The FCP Podcast

Send us Fan Mail Richard is joined by Consultant Neurologist Dr Fiona McKevitt for a practical discussion around two common neurological presentations in primary care: tremor and headache . Using two patient cases, we explore the clinical assessment, key examination findings, appropriate investigations, neurological red flags, and when referral to specialist services is indicated. A clinically focused episode designed to help frontline primary care clinicians approach neurological presentations with greater confidence. Hope you enjoy the episode! Home - Coventry & Warwickshire Training Hub https://www.cwtraininghub.co.uk/ https://collegeofparamedics.co.uk/ Association of British Neurologists https://www.theabn.org/ BASH - The British Association for the Study of Headache. National guidelines on the management of headache. https://bash.org.uk An example of advice of local migraine management advice (plus red flag headache symptoms) is here South Yorkshire Guideline Neurology Migraine Management.pdf www.migrainetrust.org A patient support website for tremor. Tremor Neurology – Primary Care Sheffield A video that helps explain the difference between essential tremor and idiopathic Parkinson's disease tremor. www.tremor.org.uk A patient support website for tremor.

Send us Fan Mail In this episode of The FCP Podcast , Richard is joined by Emily Styles to discuss the MAGIC project — a programme designed to help general practice teams prepare for and manage medical emergencies. We explore where the MAGIC project came from, the challenges it was developed to address, and how an initial idea evolved into a national programme. Emily explains the GP Quick Reference Handbook , including the clinical checklists designed to support teams during rare but high-pressure emergencies. We discuss how these resources can improve patient safety, support team performance, and provide a structured approach when every second counts. We also hear about feedback from practices using the handbook and MAGIC training, examples of its impact, and how GP practices and Primary Care Networks can access the resources and get started. A practical episode for anyone working in primary care who wants to improve their team's preparedness for managing emergencies in general practice. Hope you enjoy the episode! Home - Coventry & Warwickshire Training Hub https://www.cwtraininghub.co.uk/ MAGIC Project https://collegeofparamedics.co.uk/cop/ProfessionalDevelopment/MAGIC%20Project.aspx

Send us Fan Mail Richard is joined by Occupational Therapist LIzzie Mattacola to discuss her service improvement project she developed withing her General Practice role. We discuss how the project idea originated, the problem it aimed to solve, and what success looked like from the outset. We explore the planning process, including identifying the target patient population, selecting the right location, and deciding how best to introduce the service. We also delve into the practicalities of measuring impact—covering data collection, outcome measures, evaluation tools, and how meaningful metrics were chosen. Reflecting on the results, we discuss what worked well, what didn't go to plan, and the key findings that shaped the future of the service. Whether you're involved in quality improvement, service development, or looking to introduce change within your own organisation, this episode provides valuable insights, lessons learned, and practical advice for turning an idea into a sustainable service. Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub College of Paramedics https://collegeofparamedics.co.uk/ Home | British Geriatrics Society https://www.bgs.org.uk/ Overview | Dementia, disability and frailty in later life – mid-life approaches to delay or prevent onset | Guidance | NICE https://www.nice.org.uk/guidance/ng16 Leadership Academy – Better Leaders, Better Care, Brighter Future https://www.leadershipacademy.nhs.uk/ 10 Year Health Plan for England: fit for the future - GOV.UK https://www.gov.uk/government/publications/10-year-health-plan-for-england-fit-for-the-future

Send us Fan Mail Richard is joined by ED Paramedic ACP Greg Markham to explore emergency presentations in general practice — and what truly constitutes an emergency in the primary care setting. Through case-based discussion, they work through presentations of syncope and angioedema, focusing on structured history-taking, clinical assessment, immediate management within general practice, and clear thresholds for hospital referral. With practical insights and real-world application, this episode is designed to build confidence in recognising and managing high-risk presentations safely and effectively in primary care. Enjoy the episode. Thank you for your support Scott Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub College of Paramedics https://collegeofparamedics.co.uk/ https://cks.nice.org.uk/topics/blackouts-syncope/ Syncope toolkit | RCGP Learning https://elearning.rcgp.org.uk/mod/book/tool/print/index.php?id=12386 Overview | Transient loss of consciousness ('blackouts') in over 16s | Guidance | NICE https://www.nice.org.uk/guidance/cg109

