Resources

Bowel Cancer UK is the UK’s leading bowel cancer charity, determined to save lives and improve the quality of life of everyone affected by bowel cancer. Its vision is a future where nobody dies of the disease.

Bowel cancer is the fourth most common cancer in the UK and the second biggest cancer killer (Bowel Cancer UK, 2022a). Nearly 43,000 people are diagnosed with bowel
cancer every year in the UK (Bowel Cancer, 2022b).

This clinical skills series — Think menopause — looks at menopause-related issues to help general practice nurses (GPNs) identify, assess and manage women whose day-to-day lives may be detrimentally affected by this stage in their life. Here, Sue Thomas, advanced nurse practitioner (ANP) based in Leamington Spa, discusses the complications that can arise with genitourinary syndrome of the menopause (GSM).

Hidradenitis suppurativa (HS) is a chronic long-term condition that occurs mostly in intertriginous areas of the skin. Unfortunately, HS is often not recognised and is poorly managed in clinical practice. Early detection and referral to an appropriate service such as dermatology is essential to reduce the long-term impact of the disease. Treatment is
multifactorial and includes management of associated comorbidities and lifestyle factors, such as obesity and smoking, medication, surgical intervention and managing depression and anxiety. This article explores the assessment and management options for general practice nurses (GPNs) to consider when presented with a patient with HS.

Tracheomalacia, bronchomalacia and laryngomalacia are conditions where there is a deficiency in the functioning of the cartilage in the airway walls, which causes them to be weaker or even absent in places. This leads to an exaggerated luminal narrowing within the affected airway during expiration. The malacia may be localised or generalised. There is limited literature and published research in this area. These three conditions are seen in both children and adults. However, because of the size of the airways in small children and the more marked clinical response to any narrowing of the airway, these malacias are usually diagnosed at an earlier stage than when the conditions occur in adults. In the fully mature airway, the symptoms may be less obvious, leading to the conditions
being under-recognised and under-diagnosed in adults. It is also important to understand that in the adult population malacia may coexist with more common conditions such as asthma or chronic obstructive pulmonary disease (COPD), where breathlessness, cough, dyspnoea and other symptoms may be misattributed to these more common diseases.
This article raises awareness of these three malacia conditions.

Type 1 diabetes mellitus (T1DM) can affect individuals at any age, yet often develops in the younger population, accounting for approximately 8% of diabetes diagnoses in the UK. Although there has been extensive research into the physiology of diabetes, less work has addressed the psychosocial demands and consequent effects on management and quality of life. This article is a critical synthesis of the literature, adopting the Health Stigma and Discrimination Framework (Stangl et al, 2019) as a theoretical lens through which the multifactorial impact of stigma for individuals living with T1DM is unpacked. 
Having this understanding can help general practice nurses (GPNs) recognise how stigma within T1DM can permeate throughout the five layers of society: individual, interpersonal, community, organisational, and policy. A case study is provided to highlight how nurses working within primary and community care are well positioned to help understand the
causes of stigma for individuals living with T1DM.

Pneumonia continues to cause mortality around the world, despite advances in treatment and prevention. The disease can affect any age and can present with variable degrees of severity ranging from mild to severe, with the worst cases resulting in admission to hospital. While vaccination in the UK has impacted on the severity and death rate of this potentially devastating disease, the condition continues to be the largest cause of mortality in children with the highest death rates seen in under developed countries. This article gives an overview of treatment, management and prevention, as well as a brief insight into the possible long-term effects following recovery from pneumonia in babies and children.

Increasing cancer survival rates and evolving models of care require primary care teams to adapt their practice to meet the needs of people after a cancer diagnosis and completion of treatment. The needs of people after a cancer diagnosis are often complex and require a person-centred, holistic model of care. The ‘NHS Long Term Plan’ sets out the ethos of
personalised care for those living with long-term conditions (LTCs), including cancer. Interventions to support personalised care include cancer care reviews (CCR) in primary care. Recent Quality Outcome Framework guidance for CCR has aimed to personalise the intervention to improve patient experience. General practice nurses (GPNs) are well placed to deliver CCR but need access to education to feel confident and develop competence in this area. There are several resources that have been developed to support CCR as a personalised care intervention. These interventions need further evaluation to assess their impact on patient experience and outcomes.

The national care bundle for children with asthma is the first phase of a national plan to improve asthma care, focusing on integration of systems and effective communication. It follows several high-profile reports, national and global guidelines, with the aim of training clinicians to consistent standards, keeping children and young people (CYP) with asthma well, improving diagnosis, patient pathways and encouraging self-management. This article, the second in a two-part series, explores practical ways to implement the bundle in clinical practice and how to meet its requirements.

Here, Callum Metcalfe-O’Shea, advanced nurse practitioner diabetes specialist and co-chair for the Practice Nurse Diabetes Forum for Norfolk, provides the first in a series of articles with direct insight into the changing practice of diabetes in primary care and how general practice nurses (GPNs) can keep up to date with new evidence. This article looks at new guidance from the National Institute for Health and Care Excellence (NICE) for type 2 diabetes, identifying how the implementation of sodiumglucose co-transporter-2 inhibitors (SGLT-2i) as second-line therapy now takes place and how you can use these guidelines to advance practice. Consideration will be given to SGLT-2i use in practice, while recognising the importance of patient preference and individualised care at all stages.

I had a eureka moment reading the ‘Practice matters’ piece, ‘What do GPNs need to know about GDPR’ and a sensation of various burdens lifting off my shoulders. Now I had found a reason to have a different approach to writing up my consultations and this would be better for patients