Project: An exploration of the care pathways for children and young adults with mental health or behavioural symptoms around the health, education and social care services.

I am the mid-career GP Phoenix fellow for Ashfield North Primary Care Network (PCN). Our PCN is in an area of relative socio-economic deprivation, ex-mining community and not well connected to large teaching hospital centres in Nottingham.

Mental health disorders are under-diagnosed and recognition is frequently delayed. In my previous work as a research GP academic I have shown that the prevalence of a common mental health disorder (attention-deficit/hyperactivity disorder (ADHD)) is around 1%. There is a regional difference in the recognition of ADHD, with areas in the East Midlands having lower recognition than in the South East of England, for example. One in ten children aged 5-16 years have a diagnosable mental health problem and half of adults with mental health problems have their first symptoms in childhood. The recent 2021 Joint Services Needs Assessment report states that risk factors for mental and emotional health in Nottinghamshire are in line with the national average and are stable or decreasing. However, early reports from charities and patient groups suggest the COVID19 pandemic has had potential detrimental effects on the recognition, referrals and prevalence of mental and behavioural symptoms.

I plan to talk to health, education, social care services and map the pathway for children and young people with mental health symptoms.

Project: Reviewing data to identify health inequalities of Radford and Mary Potter PCN, then working with PCN stakeholders to develop pathways to address some of these health inequalities.

I am the mid-career GP Phoenix fellow for Sherwood PCN. Managing the growing incidence of diabetes is a major clinical challenge at present. Following the recent challenges in providing routine diabetic reviews during the COVID pandemic, I am looking at ways to change the delivery of these appointments to improve diabetic care and the patient experience. I will be considering the possibility of using virtual group consultations (potentially face to face group consultations if guidelines/COVID restrictions allow) and aim to introduce more of a holistic focus to these reviews, allowing more time to be spent on lifestyle factors. I am also looking at creating links with community partners to support patients to improve their health in general, as well as their diabetes control.

Project: Pre-school immunisations. Exploration of cultural and societal barriers to vaccination within Nottingham City East PCN with practical implementation of lessons learned.