Resources

The population is ageing and so we are seeing an increase in the prevalence and incidence of age-related conditions, such as frailty and dementia. These two conditions can often go ‘hand in hand’, making it important to ensure appropriate recognition, assessment and then management of each when experienced together. This paper uses a case study approach to illustrate and discuss the issues.

Nurses and nursing leaders continue to be overwhelmed by increasing challenges as the call to demonstrate higher levels of resilience gains momentum. And yet nurses continue to be faced with unparalleled levels of adversity, leading to a loss of hope, with many choosing to leave the profession rather than continue to be exposed to unyielding levels of stress that have the potential to threaten the survival of the profession itself. With this in mind, this paper focuses on the importance of nurses working collaboratively through the process of coaching, a construct gaining momentum as the profession seeks to expand and facilitate new ways of working in order to develop both current and future nursing leaders and, in so doing, not only strengthen the voice of nursing, but also improve the way in which nurses practice.

Asthma is an inflammatory condition which leads to narrowed and hyperresponsive airways. In recent times, the standard approach to managing asthma has been to use an inhaled corticosteroid (ICS, the preventer) to dampen down the inflammation and a short-acting bronchodilator (the reliever) to open up the airways if the person with asthma needed symptom relief. If the preventer inhaler is doing its job, the reliever should not be needed more than three times per week. The British Thoracic Society/Scottish Intercollegiate Guidelines Network guidelines currently reflect this approach (BTS/ SIGN, 2019), but later this year these guidelines will be updated based on a collaboration with the National Institute for Health and Care Excellence (NICE). NICE previously published its own asthma guidelines, which were controversial in terms of their recommendations, with a focus on using preventer therapy if a reliever was needed three times a week or more, rather than prioritising the use of anti-inflammatory treatment for an inflammatory condition. It will be interesting to see what the joint recommendations will be. In the meantime, many clinicians with an interest in asthma management are looking to the Global Initiative for Asthma recommendations for a fresh approach to asthma management (GINA, 2023).

I found the ‘Practice matters’ article about GPNs and the additional roles reimbursement scheme interesting on several levels. First, it reminds me how well placed we are as GPNs to deliver holistic personalised care across the whole population. Patients regularly
feedback that they like seeing a clinician who can listen to and help with a wide range of health issues.

The Queen’s Nursing Institute (QNI) has significant concerns about the additional roles
reimbursement scheme (ARRS), particularly the impact on general practice nurses (GPNs). With NHS England’s ARRS now funding 17 multidisciplinary team roles in primary care, the QNI is disappointed to see the continued exclusion of GPNs from the scheme.
Many practices are now employing large numbers of staff through the ARRS, with GPNs being required to support new starters, despite being excluded from recruitment into
the scheme.

A group of leading nurses have emphasised the crucial role of general practice nurses (GPNs) in reducing heart failure mortality and highlighted the need for more support in terms of specialised training.

In July, a discussion took place during a roundtable hosted by NHS England and the British Society for Heart Failure (BSH). The participants renewed their call for increased funding and protected time to empower GPNs in their efforts to lower mortality rates related to heart failure.

One of the most prevalent challenges associated with tackling malnutrition is the misunderstanding that surrounds it leading to this condition going unrecognised and untreated. Malnutrition can commonly be incorrectly understood as an inevitable result of the aging process, or a problem only faced by those living in the most extreme poverty. However, it is acutely important to understand that malnutrition caused by disease and illness is a widespread problem in the UK, and nurses can and do play an important
role in identifying and managing malnutrition in their patients, clients or service users.

Wound care in the UK has long been overlooked, often treated as a consequence of underlying health conditions rather than a distinct medical concern. However, as the prevalence of chronic wounds continues to rise, it is becoming increasingly evident that this perspective is unsustainable. Chronic wounds impact around 7% of the UK population, imposing a substantial burden on both patients and the healthcare system, with the NHS spending over £8.3 billion annually to manage the issue (Making wound care work: 9). Despite these alarming figures, wound care services remain understaffed and undervalued, straining to meet the rising demand for their expertise (Making wound care work: 4).

ieso delivers therapy for common mental health conditions, such as anxiety and depression, and strives to improve patient outcomes by understanding how these are related to the therapy received by the patient.

To fulfil this mission, we wanted to better understand the health and economic impact of different therapy types, e.g. digital interventions against standard mental health services. In particular, exploring how factors such as waiting and treatment times, and treatment effectiveness, impact patients’ health and mental healthcare costs.

Here, Susan Brookes, clinical and deputy lead, Birmingham and Solihull Training Hub (BSolTH), explains how they set themselves a challenge — namely, how could they ensure that the future general practice workforce understood and appreciated the ever-evolving roles within it? Not only that, how could they show the symbiotic relationships of these roles, include learning opportunities and make it innovative, fun and enhance other skills required to promote confident and competent practitioners? The team then went about creating an escape room experience using the background of gamification as their guide. This first ‘room’ was created for nurses and linked to wound management. Although early days in terms of its use, the initial feedback was good and BSolTH look forward to developing more rooms across a wider range of healthcare professionals.