Send us Fan Mail Richard is joined by ED Paramedic ACP Greg Markham to explore emergency presentations in general practice — and what really counts as an emergency in the primary care setting. Greg shares a structured approach to recognising and assessing the acutely unwell patient, including practical tools and resources that can support safe, confident decision-making under pressure. Through case-based discussion, they work through suspected sepsis and acute shortness of breath — covering clinical assessment, immediate management options within general practice, red flags, and when escalation is essential. A focused, clinically grounded episode designed to support frontline practitioners managing high-risk presentations in primary care. Enjoy the episode. As always - Thank you Scott for you support Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub College of Paramedics https://collegeofparamedics.co.uk/ JRCALC – Joint Royal Colleges Ambulance Liaison Committee https://jrcalc.org.uk/ Healthcare professionals - The UK Sepsis Trust https://sepsistrust.org/healthcare-professionals/ Emergency Oxygen | British Thoracic Society | Better lung health for all https://www.brit-thoracic.org.uk/clinical-resources/guidelines/emergency-oxygen/ Scenario: Acute exacerbation of asthma | Management | Asthma | CKS | NICE https://cks.nice.org.uk/topics/asthma/management/acute-exacerbation-of-asthma/ Scenario: Acute exacerbation | Management | Chronic obstructive pulmonary disease | CKS | NICE https://cks.nice.org.uk/topics/chronic-obstructive-pulmonary-disease/management/acute-exacerbation/ The Resus Room - Podcast - Apple Podcasts https://podcasts.apple.com/gb/podcast/the-resus-room/id1090433226 GP mythbusters: recently updated - Care Quality Commission Home | Resuscitation Council UK https://www.resus.org.uk/

Send us Fan Mail Richard is joined by renal consultant Dr Debasish Banerjee for a practical deep dive into sodium disorders and what those blood test results really mean in clinical practice. In this episode, we break down the interpretation of sodium levels — from hyponatraemia to hypernatraemia — and move beyond the numbers to focus on real-world decision making. Through case-based discussion, we explore key elements of history taking, red flags you shouldn’t miss, and when sodium levels become genuinely concerning. We also cover appropriate further investigations, common pitfalls, and how to manage these patients safely in primary care — including when it’s time to escalate. A must-listen for clinicians who want to get sodium right… because getting it wrong can go south fast. As always thank you to Scott for your support Hyponatraemia | Health topics A to Z | CKS | NICE https://cks.nice.org.uk/topics/hyponatraemia/ Hypernatraemia Algorithm – GP Gateway https://www.coventryrugbygpgateway.nhs.uk/resources/hypernatraemia-algorithm/ Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub College of Paramedics https://collegeofparamedics.co.uk/ UK Kidney UK Kidney Association | The leading professional body for the UK kidney community

Send us Fan Mail Richard is joined by renal consultant Dr Dabashish Banerjee for a practical deep dive into renal function tests and chronic kidney disease (CKD). In this episode, they break down what CKD actually is, how it’s diagnosed in primary care, and what the numbers really mean for your patients — beyond just the eGFR. Through case-based discussion, we explore a new diagnosis of CKD and a patient with worsening renal function, covering interpretation, red flags, progression, and when to escalate or refer. Clear, clinically focused, and designed for frontline practitioners — this episode will sharpen your confidence in managing kidney disease in everyday practice. Enjoy the episode. As always thank you for your support Scott UK Kidney CKD staging https://www.ukkidney.org/health-professionals/information-resources/uk-eckd-guide/ckd-staging Kidney Failure Risk Calculator https://www.mdcalc.com/calc/10045/kidney-failure-risk-calculator NICE - Chronic Kidney Disease https://cks.nice.org.uk/topics/chronic-kidney-disease/ FLOW Study https://www.nejm.org/doi/full/10.1056/NEJMoa2403347 Proteinuria UK Kidney https://www.ukkidney.org/sites/default/files/education/Proteinuria%20quick%20reference.pdf Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub College of Paramedics https://collegeofparamedics.co.uk/ UK Kidney UK Kidney Association | The leading professional body for the UK kidney community

