Operational failures in general practice: a consensus-building study on the priorities for improvement.

Background: System problems, known as operational failures, can greatly affect the work of GPs, with negative consequences for patient and professional experience, efficiency, and effectiveness. Many operational failures are tractable to improvement, but which ones should be prioritised is less clear.

Aim: To build consensus among GPs and patients on the operational failures that should be prioritised to improve NHS general practice.

Creating and administering video vignettes for a study examining the communication of diagnostic uncertainty: methodological insights to improve accessibility for researchers and participants.

Background: Studying clinician-patient communication can be challenging, particularly when research seeks to explore cause-and-effect relationships. Video vignettes - hypothetical yet realistic scenarios - offer advantages to traditional observational approaches by enabling standardisation and manipulation of a clinician-patient encounter for assessment by participants. While published guidelines outline stages to create valid video vignette studies, constructing high quality vignettes which are accessible to a wide range of participants and feasible to produce within time and budget restraints remains challenging.

Identifying how GPs spend their time and the obstacles they face: a mixed-methods study.

Background: Although problems that impair task completion - known as operational failures - are an important focus of concern in primary care, they have remained little studied.

Aim: To quantify the time GPs spend on different activities during clinical sessions; to identify the number of operational failures they encounter; and to characterise the nature of operational failures and their impact for GPs.

Design And Setting: Mixed-method triangulation study with 61 GPs in 28 NHS general practices in England from December 2018 to December 2019.

Improving access to appointments at Laurie Pike Health Centre.

Background: Rising demand makes it increasingly difficult for patients to access appointments. Laurie Pike Health Centre (LPHC) operates a predominantly same-day booking policy in order to manage appointment requests from its 18 000 patients. We sought to quantify the number of requests, in order to estimate the unmet demand.

Rare case of eosinophilic granulomatosis with polyangiitis in two patients with α-1-antitrypsin deficiency (PiSZ).

We present two cases of eosinophilic granulomatosis with polyangiitis occurring with α-1-antitrypsin deficiency, both PiSZ phenotype. The simultaneous occurrence of these two conditions has seldom been described in the literature, despite evidence of an association between α-1-antitrypsin deficiency and other forms of vasculitis. Both patients had pulmonary involvement and reported intermittent exacerbations of vasculitic symptoms.

A qualitative study exploring how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England.

Objectives: To explore how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England. We explored women's perceptions of deinfibulation, caesarean section and vaginal delivery; their experiences of care during pregnancy and labour; and factors that affect ability to access these services, in order to make recommendations about future practice.

Design: A descriptive, exploratory qualitative study using face-to-face semistructured interviews.