Frailty is becoming increasingly recognised as a long-term condition associated with ageing that should be primarily managed in primary care. Diagnosing frailty identifies a high-risk population group and highlights areas of clinical importance that can be treated and managed. In 2017, NHS England introduced new elements into the GP contract, which require practices to identify moderately and severely frail patients, and to offer a clinical review to those who are severely frail (NHS England, 2017b). This review should include assessment of falls risk, medication review and seeking of permission to activate the enriched Summary Care Record (SCR). This article examines the general practice nurses’ role in the care and support of older people who live with frailty, and gives guidance on how to review medication, assess falls risk and use the SCR to ensure patients’ wishes and care preferences are recorded.
There is a variability and inconsistency in how GPs carry out cancer care reviews (Meiklejohn et al, 2016). Many people report feeling abandoned after treatment finishes (Scottish Cancer Experience Survey 2015/16). This article looks at an evaluation undertaken by NHS Lanarkshire as part of the Macmillan Transforming Care after Treatment (TCAT) programme to ascertain the acceptability and feasibility of general practice nurses (GPNs) taking on the role of delivering cancer care reviews using a Macmillan Holistic Needs Assessment Tool. After Macmillan cancer training, 10 GPNs invited people with a new diagnosis to a cancer care review. A concerns checklist was sent to the patients before the review. Four hundred people were invited, with 250 accepting the offer. People reported that the time afforded by the GPN was valued and they saw them as a point of contact in the future. Fatigue, pain and worry were the top three concerns raised. It was concluded that, with training, GPNs can offer quality-assured cancer care reviews and therefore shift some of the workload from GPs.
The transition from secondary to primary care can be daunting for any healthcare professional due to the extreme changes in the working environment and clinical responsibilities/duties undertaken. Healthcare professionals may fear that their knowledge base is not up-to-date and that they will become ‘deskilled’ within the general practice setting. However, with the correct attitude and determination, a successful and varied career can be forged incorporating advanced skills and enhanced practice within the day-to-day work of a general practice nurse (GPN).
There is widespread recognition that respiratory disease has been under prioritised and neglected for many years (All-Party Parliamentary Group [APPG], 2014). Those of us who work in primary care feel this is improving, although we recognise we still have a long way to go. We have welcomed guidance and guidelines that promote good respiratory care, as the patient, not the diagnosis, is key to what we do.
In each issue of the Journal of General Practice Nursing we investigate a topic currently affecting our readers.
Here, Amanda Andrews, programme lead in undergraduate nurse education, Education for Health, looks at how GPNs can support people with multiple sclerosis
Frailty is a clinical syndrome which focuses on loss of reserve, energy and wellbeing. Currently, older people with frailty tend to present late and often in crisis to health and care services so their care may be hospital-based, episodic, and unplanned. There is a need to reframe frailty as a long-term condition that can be mainly managed within a primary and community care setting, with timely identification for preventative, proactive care underpinned by supported self-management and person-centred care. General practice nurses (GPNs) will play a vital role in this new paradigm for frailty as key workers, coordinators of care, and supporters to patients and their carers at all stages of the frailty trajectory.
In each issue of the journal we speak to general practice nurses and hear what they have to say about their role in primary care.
Beverley Bostock-Cox, nurse practitioner, Mann Cottage Surgery, Moreton-in-Marsh; education lead, Education for Health
This article focuses on prevention in the Five Year Forward View (NHS England, 2014a) and the role of primary care, particularly the role of the general practice nurse (GPN). It will:
By reading the article in each issue, you can learn all about the key principles of subjects that are vital to your role as a general practice nurse.
The use of compression hosiery is commonplace in primary care. Traditionally, compression hosiery has been used to prevent leg ulceration, including prevention of the recurrence of leg ulcers and skin breakdown after ulcers have healed (Nelson and Bell-Syer, 2012).