Send us Fan Mail Richard is joined by renal consultant Dr Dabashish Banerjee to break down the interpretation of renal function tests — without the nephrology-induced headache. In this episode, we explore when renal function tests should be requested , what they actually include , and how to interpret results confidently in clinical practice . The conversation then focuses on potassium disorders , using real-world cases to unpack hypokalemia and hyperkalemia. We discuss key history points, relevant investigations, red flags not to miss, and when referral. A practical, case-based episode aimed at clinicians working in primary care, urgent care, and acute settings. Hope you enjoy the episode As always massive thank you to Scott Richard Tennant - richard.tennant@nhs.net Coventry and Warwickshire Training Hub Home - Coventry & Warwickshire Training Hub College of Paramedics https://collegeofparamedics.co.uk/ UK Kidney UK Kidney Association | The leading professional body for the UK kidney community Overview | Sodium zirconium cyclosilicate for treating hyperkalaemia | Guidance | NICE https://www.nice.org.uk/guidance/ta599 ABCD-UKKA joint finerenone consensus statement | UK Kidney Association https://www.ukkidney.org/about-us/news/abcd-ukka-joint-finerenone-consensus-statement Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias | New England Journal of Medicine https://www.nejm.org/doi/abs/10.1056/NEJMoa2509542 Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) https://kdigo.org/wp-content/uploads/2023/04/Diabetes-Management-in-Chronic-Kidney-Disease-Consensus-Report-by-the-ADA-and-KDIGO.pdf UKKA Clinical Practice Guideline – Management of Hyperkalaemia in Adults – October 2023 https://www.ukkidney.org/sites/renal.org/files/FINAL%20VERSION%20-%20UKKA%20CLINICAL%20PRACTICE%20GUIDELINE%20-%20MANAGEMENT%20OF%20HYPERKALAEMIA%20IN%20ADULTS%20-%20191223_0.pdf Optimization of RAASi Therapy Toolkit - International Society of Nephrology https://www.theisn.org/initiatives/toolkits/raasi-toolkit/#Challenges

Send us Fan Mail Richard is joined by consultant ophthalmologist Dr Stella Hornby for a practical deep-dive into eye assessment in general practice. In this episode we break down real-world cases including: 👁️ Acute vision loss 👁️ Eyelid swelling 👁️ Foreign bodies Together we cover structured history taking , focused clinical assessment , red flags you absolutely can’t miss , and — crucially — when, where, and how urgently to refer . If eyes make you nervous… this one’s for you. As always big thank you to Scott for your support. Richard Tennant - richard.tennant@nhs.net ‎ Eye Handbook https://apps.apple.com/us/app/eye-handbook/id335546959 Primary Care Eye Service https://primaryeyecare.co.uk/

Send us Fan Mail Richard is joined by consultant ophthalmologist Dr Stella Hornby to discuss the assessment of patients presenting with eye symptoms. This episode provides a practical introduction to ocular assessment and common presentations, before exploring real-world cases including red eye and changes in vision. Key elements of history-taking, relevant investigations, red flags, and appropriate referral pathways are discussed to support safe clinical decision-making. As always big thank you to Scott for your support. Richard Tennant - richard.tennant@nhs.net ‎ Eye Handbook https://apps.apple.com/us/app/eye-handbook/id335546959 Primary Care Eye Service https://primaryeyecare.co.uk/ TAKE YOUR GLASSES AND DO NOT DRIVE TO THE EYE HOSPITAL

Send us Fan Mail Richard is joined on the podcast by consultant hematologist Dr Suzy Morton. During the episode we discuss interpretation of Full Blood Counts. Including, a introduction to platelets and common reasons for platelets being affected. We then utilise Suzy's knowledge to discuss cases including thrombocytosis and thrombocytopenia. Including, pertinent history, further investigations , red flags and referral. As always big thank you to Scott for your support. Richard Tennant - richard.tennant@nhs.net British Society for hematology https://b-s-h.org.uk/ Blooducate podcast https://podcasts.apple.com/gb/podcast/blooducations-podcast/id1477503846 College of Paramedics https://collegeofparamedics.co.uk/ Coventry and Warwickshire Training Hub https://www.cwtraininghub.co.uk/

Send us Fan Mail Richard is joined on the podcast by consultant hematologist Dr Suzy Morton. During the episode we discuss interpretation of Full Blood Counts. Including, a introduction to white blood cells and common reasons for white blood cells being affected. We then Utilise Suzy's knowledge to discuss cases including neutropenia and raised lymphocytes. Including, pertinent history, further investigations , red flags and referral. As always big thank you to Scott for your support. Richard Tennant - richard.tennant@nhs.net British Society for hematology https://b-s-h.org.uk/ Blooducate podcast https://podcasts.apple.com/gb/podcast/blooducations-podcast/id1477503846 College of Paramedics https://collegeofparamedics.co.uk/ Coventry and Warwickshire Training Hub https://www.cwtraininghub.co.uk/

Send us Fan Mail Richard is joined on the podcast by consultant hematologist Dr Suzy Morton. During the episode we discuss interpretation of Full Blood Counts. Including, a introduction to full blood count, why we should be requesting a full blood count and common reasons for red blood cells being affected. We then Utilise Suzy's knowledge to discuss cases including microcytic and macrocytic anemia. Including, pertinent history, further investigations , red flags and referral. As always big thank you to Scott for your support. Richard Tennant - richard.tennant@nhs.net British Society for hematology https://b-s-h.org.uk/ Blooducate podcast https://podcasts.apple.com/gb/podcast/blooducations-podcast/id1477503846 College of Paramedics https://collegeofparamedics.co.uk/ Coventry and Warwickshire Training Hub https://www.cwtraininghub.co.uk/

