BJGP Interviews

About BJGP Interviews

Listen to BJGP Interviews for the latest updates on primary care and general practice research. Hear from researchers and clinicians who will update and guide you to the best practice. We all want to deliver better care to patients and improve health through better research and its translation into practice and policy. The BJGP is a leading international journal of primary care with the aim to serve the primary care community. Whether you are a general practitioner or a nurse, a researcher, we publish a full range of research studies from RCTs to the best qualitative literature on primary care. In addition, we publish editorials, articles on the clinical practice, and in-depth analysis of the topics that matter. We are inclusive and determined to serve the primary care community. BJGP Interviews brings all these articles to you through conversations with world-leading experts. The BJGP is the journal of the UK's Royal College of General Practitioners (RCGP). The RCGP grant full editorial independence to the BJGP and the views published in the BJGP do not necessarily represent those of the College. For all the latest research, editorials and clinical practice articles visit BJGP.org (https://bjgp.org). If you want all the podcast shownotes plus the latest comment and opinion on primary care and general practice then visit BJGP Life (https://www.bjgplife.com).

Publisher

The British Journal of General Practice

Category

health & fitness · health & fitness · science

Language

en

Explicit

No

First episode

25 Sept 2020

Latest episode

3 Nov 2026

Latest episodes

251 episodes in the feed.

1. 

