pitfalls and how to avoid them. The principles of all we discuss are elaborated on in the ‘Teaching and Learning Co…
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Neurodevelopmental Disorders in Children (focus on FASD)
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Doctors Sara and Lisa speak with Consultant Psychiatrist Dr Raja Mukherjee about neurodevelopmental disorders in children. He has an interest in Foetal Alcohol Spectrum Disorder (FASD) and this is the focus of the talk. We cover what neurodevelopmental disorders are, discuss neurodiversity, common disorders such as Autism, ADHD, Dyspraxia aka Devel…
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Dealing with Uncertainty in General Practice - Summer Replay
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*Recorded in June 2020 - Summer Replay* In this episode Lisa and Sara talk to Dr Avril Danczak, a GP with an interest in managing uncertainty in medicine which led to her co-authoring the RCGP published book called Mapping Uncertainty in Medicine. We cover what uncertainty is, and why it is important to address this within medicine and general prac…
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This week’s episode is designed for primary care clinicians wanting an overview of current diabetes management. Doctors Lisa and Sara are joined by Dr Marlon Morais and Nicola Milne to talk first about Type 1 diabetes briefly (from the GP point of view) before going on to discuss the recent changes to the NICE guidelines for management of Type 2 Di…
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Doctors Lisa and Sara are joined by Diabetes Lead for Manchester CCG GP Dr Marlon Morais and Diabetes Support Lead and Diabetes Specialist Nurse Nicola Milne to discuss diagnosis of Diabetes Mellitus. We go through the types of Diabetes Mellitus, touching on MODY and LADA and get advice on avoiding common pitfalls in making a new diagnosis of Diabe…
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Doctors Lisa and Sara welcome Consultant Haematologist Dr Chris Gregory back to the podcast to discuss bruising and bleeding issues. We go through history, examination and differentials including patterns of bleeding more associated with different causes. We cover what constitutes excessive/concerning bleeding and blood test values that would lead …
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Drs Lisa and Sara were thrilled to welcome Professor Dame Helen Stokes-Lampard onto the podcast to talk about one of her passions within medicine - social prescribing. They discuss what social prescribing is and why it matters. They talk about the National Academy of Social Prescribing, and its current roles and remit. There are some great examples…
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Today Lisa and Sara welcome Dr Rachel Morris back onto the podcast. Rachel is a former GP who has previously worked in GP education. She is now an executive coach and host of the wonderful podcast You Are Not a Frog. The discussion in this episode is all about assertiveness - we chat about what assertiveness is, general tips, frameworks and models …
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This is another episode with a focus on Urology. Doctors Lisa and Sara invited Professor Ian Pearce back to speak about overactive bladder and urinary incontinence in women. They discuss the types of lower urinary tract symptoms in women (drilling down into the definitions of commonly used terms), before looking at the red flags to consider. They t…
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ARRS Roles Clinical Supervision - Your Questions Answered
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Doctors Lisa and Sara speak to Judith Dawson to learn all about the ins and outs of supervising the Additional Roles Reimbursement Scheme members as the landscape stands at the moment. They discuss who can be a supervisor, the training involved and what that might mean for the day job. Useful resources: Greater Manchester Primary Care Careers: http…
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This is another episode in the series looking at all of the different roles that exist within primary care. Doctors Lisa and Sara speak to Charlotte Cockman who is a Dietician working in Primary Care in South Manchester. They discuss what a Dietician is and what the role can look like in Primary Care. It’s a new role and can be tailored to best sui…
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Drs Sara and Lisa tackle another urology topic today - recurrent urinary tract infections (UTIs) in non-pregnant women. They speak to Ian Pearce who is a consultant urologist at Manchester Royal Infirmary. They discuss what UTIs are, and what makes them recurrent vs relapsing. They also chat through how to assess someone with recurrent UTIs and hig…
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Working with the Marginalised with Dr Austin O Carroll
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****DISCLAIMER - CONTAINS STRONG LANGUAGE**** Doctors Lisa and Sara talk with GP Dr Austin O'Carroll. Austin works in Inner-City Dublin with marginalised and homeless/rough sleeping communities. He is co-founder of Safetynet Ireland, North Dublin City GP Training, and GPCareForAll. He talks to us about his take on how unhelpful the label of persona…