Send us Fan Mail Richard is joined on the podcast by consultant hepatologist Dr Sophia Than. During the episode discuss the interpretation of liver function tests. We use Sophia expert knowledge to discuss cases of raised ALP and Bilirubin including history, red flags, further investigations and referral. As always big thank you to Scott for your support. Richard Tennant - richard.tennant@nhs.net British Society of Gastroenterology - Management of abnormal liver function tests https://www.bsg.org.uk/clinical-resource/guidelines-on-abnormal-liver-blood-tests FIB-4 https://www.mdcalc.com/calc/2200/fibrosis-4-fib-4-index-liver-fibrosis NAFLD score https://www.mdcalc.com/calc/3081/nafld-non-alcoholic-fatty-liver-disease-fibrosis-score Kings college acute liver injury https://www.mdapp.co/kings-college-criteria-calculator-527/ Change Grow Live https://www.changegrowlive.org/ Coventry and Warwickshire Training Hub https://www.cwtraininghub.co.uk/ British Society of Gastroenterology https://www.bsg.org.uk/

Send us Fan Mail Richard is joined by palliative care doctor Alistair Duncan and Nurse specialist Angela Wilson to discuss palliative care assessment. During the episode we utilise their skills and knowledge to discuss the deteriorating palliative patient. Including pertinent history, red flags and when to refer. Hope you enjoy the episode. Please leave some feedback about the episode. Thank you Scott for all your help as always! Angela Wilson - angela.wilson2@swft.nhs.uk Alistair Duncan - Alistair.Duncan@swft.nhs.uk West Midlands Palliative Care Guidance https://www.westmidspallcare.co.uk/wmpcp/guide/ Scottish Palliative Care Guidance https://www.palliativecarescotland.org.uk/news/news/new-guidelines-on-palliative-care-in-scotland-published/#:~:text=The%20guidelines%20provide%20practical%2C%20evidence-based%20or%20best-practice%20guidance,end%20of%20life%20care%20and%20use%20of%20medicines. Macmillan https://www.macmillan.org.uk/?gclid=f45758439b8e10e75a253f9ad779540a&gclsrc=3p.ds&msclkid=f45758439b8e10e75a253f9ad779540a NICE Prescribing in Palliative Care https://bnf.nice.org.uk/medicines-guidance/prescribing-in-palliative-care/ SPICT tool https://www.spict.org.uk/ Coventry and Warwickshire Training Hub https://www.cwtraininghub.co.uk/ College of Paramedics https://collegeofparamedics.co.uk/

Send us Fan Mail Richard is joined on the podcast by consultant hepatologist Dr Sophia Than. During the episode we introduce liver function tests. We discuss what is included in a liver function test, who needs a liver function test, any guidance for clinicians in interpreting liver function tests and some common reasons for abnormal liver function test. We then discuss a case of a raised alanine transaminase, including history, red flags, further investigations and referral. As always big thank you to Scott for your support. Richard Tennant - richard.tennant@nhs.net British Society of Gastroenterology - Management of abnormal liver function tests https://www.bsg.org.uk/clinical-resource/guidelines-on-abnormal-liver-blood-tests FIB-4 https://www.mdcalc.com/calc/2200/fibrosis-4-fib-4-index-liver-fibrosis NAFLD score https://www.mdcalc.com/calc/3081/nafld-non-alcoholic-fatty-liver-disease-fibrosis-score Kings college acute liver injury https://www.mdapp.co/kings-college-criteria-calculator-527/ Change Grow Live https://www.changegrowlive.org/ Coventry and Warwickshire Training Hub https://www.cwtraininghub.co.uk/ British Society of Gastroenterology https://www.bsg.org.uk/