   3 Nov 2026

   When women’s pain goes unheard: chronic pelvic pain and sexual violence

   Today, we’re speaking to Cate McCarter and Amanda Williams. We’re here to discuss the research they’ve recently published here in the BJGP titled, ‘Understanding chronic pelvic pain in women survivors of sexual violence: a qualitative study’. Title of paper: Understanding chronic pelvic pain in women survivors of sexual violence: a qualitative study Available at: https://doi.org/10.3399/BJGP.2026.0057 (https://doi.org/10.3399/BJGP.2026.0057) Chronic pelvic pain (CPP) is common and can be difficult to treat. Some women with CPP are survivors of sexual violence. How such women understood their pain was strongly influenced by feeling ignored by doctors and shamed by both CPP and sexual violence. According to women in our study, a ‘good enough’ response from GPs involved being seen as a whole person, being asked about sexual violence, pain being adequately investigated, and the GP acknowledging what is not understood about CPP and sexual violence. This allowed the negotiation of a pain explanation that validated the woman’s experience and integrated her social context with medical results, delivered with empathy and understanding. Transcript This transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions. Speaker A 00:00:00.240 - 00:00:56.560 Hi, and welcome to BJGP Interviews. I'm Nada Khan and I'm the senior research editor here at the bjgp. Thanks for listening to this podcast today. In today's episode, we're Speaking to Kate McCarter, a clinical psychologist and Professor Amanda Williams. Amanda is emeritus professor of Clinical Health psychology based at ucl, and we're here to discuss the paper that they've recently published here in the bjgp, which is titled Understanding Chronic Pelvic Pain in Women Survivors of Sexual Violence A Qualitative Study. So, Kate, I think I'll start with you. And we were talking just about, you know, how important this work is, and perhaps we could just start by talking about why you wanted to explore the experiences of women with chronic pelvic pain who have also experienced sexual violence. What did you feel was missing from what we already know in this area? Speaker B 00:00:57.650 - 00:02:15.360 Yeah, I suppose the. I approached this research topic with anecdotal evidence, having worked with survivors of nursing and sexual violence for about 10 years before I started researching this. Just anecdotal evidence that lots of women also lived with chronic pelvic pain. And I didn't, you know, I hadn't any thoughts about the association really, or whether it was causal or what, but I just noticed that the women I was supporting before training as a psychologist, they were living with chronic pelvic pain, and a lot of them had found it very difficult to seek health care and to receive health care for that. So I just started speaking to Amanda about that, and from our conversations, we started thinking about the meaning of pain and how there's an established association within the literature about chronic pain, chronic pelvic pain after sexual violence. But what's the meaning of that for the women who live with it? That felt missing. And because meaning, personal meaning, is so key to understanding a personal lived experience of pain, it felt like a gap that we could begin to address by asking women, how do you make sense of the pain that you're living with? Came from there, really. Speaker A 00:02:15.440 - 00:02:24.400 And your background is as a clinical psychologist. So interpreting what pain means is quite a personal thing for a lot of women, isn't it? I guess. Speaker B 00:02:24.480 - 00:03:23.180 Yeah, absolutely. Yeah. Is very personal and. And complex as well. The. The attempts to understand exactly what pain means to a woman is, you know, you take into account those experiences of trauma very often, but not always, and you take into account the social context and what's going on around them, how sort of how they've come to be in the situation they're in. So, yeah, it is Highly personal and effective treatment can't really start until that's understood because the way that a woman will approach her attempts to seek health care is very much led by how she makes sense of it. So if she's. Some of the women in the study linked it to surviving sexual violence, then the meaning is wrapped up in that. Has she disclosed that to her healthcare provider? Does she feel able to. It's an incredibly difficult thing to talk about. Has she been asked? So, so yeah, very personal, absolutely. Speaker C 00:03:23.820 - 00:04:12.840 And I think often sort of co created in the encounter with healthcare professionals and that can go either way and in the paper are examples of both. But women are looking for information and understanding to incorporate into the meanings of pain and that doesn't always happen. Or they get multiple different accounts which are incompatible. People really struggle. I mean, I've worked in pain for 35 years and I hear this in all sorts of pain, but I think particularly where there isn't anything very definite, no tissue damage to identify, nothing to show for it, as it were. Speaker A 00:04:12.920 - 00:04:36.579 And this is a really sensitive area. And you interviewed 10 women about both their pain and their experiences of sex, sexual violence. I just wanted to touch on how you approached these conversations and how you learned from listening to women in this way, sort of taking both of these things into account. And we'll go a little bit more in depth into the themes that you discovered. But yeah, just as a sort of overview. I wonder if you wanted to comment on that. Speaker B 00:04:36.739 - 00:05:54.960 I suppose it started with I believe that you've been sexually assaulted. There was no question about that. And I think the reason I say that is because that's. That's often disbelieved or dismissed or minimized by anyone. It's not specific to healthcare at. By anyone that a woman tells about her experience. So I think it started from that even before we had a conversation. The advertisement, the information sheet about consenting into the study was. I tried to make it as validating as possible. It was an opportunity to talk in depth about a topic, topics that are taboo, that are not spoken about, that are shamefully hidden. And I think giving women the opportunity in a space where they felt believed meant that women perhaps relaxed into the conversation as we got talking. I think also it helped that it was a semi structured interview so I was very much able to follow where that woman was going. But I think also the women were so motivated to talk to me, they really encouraged me to publish. I wasn't. I don't love writing. Amanda's very good at writing. I don't love it, but I really wanted to do it for them. I said I would and therefore I did. Speaker A 00:05:55.360 - 00:06:05.120 And one of your main themes was attempts at silencing women. What did women mean by that and what were they experiencing when they tried to get healthcare for their pain? Speaker B 00:06:05.600 - 00:07:28.130 So this, this was a finding that really fitted with both experiences of pain and of surviving sexual violence. And women were talking about being actively told not to talk about those things. So sometimes they're disclosed to a family member and they'd been told, I don't believe you, or don't talk about that. That's just something that women have to go through. But also, unfortunately, some encounters with health care professionals as well. So not being believed, not being asked as well. That was a really significant part of some of the women's narratives, that if you don't ask, then I won't tell you. And that's, that's not a new finding that's fairly established within primary care. The women in this study really just backed up that finding that women want to be asked that it's, it facilitates disclosure of difficult experiences, sexual violence being one of those. So if they'd, if they'd been asked, then they were more likely to disclose. But, yeah, it's the responses to that disclosure that were, that was silencing and that fitting within a societal context of minimizing sexual violence, of minimizing particularly women's pain, particularly in the pelvic area. And the message of just get on with it, really. Speaker A 00:07:28.850 - 00:07:44.440 And I wonder just a little bit, I mean, that comes through quite strongly, that experience of not being believed or of having pain attributed to mental health problems. But why do you have any thoughts, either of you, about why that happens, particularly with chronic pelvic pain in women? Speaker B 00:07:44.840 -...

2. 

