Resources

Most women will be familiar with this sentence, usually uttered moments before a women’s health procedure. But, what if you do find it painful?

Cervical screenings are really important to me because of family medical history, and they offer early identification of abnormal cells before they develop into cervical cancer. But the arrival of the invitation letter to my next screening would bring on a sense of dread as I recalled the excruciating pain I experienced last time.

The prevalence of multimorbidity is increasing in the UK, and not just in older patients. Improvements in treating acute illnesses and increased awareness of the impact of mental health conditions on people’s physical health mean that multimorbidity should be addressed in a large number of patients. This article uses two case studies to illustrate what this looks like in practice and how general practice nurses can work with patients to improve their overall health.

Testicular cancer can affect men of any age but is most commonly seen in young males. The disease is often asymptomatic and is detected when the patient finds a painless lump in the testes. The condition is associated with a good prognosis if found and treated early. This article gives an overview of the types of testicular cancer, its symptoms, management, and complications, with a view to increasing knowledge of this malignancy among nurses and non-medical prescribers.

Intertriginous dermatitis is a common inflammatory condition affecting opposing skin surfaces within anatomical folds, arising from the combined effects of moisture, friction and impaired barrier function. It is increasingly recognised as a subtype of moisture-associated skin damage and represents a significant burden across acute, community and long-term care settings, particularly among older adults and individuals with multimorbidity. This article examines the epidemiology, risk factors and pathophysiology of intertrigo, with particular emphasis on populations at heightened risk, including those with obesity, diabetes mellitus, immobility or continence impairment. It outlines a structured approach to history-taking, clinical examination and differential diagnosis, highlighting challenges related to skin tone variation and the identification of secondary infection. Evidence-informed management strategies are discussed, encompassing uncomplicated intertrigo, infection-associated disease and targeted care for high-risk anatomical sites. The article emphasises the central role of general practice nurses in early recognition, accurate clinical assessment, antimicrobial stewardship and preventative leadership. A proactive, person-centred approach to prevention and longterm management is advocated to reduce recurrence, prevent complications, and improve patient outcomes.

This is the first article in a series of pieces on less known long-term conditions. Sickle cell disease (SCD) is a group of inherited disorders caused by a group of autosomal recessive gene mutation inherited disorders. It affects the haemoglobin (Hb) in the blood and is a devastating chronic condition which causes significant morbidity, resulting in markedly reduced life expectancy (Bhatia and Sheth, 2015). General practice nurses (GPNs) can have a key role in the care and management of patients with SCD, so having an understanding of what it is, who it affects, its symptoms and complications, as well as essential immunisations and treatments is important.

This article examines the transition process from paediatric to adult healthcare for young people with complex medical needs, focusing on how to increase the involvement of general practice. Poorly managed transitions can lead to increased morbidity and mortality in young adults. Guidelines, including those from the Care Quality Commission (CQC, 2014) and the National Institute for Health and Care Excellence (NICE, 2023), recommend greater involvement of general practice in the transition process, yet limited guidance is offered on implementation. To identify opportunities to improve the transition process, an audit within a specific region was conducted to assess current practices. This identified a small cohort of patients undergoing transition. Based on these findings and consultations with stakeholders, a series of targeted interventions were developed. These included using a dedicated SNOMED code to track transition, use of care coordinators to address additional vulnerabilities, and implementation of a ‘Transition on a page’ document to streamline communication between general practice and secondary care. Although several challenges prevented a pilot from proceeding as planned, the proposals were approved by the local integrated care board (ICB) and disseminated by clinical governance leads to all general practice staff for ongoing embedding. The hospital transition team will review implementation to assess impact. This project highlights a nationwide issue requiring further action to establish effective transition practices across healthcare settings.

Diagnosing and managing lower urinary tract infections (UTIs) in women aged 65 years and over is important to ensure their health and wellbeing. This article explores how to diagnose lower UTI, considering alternative diagnoses especially in older adults, as their symptoms may mimic UTI but may indicate other underlying conditions. It also looks at how to manage and treat uncomplicated lower UTI and provides guidance on recurrent UTI, usually defined as three or more episodes in a year.

Fit for the Future aims to move care from hospital to community through neighbourhood health services, elevates prevention as a national priority and commits to stronger workforce development. For nurses working in general practice, this creates opportunity: neighbourhood reform is located in and around general practice, and prevention priorities align with core general practice nurse (GPN) work in screening, immunisation and long-term condition management. However, the plan does not identify general practice nursing as a distinct workforce group, leaving role definition, staffing assumptions and development routes to local implementation. Without early engagement in neighbourhood design, GPNs risk limited influence on workforce models and uneven access to chapter 7’s ‘best employer’ offer, particularly for practice-employed nurses. This article outlines the plan’s implications and argues that visible nursing representation is essential to secure investment and progression pathways.

This is the second part of a two-part article on the gut microbiome. Part 1 looked at why the gut microbiome is so important for health and wellbeing and the problems that an unbalanced microbiota (otherwise known as dysbiosis) can cause. This article looks at the factors that can lead to dysbiosis and discusses steps that can be taken to restore it to a healthy state.

General practice nurses (GPNs) have a unique part to play in meeting the future needs of populations in primary care. Their role has evolved rapidly over the past three decades driven by an increase in long-term conditions, an ageing population, and the need to address workforce challenges in primary care. GPNs provide a broad range of patient services, including health promotion, preventative screening, assessment and management and management of acute care. There have, however, been challenges about differences in education as, unlike training for other healthcare professions such as district nurses or health visitors, there has been a lack of standardised training pathways for GPNs. Many GPNs have had a piecemeal training with a fragmented approach to their education. Despite these challenges, publication of the Queen’s Institute of Community Nursing (QICN, 2023) Field Specific Standards for Education and Practice for Community Specialist Practitioner Qualifications (SPQ) built on the Nursing and Midwifery Council (NMC) Standards of Proficiency has led to clear educational pathways for new GPNs.