Send us Fan Mail Richard is joined on the podcast by Advanced Clinical Practitioner (Nurse) and ReSPECT fellow Debbie White. During the episode we discuss the 'Recommended Summary Plan for Emergency Care and Treatment' (ReSPECT). We discuss the relevant background to the ReSPECT process, including why it was started, who the process is for, when should the process start and what are the legal implications for clinicians. We then discuss two cases including an acutely unwell patient refusing further care and a new cancer diagnosis. We us Debbie's expertise for the appropriate use of ReSPECT process in these situations. Hope you Enjoy the episode As always big thank you to Scott for your support. Richard Tennant - richard.tennant@nhs.net Resuscitation Council https://www.resus.org.uk/respect Warwick University Respect Tools https://warwick.ac.uk/fac/sci/med/research/hscience/sssh/research/respect/resources E Learning for Health https://portal.e-lfh.org.uk/Component/Details/626543 GMC CPR Professional Standards https://www.gmc-uk.org/professional-standards/the-professional-standards/treatment-and-care-towards-the-end-of-life/cardiopulmonary-resuscitation-cpr Advanced Care Planning Guidance CCG https://www.cqc.org.uk/sites/default/files/20210318_dnacpr_printer-version.pdf MENCAP Reasonable Adjustments https://www.mencap.org.uk/easyread/about-reasonable-adjustments DNACPR Guidance https://www.turning-point.co.uk/_themesdelivery/content-delivery/assets/dnacpr-content/dnacpr-information-pack/content/index.html#/ Coventry and Warwickshire Training Hub https://www.cwtraininghub.co.uk/ College of Paramedics https://collegeofparamedics.co.uk/

Send us Fan Mail Richard and Sophie are join by palliative care doctor Alistair Duncan and Nurse specialist Angela Wilson to discuss palliative care assessment. During the episode we then utilise their skills and knowledge to discuss a case of a palliative care patient with low mood/depression and nausea/vomiting. Including pertinent history, red flags and when to refer. Thank you Scott for all your help as always! West Midlands Palliative Care Guidance https://www.westmidspallcare.co.uk/wmpcp/guide/ Scottish Palliative Care Guidance https://www.palliativecarescotland.org.uk/news/news/new-guidelines-on-palliative-care-in-scotland-published/#:~:text=The%20guidelines%20provide%20practical%2C%20evidence-based%20or%20best-practice%20guidance,end%20of%20life%20care%20and%20use%20of%20medicines. Macmillan https://www.macmillan.org.uk/?gclid=f45758439b8e10e75a253f9ad779540a&gclsrc=3p.ds&msclkid=f45758439b8e10e75a253f9ad779540a NICE Prescribing in Palliative Care https://bnf.nice.org.uk/medicines-guidance/prescribing-in-palliative-care/ Coventry and Warwickshire Training Hub https://www.cwtraininghub.co.uk/ College of Paramedics https://collegeofparamedics.co.uk/

Send us Fan Mail Richard and Sophie are join by palliative care doctor Alistair Duncan and Nurse specialist Angela Wilson to discuss palliative care assessment. During the episode they define palliative care, what the journey may look like for patients, who is involved and when should specialist team get involved. We then utilise their skills and knowledge to discuss a case of a palliative care patient with pain. Including pertinent history, red flags and when to refer. Thank you Scott for all your help as always! West Midlands Palliative Care Guidance https://www.westmidspallcare.co.uk/wmpcp/guide/ Scottish Palliative Care Guidance https://www.palliativecarescotland.org.uk/news/news/new-guidelines-on-palliative-care-in-scotland-published/#:~:text=The%20guidelines%20provide%20practical%2C%20evidence-based%20or%20best-practice%20guidance,end%20of%20life%20care%20and%20use%20of%20medicines. Kathryn Mannix https://www.kathrynmannix.com/ Coventry and Warwickshire Training Hub https://www.cwtraininghub.co.uk/ College of Paramedics https://collegeofparamedics.co.uk/

Send us Fan Mail We welcome Dr Graham Dunthorn to the podcast who is a GPwSI in Pain management. During the podcast we define chronic pain, symptoms and types of pain. We discuss assessment of a patient with fibromyalgia including history taking, diagnosis , investigations , red flags and referral. As always thank you for your help with the podcast Scott and thank you to our guest Graham for giving us his time on the podcast. NICE Guidelines Chronic Pain https://www.nice.org.uk/guidance/ng193 Royal College of Physicians https://www.rcp.ac.uk/improving-care/resources/the-diagnosis-of-fibromyalgia-syndrome/ Diagnosis of Fibromyalgia To make a diagnosis using the ACR 2016 criteria the following need to be present 1 - Widespread pain index (WPI) ≥7 and symptom severity scale (SSS) score ≥5 OR WPI 4–6 and SSS score ≥9. 2 - Generalised pain, defined as pain in at least 4 of the 5 body regions, is present 3 - Symptoms have been present at a similar level for at least 3 months. Symptoms Severity Score (SSS) and Widespread Pain Index (WPI) calculator https://rheumcalc.com/fibromyalgia/ Live Well With Pain https://livewellwithpain.co.uk/ Flippin Pain https://www.flippinpain.co.uk/ Pain Toolkit https://www.paintoolkit.org/ Rethink Pain https://rethinkingpain.org/ Fibromyalgia UK https://www.fmauk.org/