   27 Oct 2026

   From barriers to belonging - Black researchers in academic primary care

   Today, we’re speaking to Dr Rupinder Bajwa, a Research Fellow based in the centre for Academic Primary Care at the University of Nottingham. Title of paper: Unpacking barriers to and facilitators for research leadership for Black primary care researchers: a qualitative study Available at: https://doi.org/10.3399/BJGP.2026.0175 (https://doi.org/10.3399/BJGP.2026.0175) Researchers of Black heritage are underrepresented in primary care research leadership, and there is limited evidence on their lived experiences of why this underrepresentation exists. This study addresses this evidence gap and highlights how systemic inequities, racism, and inequitable academic practices contribute to this lack of representation. This study also presents practical enablers to improve progression and retention, such as proactive leadership, tailored career support, and increasing visibility of Black role models in academic primary care. These findings emphasise the need to foster inclusive research environments that strengthen the diversity and relevance of primary care evidence. Transcript This transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions. Speaker A 00:00:01.120 - 00:00:54.620 Hi and welcome to BJGP Interviews. I'm Nada Khan, I'm the Senior Research editor at the BJ gp. And thanks very much for joining me here to listen to this podcast. In today's episode, we're speaking to Dr. Rupinder Bajwa. Rupinder is a research fellow based in the Centre for Academic Primary Care at the University of Nottingham. We're here to talk about the paper she's recently published in the BJGP titled Unpacking Barriers to and Facilitators for Research Leadership for Black Primary Care A Qualitative Study. So, hi, Rupinder, it's really great to meet to talk about this work and I wonder if we could just start by talking through what prompted you and your team to look at the experiences of black researchers in academic primary care. And I'm wondering what we already knew in this area and what you felt was missing from the picture. Speaker B 00:00:55.260 - 00:01:34.840 Firstly, thank you so much for having me on to talk about the work that we did so the way this sort of came about. So primary care serves some of the most diverse communities in the uk, but what we realised is, when you look at primary care, researchers of black heritage remain largely underrepresented, especially in more senior academic and leadership roles. And so because of that, we wanted to understand, well, why does this gap exist and, you know, what can we do to improve representation but also improve retention of researchers of black heritage and their career progression as well? Speaker A 00:01:34.920 - 00:01:43.320 And you spoke to people from a black background, is that right? So talk us through just who you discussed this project with and how you got those. Speaker B 00:01:43.640 - 00:03:01.100 Yeah. So to start with the project team itself, there's myself, I'm a researcher of South Asian heritage. We had Adwa and Ralph, who are researchers of black heritage. Manpreet Rains is a researcher of South Asian heritage. We have Professor Joe Kai on the team, who is also of Asian Heritage. And we had Professor Christian Mallon on the team as well, who is a senior leader at the School for primary Care research. And so we had sort of that diversity within the study team. We predominantly wanted to speak to researchers of black heritage who are working in academic primary care across all levels, so from junior up to senior. And we also spoke to leaders of departments where, you know, they're leading academic primary care departments as well. And we, you know, really wanted to explore what, especially with the researchers, you know, barriers that they've experienced or barriers that they know of as well as what's gone well for them as well, you know, for their progression opportunities that they've had, but also, you know, what their thoughts and feelings were around the current level of representation and what could be done and with leaders as well. We sort of spoke about some of the barriers, but also some of the work that might be going on on to address some of these barriers as well. Speaker A 00:03:01.340 - 00:03:25.340 Just the introduction to your paper and work that's been done more widely in this area. We do know that the underrepresentation of researchers of black heritage drops off, particularly as sort of more senior levels of academia. And I wonder what you heard from the experiences of researchers as they move through their careers and why does that progression seem to become more difficult? Speaker B 00:03:26.280 - 00:04:51.480 Yes. So a lot of what we found in the project isn't just an academic primary care problem. I'll start with that. It does speak to wider challenges across academia. So when you look at academia as a whole, I think it's around 1% of professors are of black heritage. So that's quite a small number. Speaking to researchers around their progression. We wanted to understand what some of those challenges are. And what came through was there are a lot of structural and systemic barriers that continue. So structural and systemic racism is one key challenge. And when we were speaking to researchers, what this looked like. You know, it was more, it could be subtle microaggressions being passed up for opportunities, stereotypes, but also sometimes the academic culture could be quite exclusionary and researchers found that it was sometimes difficult to find opportunities. There was limited access to some development opportunities as well. And especially for a junior level, sort of the short term contracts and the funding insecurity made that progression difficult. And for those who were sort of mid career researchers and thinking about the next steps, it was, you know, well, what does that look like? What support is available? Is there any support available? And there was challenges around that is finding adequate support, adequate mentorship and sponsorship as well. Speaker A 00:04:51.810 - 00:05:10.690 And you know, you're talking about these structural and interpersonal barriers as well. But I wonder how that impacts things like academic funding or recognition and how that's distributed. Did they talk about barriers to getting funding or grants and recognition for the work they were doing? Speaker B 00:05:10.770 - 00:06:02.430 Yeah, so this was a, this was a concern as well that came up and researchers were keen to highlight that, you know, this is a challenge across the board in terms of research funding. A lot has changed in the last few years. Pools of funding have got smaller, but it seems to be there's additional challenges involved for minoritised researchers in terms of how to get that funding, how to apply for that funding, you know, how to position yourself for that Funding, unless you know it, you don't know it. And it can be even more challenging if you're a minoritised researcher where you may be starting off on a slightly different footing, coming into the space. And that can make it really difficult for funding. But more recently, I know NIHR and funding bodies are now looking at this and making proactive steps to address that, which is really positive. Speaker A 00:06:02.910 - 00:06:18.030 And one thing that really struck me was the difficulty that some people felt in speaking up about discrimination. So what did the people that you spoke to tell you about raising concerns? And I wonder whether that says something about sort of the culture within academic institutions as well. Speaker B 00:06:18.400 - 00:07:15.700 Yeah, this came up across levels as well. So it wasn't just junior researchers, but senior researchers reflected on their experiences as junior researchers as well. And there was a concern around the impact that raising issues could have on their careers, but also concerns around actually, will anything be done about it? If I raise it, what's going to come out of this? And so people might not report it then if they a, feel it will impact their career and impact their trajectory. But then also if they feel that actually, you know, I don't really have faith that the system will address this or anything will change that then will leave them feeling like actually it's not worth reporting it. And that in itself is challenging because if you've been, you know, if you've experienced that, you should be able to go somewhere that's impartial and that will take your experiences seriously and look into it and address that. Speaker A 00:07:16.190 - 00:07:31.070 And you mentioned that when you conducted this study, you also wanted to look at things that helped people to stay and progress. So I wonder if you could talk through just some of these different areas because there...

