Resources

The independent investigation of the National Health Service in England led by Lord Darzi sets out the issues which will need addressing in the NHS 10-year plan. In his report,  Lord Darzi identifies the deteriorating performance of the NHS and highlights important difficulties, including health inequalities, worsening public health, long waiting
times and stagnant real term finance.

It’s that time again. A new government full of optimism and a freshly minted prime minister bursting with new ideas, the honeymoon period yet to slip into acrimony and divorce.

And we all know what comes next — a new report on the state of the NHS, usually followed by a top-to-bottom reorganisation that will miraculously shorten A&E waiting times, solve the staffing crisis and promise millions of pounds for community services or ailing critical care, whichever happens to be the flavour of the day.

After a long wait, and years after updated international guidelines, the National Institute for Health and Care Excellence (NICE) has worked with the British Thoracic Society (BTS) and the Scottish Intercollegiate Guidelines Network (SIGN) to produce a unified guideline on asthma for the UK (NICE et al, 2024).

Here, Callum Metcalfe-O’Shea, UK professional lead for long-term conditions at the Royal College of Nursing (RCN), provides an overview of the important role that GPNs play in supporting patients living with long-term conditions. The value of GPNs will be explored, as well as the interventions they provide, relationships built between patients and nurses, and how we need to continue championing the GPN role to support the future of patient care.

Chronic breathlessness is very difficult to live with. It has widespread effects on both patients and those who care for them. And yet there are many ways that people can learn to cope with it, including using breathing techniques, adopting comfortable positions and using handheld fans and mobility aids. General practice nurses (GPNs) and other healthcare professionals have a vital role in helping people to manage their breathlessness. First, GPNs should acknowledge that breathlessness is difficult to live with and tell their patients that it is right that they have raised it as an issue to be addressed. Then, they can help patients to learn to manage their breathlessness and guide them to other sources of information and support. Some healthcare professionals find it hard to talk about breathlessness, but if they can help patients to see that it is an expected symptom, which is manageable, this could have a huge effect on their lives and help them to learn to live well with the condition.

Asthma is one of the most common long-term conditions (LTC) in the world. The UK has one of the highest prevalence rates of asthma worldwide, with asthma-related deaths continuing to rise each year. Supported self-management is imperative to enable people with asthma to live well. Low levels of self-management are linked to increased cost,
faster disease progression, early mortality, and increased multimorbidity (NHS England, 2024). This article highlights how primary care nurses, such as general practice nurses (GPNs), are well placed to support people living with asthma to self-manage their condition through the use of motivational interviewing and personalised asthma action plans (PAAPs), using a case study to demonstrate learning.

Anaemia is a common condition occurring worldwide. There are several different forms of anaemia, with iron deficiency anaemia (IDA) and anaemia of chronic disease (ACD) being two of the most prevalent types. Both have similar symptoms but are associated with different causes. Differentiating between the two types and confirming the diagnosis can be a difficult process. This article gives an insight into these two diseases, providing nurses and nonmedical prescribers with an understanding of assessment, diagnosis and treatment.

The purpose of this article is not to discuss the pathophysiology of pain in detail, but to focus on the clinical importance of assessing and managing leg ulcer pain. Effective pain management is crucial for improving patient comfort, promoting wound healing and improving overall quality of life. The article explores how to assess pain, including the importance of understanding a patient’s pain experience, use of pain scales, and distinguishing between different types of pain. It also discusses pharmacological approaches to pain relief and offers suggestions as to how healthcare professionals can minimise pain during dressing changes, a frequent source of distress for patients with leg ulcers.

The mental health and wellbeing of children and young people (CYP) is an area of growing concern, with many experiencing challenges that do not meet the threshold for specialist services but still requiring support. General practice nurses (GPNs) regularly come across young people in their line of work, and those who feel comfortable doing so may be well-positioned to provide some support in this area — be it opportunistically if mental health concerns are identified as part of another presentation, or as the focus of a consultation. Building on the discussion of assessment and referral processes in a previous article (Al-Yassin, 2024), this piece explores practical strategies for supporting CYP with mental health concerns. It describes the widely adopted THRIVE Framework and how the role of the GPN fits into this with a focus on the ‘thriving’ and ‘getting advice’ quadrants. This article introduces for the first time the 6S technique, including stigma reduction, simple explanations, self-help, signposting, support and safety netting, and provides comprehensive resources and signposting to guide both new and experienced GPNs in supporting the mental health of CYP.

Despite advances in wound care, treatment of lower limb ulceration remains suboptimal, with poor outcomes often attributed to inadequate diagnosis, failure to follow evidence-based practice, and variations in care delivery. These shortcomings result in delayed healing, reduced quality of life (QoL), and a significant economic burden on healthcare systems. Compression therapy is the recommended treatment for venous ulcers and ulcers with mixed aetiology, however there are some individuals who may not respond to compression alone or who are unsuitable due to arterial status. Recent advances in adjunctive therapies, such as the geko® device, offer promising results for these patients. This muscle pump activation (MPA) device activates the calf and foot muscle pumps, increasing venous, arterial and microvascular blood flow. This article examines the impact of leg ulceration on healthcare services and patient outcomes, while exploring the potential of the geko® device to improve healing rates and reduce associated costs.