Resources

This article discusses key concepts that general practice nurses (GPNs) can consider when supporting men with longterm conditions (LTCs) in primary care. It looks at relevant statistics alongside common LTCs GPNs may see in primary care, and offers practice points to help GPNs feel more confident in addressing men’s health in those with LTCs. It also explores barriers that may prevent men from accessing healthcare services. By considering these points in primary care, GPNs can better advocate for male patients and improve outcomes.

In November 2023, the UK Joint Committee on Vaccination and Immunisation (JCVI) recommended the introduction of a universal childhood varicella (chickenpox) vaccination programme. The vaccine will be administered as part of a combined measles, mumps, rubella, and varicella (MMRV) vaccine from 2026. This article explores the rationale for introducing the chickenpox vaccine in the UK, its potential public health impact, the possible implications for uptake of the MMR vaccine, and the role of nurses in supporting implementation. It describes the evidence from other countries which demonstrates significant reductions in varicella incidence, complications, and hospitalisations following vaccination, and the influence on the JCVI’s decision of updated cost-effectiveness modelling, reduced post-pandemic immunity, and public health alignment with international practice. It further discusses potential challenges, including public perceptions of necessity, the small risk of febrile seizures with MMRV, and the risk that vaccine hesitancy will affect MMR uptake.

More and more research is showing how important the health of the gut is to physical and mental wellbeing and the number of papers published on the subject has grown exponentially; now thought to be around 75,000. The bacteria, yeast and viruses that live in our gut are called the gut microbiome and there are around 100 trillion of them. Many of these microbes are beneficial and even essential to human health, while others can be harmful. This symbiotic relationship benefits microbes and their hosts as long as the body is in a healthy state. Sometimes dysbiosis develops when the more harmful bacteria get to overwhelm the system leading to ill health (Medical News Today, 2023). By reducing factors that harm the good microbiome and increasing factors that help it to be restored to the right balance, much can be done for wellbeing. This two-part article explores why a good balance of microbiota is important and what factors encourage a healthy microbiota and what factors cause an imbalanced one. It is in two parts because it is now such a vast and popular subject; with this first part exploring why the gut microbiome is so important for health and wellbeing and what an unbalanced microbiota (otherwise known as dysbiosis) can lead to.

The presentation of a painful leg in primary and urgent care has many possible differentials. It is essential that clinicians take a structured and comprehensive approach to assessment, including history-taking and face-to-face physical examination to ensure that nothing is missed (Armstrong, 2020). This article is not intended as a substitute for practical learning in physical assessment and history-taking, but rather it serves as an aide memoire for those who are still developing these clinical skills.The possible differentials of painful legs — whether upper or lower, unilateral or bilateral — are discussed, looking at key areas such as clinical presentation, correct assessment and history-taking, red flags, relevant investigations, and an introduction to treatment options. References to resources available, e.g. national guidelines, are also provided.

If detected early, cervical cancer is one of the most effectively treated cancers. Therefore, attendance at cervical screening appointments, where the health of the cervix can be checked, is vitally important. However, there is a known health inequality in relation to the LGBTQIA+ population and attendance at cervical screening appointments. Some barriers to attendance include administrative processes, previous negative experiences with healthcare professionals, discrimination and embarrassment. This literature review was undertaken to explore the experience of LGBTQIA+ people and cervical screening from a global perspective. A total of nine papers were included and thematically analysed. The fours themes identified were discrimination, gender dysphoria, interpersonal and emotional experiences and relationships with healthcare providers. Healthcare professionals, such as general practice nurses (GPNs), should be aware of potential factors which may prohibit attendance from this population and encourage and increase engagement with the cervical screening programme. It is imperative that care provided should be person-centred, compassionate and informed to support reattendance and, importantly, engagement with the healthcare system as a whole.

Having the ability to reflect on professional practice is an essential skill of a registered nurse practising in the UK, and in England, nursing associate, and is a key tenet of the Nursing and Midwifery Council (NMC) revalidation. While demonstrating the importance of reflection, this paper encourages nurses to think beyond the defined constraints of reflection and move towards the more dynamic approach of critical reflection and concludes by introducing the concept of [nursing] praxis — a process which requires nurses to demonstrate a greater understanding of the complex nature of the political, social, economic and environmental constraints under which we live and work and act in a way to reduce their impact.

While seeing the advanced GPN role as distinctly different to acute ANPs within our practice, I also needed to consider symptoms and conditions which perhaps link to or commonly present in GPN appointments where we can offer value and reduce workload within the team. Hypothyroidism is in my mind one of these and yet I needed some clarity around diagnosis which Margaret Perry’s excellent and comprehensive article has provided.

The medication landscape for type 2 diabetes has changed dramatically over the last year and I needed some confirmation around where older medications such as gliclazide still had a place. Susan Camphor clearly sets out clinical scenarios where gliclazide still fits, but also situations to avoid

We’ve all been there, frustrated by that patient who just won’t keep an eye on their blood glucose levels or refuses to give up smoking despite the risk to their general health. In your everyday work as a general practice nurse (GPN), you know how hard it can be to persuade some patients to adopt lifestyle improvements that might be painful in the short term but will have long-term health benefits.

Like many skin conditions commonly encountered in primary care (e.g. dermatitis, psoriasis and acne vulgaris), hidradenitis suppurativa (HS) can be both difficult to spell and pronounce. HS can also be difficult to identify, despite being an inflammatory skin condition that affects as many people as psoriasis (Penzer Hick, 2022). As a consequence, it can sometimes take several years for patients to get a diagnosis; approximately 35% of people with HS reported it taking three to 10 years to be diagnosed (Nicolle, 2022).

The days of ringing up your GP surgery and being blindly booked into a GP appointment are long-gone for the majority of surgeries in the UK. Patients are living longer, and there is increased awareness of acute and chronic conditions. Combined with NHS treatment backlogs, these factors have significantly increased demand on GP surgeries, which are struggling with limited resources.