Resources

In primary care, there is a lack of understanding and awareness among some clinicians regarding mental health issues that military veterans experience. The aim of the project outlined here was to identify military veterans in one primary care centre, screen them for anxiety and depression, and offer them the most appropriate treatment and support. An emotional health check template was used to identify military veterans for anxiety and depression. Training was also offered to staff in the practice and appropriate services were identified and listed on a leaflet. By the end of the project, the number of military veterans identified in the practice had increased from 19 to 200, 45 with a diagnosis of depression and five with post-traumatic stress disorder (PTSD). Only four veterans were offered emotional health checks during the project period due to restrictions in place for the COVID-19 pandemic. This article shows how the process of identifying military veterans and developing a system of screening for depression and anxiety as well as introducing new staff training has been effective. Adding missing elements to the template will improve follow-up and evaluation in the future.

Telephone and video consultations have become a prominent part of practice in the pandemic, bringing undoubted benefits but also some challenges. Due to the inability to examine patients or read their body language, successful remote consulting may call for some adjustments to the normal way of talking with patients. Here, Dr Roger Neighbour OBE, retired GP from Hertfordshire and a past President of the Royal College of General Practitioners, considers how to prepare for and begin a remote consultation, describing a simple seven-stage approach to clinical problem-solving: getting the story, doing the clinical work, and agreeing the management plan. It encourages you to think aloud as a way of keeping the patient involved, and offers some advice on bringing the conversation to a close.

Much-loved family recipes inspire intergenerational and international cookbook

People who are extroverted tend to seek social stimulation and opportunities to engage with others through social interaction. Yet, whether you have an introvert or extrovert personality, loneliness can strike anyone. Being an extrovert by nature, experiencing enforced lockdown earlier this year was initially extremely daunting and challenging for me. Although well past the ‘flush of youth ‘, I am still in a section of life where my calendar was filled with meetings, attendance at international conference/exhibitions, networking and travelling, giving me a purpose to manage my professional and home life with positivity.

Many men with prostate cancer do not experience symptoms until the disease has spread. This means that they risk being diagnosed too late, when the cancer is incurable. With your help, asymptomatic men with prostate cancer could be recognised earlier and their lives could be saved. Prostate Cancer UK believes general practice nurses (GPNs) are in a unique position, as they are ideally placed to recognise men at higher risk of prostate cancer and help ensure that prostate-specific antigen (PSA) testing is delivered to best effect.

Viscopaste and Ichthopaste bandages have been available in the wound care dressings market since the 1950s and 1930s respectively and are widely used within their clinical indications, primarily in lower limb management to treat leg ulcerations and the skin conditions associated with a leg ulcer. The products are commonly used within dermatology to manage chronic lichenified (thick and leathery) skin conditions, such as atopic eczema and dermatitis. Recently, Viscopaste and Ichthopaste bandages have been utilised in the management of skin conditions related to chronic oedema, for the treatment of patients with a diagnosis of red leg syndrome, which is often misdiagnosed as cellulitis (Elwell, 2014).

Nutrition and hydration are vital components of successful wound management. Malnutrition is associated with a delay or failure of the wound healing process and this article discusses the macro and micronutrient requirement of each stage of the wound healing process. Holistic wound assessment, including assessment of nutrition and hydration, plays a significant part in successful wound management, in partnership with controlling exudate with appropriate wound care products.

Cervical cancer is the fourth most common cancer in women worldwide, with around 311,000 women dying of the disease in 2018 (World Health Organization [WHO], 2020). In the UK, cervical cancer accounts for approximately 870 deaths each year. Effective primary (human papilloma virus [HPV] vaccination) and secondary (screening and treating precancerous lesions) strategies are therefore paramount in preventing unnecessary mortality, especially given that cervical cancers are one of the most successfully treated if caught early (WHO, 2020). Obtaining an adequate sample during cervical screening is of the utmost importance to ensure early histological changes are detected. Whether lubrication should be used during the screening process is a contentious issue, since contamination of the sample with lubricant can mean that vital histological changes are missed, thereby putting women at risk. This also needs to be balanced with women’s comfort, since an uncomfortable experience may lead to women failing to attend for future screening. This article looks at the current literature available, with recommendations for further research.

As the NHS and general practice changes, the authors raise questions about of one of the fundamental human responses we all can have to each other. This article looks at the dynamics and impact of listening in health care for nurses and staff. The close relationship between active listening and safe, lawful and ethical health care are explored. It combines current academic doctoral work, wider research, practical experience and psychological thinking on how listening is a conduit of care and humanity. The article shares stories, research and observation to ask what communicative listening looks like, why it matters, and how we practice this powerful skill. The authors come from different and complementary backgrounds, bringing together a wealth of experience and knowledge to challenge and explore the concept and practice of listening.

Lockdown, as a result of the current health crisis, has demonstrated the risks that social isolation can have on physical and mental wellbeing. Social isolation and loneliness in the UK are rising, with nine million adults reported to be lonely and little chance of this changing once full restrictions are lifted post lockdown. While four million of this group are elderly, the remaining five million come from a diverse range of age and social groups, highlighting the diversity of this complex problem. To address the challenges loneliness produces, a multifaceted approach needs to be taken to find solutions and tools to help those working in primary care support the most vulnerable patients. Digital technology, in particular virtual reality (VR), may be one area that could provide some answers.