People with physical-mental comorbidity have a poorer quality of life, worse clinical outcomes and increased mortality compared to people with physical conditions alone. South Asians (SAs) are the largest minority group in the UK and are more likely to have long-term conditions (LTCs) such as diabetes and heart disease. SAs are less likely to recognise symptoms which may represent mental health problems. To explore how people of SA origin with LTCs understand, experience and seek help for emotional distress, depression and anxiety. Systematic review of qualitative studies exploring emotional distress in SAs with diabetes or coronary heart disease, within primary and community care settings worldwide. Comprehensive searches of eight electronic databases from inception to 1st September 2021. Data extracted included study characteristics, and understanding, experience and help-seeking behaviour for emotional distress. Thematic synthesis was undertaken. The CASP checklist for qualitative studies was used to assess quality of papers, and GRADE-CERQual used to determine the overall strength of evidence. Twenty one studies from 3,165 unique citations were included. Three main themes were identified. Understanding of emotional distress: non-medical terminology used, such as ‘tension,’ and a complex relationship between emotional and physical illness. Experiences of emotional distress: multiple forms of inequality, distress at diagnosis of their LTC, cultural factors, and gender differences. Help-seeking behaviour: self-management, seeking help from family, friends, and faith, and inadequate clinical support. This review provides a greater understanding of SAs’ conceptualisation of emotional distress in the context of LTCs, to support improvement in its recognition and management.

It was interesting to read about increasing the flow and plugging the leaks for the GP workforce pipeline. 1 The initial stage of GP recruitment was stated to be during medical school but our experience of widening participation has made it start earlier. The Selecting for Excellence Final Report highlights the need for medical schools to support students from wideningparticipation backgrounds, the key role of doctors in widening participation, and how this can be supported. 2 The School of Medicine at Keele University this year arranged for visits for 17 local college students from widening-participation backgrounds to spend a day in general practice. This was one of their five core days of the Steps2Medicine scheme arranged by the School of Medicine. All students on the scheme with suitable exam grades are given a guaranteed interview at Keele. The students were given a list of 20 specific tasks to complete during 'My day in general practice'. These included listening to heart and lung sounds, taking a pulse, and watching a procedure such as venepuncture or an intramuscular injection. Students were encouraged to spend time with a GP, practice nurse, and at reception. We asked students for verbal and written feedback, which was almost entirely incredibly positive. Comments included 'Dr x is a huge role model', 'it [general practice] is an incredibly rewarding and diverse job', '[i]t's really interesting and varied and has increased my interest in the possibility of going into the job', and 'I loved the GP visit and it was an amazing experience which made me 100% sure that I want to go into medicine'. And what did the GPs who took part think? 'Brilliant', 'truly inspiring', and one GP commented that a student had said 'this has been the best day of my life!' We believe that such student visits could form part of the solution to the workforce crisis by encouraging and inspiring local students from any background, not just widening-participation backgrounds, to enter a career in general practice. And we may well have also stumbled on a way of improving GP retention, by reminding GPs just how inspirational they are!