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Doctors Lisa and Sara talk with Consultant Urologist Dan Burke about Lower Urinary Tract Symptoms in Men. We start with how to divide symptoms into voiding and storage. Red flags to consider are discussed, before tackling cases that lead us to talk about bladder diaries, tips for assessing the prostate and how PSA discussions have changed since the…
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This episode is part 2 of our focus on Quality Improvement. This time Drs Lisa and Sara are joined by Dr Varshini Rajakulendran alongside Dr Joanna Bircher. Varshini is a GP who is on the NHS England fellowship, and she talks to us about a quality improvement example that she is currently working on around weight management. Joanna (our resident QI…
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This is another episode in the series looking at all of the different roles that exist within primary care. Lisa and Sara speak to Heidi West who is a nursing associate as well as an apprenticeship facilitator for nursing associates, and Marina Khan who is a trainee nursing associate. They discuss what a nursing associate is and how they differ fro…
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Joining doctors Lisa and Sara on today’s episode are GP and Perinatal Mental Health Champion Dr Carrie Ladd and Perinatal Psychiatrist Dr Sarah Jones. We discuss types of mental illness that can be experienced in the perinatal period and the challenges in primary care when helping patients and families. We cover tips for addressing these challenges…
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Cardiology and Gastroenterology Advice and Guidance Themes
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Drs Lisa and Sara are joined by GP Dr Nikesh Vallabh, Consultant Cardiologist Dr Karthikeyan and Consultant Gastroenterologist Dr Bliss to discuss advice and guidance. For those unfamiliar, the advice and guidance system came about to try to ease pressure on the long outpatient waiting lists, providing a different way of managing some cases. It is …
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Drs Lisa and Sara welcome Dr Joanna Bircher back to the podcast to speak about an area which she is very passionate about - Quality Improvement. We talk about what quality improvement is, how it differs from audits and why it’s so important within general practice. We also learn about the processes that can be followed when approaching quality impr…
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Drs Lisa and Sara talk to Dr Luke Wookey, Dr Joanna Bircher and Ava Bircher for an introduction to Trans and Non-Binary Health in General Practice. We start with all important definitions, which leads us to talking about coding, healthcare records and a discussion about screening and health inequalities. We talk about how our practices and consulta…
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Lisa and Sara speak to Sam Howard, who is an advanced clinical practitioner in primary care. She talks us through her career journey to date and what her job looks like now, as well as highlighting the varied role of an advanced clinical practitioner. She also explains details about supervision, registration and training requirements. This episode …
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This episode is another of our lovely chats with wider members of the primary care team. Today Lisa and Sara speak to Vishika Rabadia, a senior pharmacist who is working in primary care in a PCN and CCG pharmacist role. She gives insights into the varied roles of a pharmacist within primary care, the training, and what the supervision and registrat…
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Working in General Practice can be challenging at the best of times, but needless to say has been more challenging of late. Lisa and Sara are joined by Dr Rachel Morris; GP, coach and host of You are not a Frog Podcast. She talks us through her top tips for looking after yourself in general practice. These include: the importance of framing this di…
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An Approach to Assessing Peripheral Paraesthesia
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Back by popular demand, Consultant Neurologist Dr Matt Jones joins us to share his approach to assessing patients with peripheral paraesthesia. Patients don’t present with textbook terms. Dr Matt Jones takes us through how to de-code tingling, numbness and burning, and take a structured approach to these often difficult presentations. We cover the …
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Lisa and Sara are joined again by the lovely Dr Rachel Hilton, who is a speciality doctor in Dermatology. In this episode she takes us through psoriasis - what it is, differentials to consider and associated triggers and comorbidities. She then systematically talks about the management of psoriasis, how this might need to be amended for pregnant pa…
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