3. 

   20 Oct 2026

   Recurrent UTIs: which non-antibiotic approaches actually work?

   Today, we’re speaking to Professor Miriam Santer, a GP in Dorset and Professor of Primary Care Research based at the University of Southampton. Title of paper: Non-antibiotic interventions to prevent recurrent urinary tract infections in women: overview of systematic reviews of randomised controlled trials DOI: https://doi.org/10.3399/BJGP.2026.0055 (https://doi.org/10.3399/BJGP.2026.0055) Recurrent urinary tract infection (UTI) is very common and defined as two or more UTIs in the last six months or three or more UTIs in the last 12 months. Long-term antibiotic prophylaxis is widely used but other preventative strategies have been suggested. This overview of systematic reviews found good evidence for some treatments but identified unresolved questions such as treatment adherence for vaginal oestrogen, questions about long-term use for methenamine hippurate and optimal dosage for cranberry. Increased fluid intake has been shown to be of benefit for women drinking less than 1.5 litres at baseline but is without robust evidence in other groups. The evidence base is still developing for other treatments, such as vaccines. Transcript This transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions. Speaker A 00:00:00.560 - 00:00:55.830 Hi and welcome today to BJJP interviews. I'm Nada Khan and I'm the Senior Research editor for the bjgp. In today's episode, we're talking to Professor Miriam Santer, a GP in Dorset and Professor of Primary care research based at the University of Southampton. We're here to discuss the recent paper she's published here in the BJJP titled Non Antibiotic Interventions to Prevent Recurrent Urinary Tract Infections in Women. An Overview of Systematic Reviews of Randomized Controlled Trials. So, hi Miriam, it's nice to see you again. And I suppose to start with, it's worth acknowledging that recurrent UTIs are something that we see incredibly often as GPs, but they can also have a really big impact on women's lives and I guess I just wanted to go through what prompted you to take this angle in this review and think about non antibiotic options for preventing them? Speaker B 00:00:56.520 - 00:02:38.580 Well, it was exactly that, that I had a colleague, a non clinical colleague who had recurrent UTI and I guess I hadn't really appreciated the massive impact that they had in terms of, you know, keeping, being ill, keeping missing work, everything else. And it did make me think again about my own practice, whether I really manage recurrent UTI or whether I just manage it as a series of one off events. So it made me think about my own practice. And then also the reason we looked at non antibiotic options was because the Primary Care Research Centre in Southampton where I work, we do a lot of work on infections and on antimicrobial stewardship and we were aware that prophylactic antibiotics tend to be quite well used and also series of one off antibiotic episodes are quite well used but that the non antibiotic interventions, we felt they were less well used and just wanted to know the evidence behind it. Apart from doing infections research, we also do a lot of research on how to support people self manage long term conditions and we thought we could make a brilliant resource or online intervention to help people prevent urinary tract infection. And as part of that we just wanted to know a bit more about the evidence based and in some ways we were a little disappointed that there wasn't much evidence for some of the very commonly advised things, but also surprised that for some things like methenamine and vaginal estrogen, actually the evidence base is, is pretty well established now. So it was interesting. Speaker A 00:02:38.900 - 00:03:04.080 Yeah. And as you said, there's a huge number of things that women are told might help prevent recurrent UTIs and this was an umbrella review that brought together evidence from 27 systematic reviews. But let's just talk through what. So you mentioned about vaginal oestrogen, because this seems to be one of the clearest messages from the review. Talk us through what you found and how strong is the evidence here? Speaker B 00:03:04.480 - 00:04:07.360 So there were seven systematic reviews covering vaginal estrogen and they were pretty positive and especially the most recent one. To be fair, most of the evidence is in post menopausal women, but the NICE guideline changed