Resources

As the NHS pivots towards innovation to address the Covid-19 backlog, support overburdened staff and elevate standards, it might be all too easy to assume that much of the focus will be on digital technologies and cutting-edge concepts. 
However, to establish a better health service, it is imperative that careful consideration is given to all areas of medical supply — not just the big-ticket items of equipment and digitalisation of services, but also the simpler items which can make a huge impact on patient outcomes, such as compression hosiery.

Here, Poppy Brooks, chair of the British Society for Heart Failure’s Nurse Forum, shares some insights from a joint webinar held by the British Society for Heart Failure and the British Association of Cardiovascular Prevention and Rehabilitation (BACPR).
This webinar, held during National Cardiac Rehabilitation Awareness Week 2022, sought to showcase new thinking on cardiac rehabilitation for those with heart failure. The recording is available to watch at: www.bsh.org.uk/webinar-fit-for-the-future/.

When patients present with red lower legs, the cause is often assumed to be cellulitis or erysipelas. There are, however, several alternative conditions which mimic the clinical signs of cellulitis or erysipelas, which can lead to misdiagnosis. It is important that the cause is correctly diagnosed to prevent inappropriate prescribing of antibiotics. This article discusses the different potential causes of ‘red legs’, in addition to cellulitis and erysipelas, together with clinical signs and symptoms to enable general practice nurses (GPNs) to differentiate between them and implement appropriate treatments

This article, the first in a two-part series, aims to raise awareness of upper airway disorders, as defined by the recently published upper airway disorders position paper from the Royal College of Speech and Language Therapists (RCSLT; Haines et al, 2021). It provides a summary of the aetiology and clinical presentations for persistent throat symptoms, refractory chronic cough, and inducible laryngeal obstruction. These disorders are primarily related to laryngeal dysfunction, rather than lower airways disease, virus, or infection. Recognising the immense time pressures within clinical practice, tables have been included that could be provided to support patients with understanding their symptoms. Part two will look at managment approaches, including self-care strategies, and advice on where to refer people presenting with upper airway disorder symptoms.

Ovarian cancer affects women around the world and is a devastating diagnosis not only for the woman affected, but also her family and friends. Symptoms are such that both the patient and clinician may mistakenly attribute them to some other cause, leading to a delay in investigation. For this reason, many women are diagnosed late when spread of the cancer has already occurred, leading to poorer prognosis. This article hopes to give general
practice nurses (GPNs) and non-medical prescribers an insight into this disease, so that they will have a high index of suspicion when patients present with non-specific symptoms, leading to earlier diagnosis and hopefully better outcomes.

Vegan and vegetarian diets are becoming increasingly popular. However, it seems that instead of carefully balancing out the diet, especially a vegan one, some people are turning to fast, ultra-processed food and less nutritious meatfree food, putting themselves at risk of nutrient deficiencies. For vegans, getting enough vitamin B12 seems to be the biggest problem, as it is only found in animal products. Permanent neurological damage can result from deficiencies and supplements of this nutrient are recommended. Other nutrients that can go short include omega-3 fatty acids, calcium, iron, zinc, iodine, selenium and vitamin D. This article looks at how these shortages can be overcome

The six to eight-week infant examination is undertaken in primary care, predominantly by GPs, and is a vital repeat examination of the newborn infant physical examination (NIPE) to ensure that any congenital abnormalities are not missed, as some may not become apparent until this age. Although national standards exist for the NIPE in the form of the NIPE handbook (Public Health England [PHE], 2021), no such national standards exist for the six to eight-week infant check.

Deconditioning is a term used to describe the physical decline a person might experience following a period of inactivity. It has long been recognised, but has previously been associated with prolonged periods of immobility or hospitalisation resulting from injury or illness. As we come out of the Covid-19 pandemic and the associated periods of lockdown and shielding the more vulnerable, there is evidence that some of the population are suffering the effects of deconditioning. It is apparent that this may be with or without coexisting medical conditions and needs to be considered as an additional or stand-alone diagnosis where symptoms exist, or where worsening of an underlying medical condition could be as a result of deconditioning. This article considers the causes and effects of deconditioning, its impact on physical and mental health, and how we can approach reconditioning programmes through health and society

Cervical screening can be a lifesaving intervention, but the test is not easy for every patient. An almost infinite amount of factors can make the test difficult: it is invasive, it can be very hard for those with physical disabilities, and even getting a convenient appointment can be challenging. The same is true for trans men and/or non-binary people with a cervix. However, for this group, there are additional personal and systematic barriers to accessing routine cervical screening, as well as potential discrimination because of their gender identity. Here, Eluned Hughes, head of health information and engagement, Jo’s Cervical Cancer Trust, looks in detail at a number of these barriers and gives practical tips to help general practice nurses (GPNs) overcome them, and presents a patient’s experience of attending cervical screening

Last week at the end of a triage call a patient said, ‘thank you — I really feel you have listened to me’. The feedback meant a lot to me on a day when I was struggling a bit to keep ahead and helped me to stop for a moment and reflect on what our role in primary care is all about. It’s holistic, it’s often the patient’s first port of call and it’s important to the
people who reach out to us for help. Reading this issue’s ‘practice matters’ discussion about food insecurity, I have reflected further that it’s not just listening that we need to do, but rather use all of our senses to help us in our role and let us see the bigger picture that is required for good general practice consultations.