in 2024 to say perimenopausal and postmenopausal, because there's awareness in the rest of the menopause literature that actually genital urinary symptoms in menopause are often do present before menopause. So it's a slightly confusing message. The evidence base for prevention of UTIs is postmenopausal, but the guidelines are perimenopausal and postmenopausal. But the evidence is pretty strong. It's been amassing over a number of years. Seven systematic reviews have been positive about it. Unlike systemic oestrogen, where systematic reviews have been pretty conclusive that systemic estrogen doesn't make a difference in preventing recurrence. But of course, women can take both at the same time if they need to. Speaker A 00:04:07.520 - 00:04:21.750 And one thing I found really interesting was that there was particularly low uptake of vaginal estrogen in more deprived areas. Do you think that there's something driving that and what can we do to try to prevent that sort of inequity in access? Speaker B 00:04:21.990 - 00:05:59.500 And it's tempting to say more research needed. And that was something we found in the literature, that there's a suggestion that vagina strings are less used in the UK than elsewhere. They're less used in areas of greater socioeconomic deprivation. And also it's not very well understood whether it's a prescribing issue or whether it's an uptake and adherence or acceptability issue. There's. So for prescribers, there's some things that are off putting. So I don't really understand why vagina are not licensed for prevention of uti, given the evidence base for women. It's a number of other things. Sometimes, you know, not having had a sufficiently informed discussion about all the different types, you know, gel cream, pessaries, and sometimes it's also that the patient information leaflet that comes with the packet describes it as hrt, where it's really very little of it is systemically absorbed. So it, it is, it's safer than hrt. I mean, of course HRT is Pretty safe. Vaginal estrogen is even safer. But that message doesn't always get across. And then also maybe it's because the information leaflet and all the other information tends to focus on genital urine symptoms of the menopause that people don't necessarily link it in their minds. And I'm talking about prescribers as well as women with preventing UTI and maybe just don't keep using it long enough. So more research needed. But I think there's a number of barriers to uptake regarding vaginal estrogen and. Speaker A 00:05:59.500 - 00:06:22.180 I can think of a lot of conversations I've had with women with recurrent UTIs and suggesting vaginal estrogen and often they're quite surprised but quite happy that I'm suggesting something that could work. So I think there is a bit of a information asymmetry there between what some prescribers are doing, maybe people who are really used to prescribing these things and patients as well. Speaker B 00:06:22.340 - 00:06:41.460 And I've also certainly met a few women who said, oh, was I meant to keep using that? They don't necessarily see it as a, as something they need to take in the long term to keep preventing it, you know, which is. And for something which you're only doing twice a week, that is a slightly challenging behavior to keep remembering to use it. Speaker A 00:06:41.790 - 00:06:52.350 And I guess one other thing that you also found really good evidence for was methanomine. Talk us through how we should be thinking about methanamine in relation to long term prophylaxis as well. Speaker B 00:06:52.670 - 00:07:29.200 So methenamine has also made it into the nice guideline on preventing recurrent uti. And I think I might have forgotten to say so that's anyone who's had two UTIs in six months or three UTIs in 12 months. And the evidence is pretty good for methenamine as well as vaginase drinks. As someone who hasn't responded to basic lifestyle advice, we might come on to that. The evidence is a little bit poor, but it's still suggested that you discuss lifestyle advice first. Should, if they're perimenopausal or menopausal, consider vaginal estrogen, but at all ages consider methenamine. Speaker A 00:07:29.760 - 00:07:39.680 Interesting. And do you think that I don't know if there's any evidence in these reviews about how they're used or whether they're underused or do you think gps are confident in prescribing these? Speaker B 00:07:40.310 -...

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