Resources

In the final part of our Monitoring matters series, Callum Metcalfe-O’Shea, advanced nurse practitioner and UK professional lead for long-term conditions with the Royal College of Nursing (RCN), discusses lipid management. Again, the term long-term conditions covers type 2 diabetes, asthma/chronic obstructive pulmonary disease (COPD), autoimmune rheumatic diseases and inflammatory bowel diseases  (Crohn’s/colitis). Lipid management is ever evolving with new and emerging treatments available, and many both positive and difficult conversations often occur between general practice nurses (GPNs) and patients around this clinical issue. This article defines lipid management in the context of long-term conditions, highlighting assessment tools alongside treatments to help GPNs identify the
evidence needed to have discussions with patients around lipid management. Treatment options will be considered, but application to local formulary and policy is required.

Although most healthcare professionals agree that medication is the only real treatment for gout, addressing diet can help to prevent its development and possibly help ease symptoms, especially when it comes to weight issues and avoidance of alcohol. Observational data shows some dietary treatment to be effective, in particular healthy diets such as DASH and the Mediterranean diet. Gout usually presents with other comorbidities which benefit from a healthy diet. The author recommends that all gout patients should have a dietary assessment and then guidance on how diet can be improved.

Asthma is one of the most prevalent lung conditions in the UK. Around eight in 100 people are diagnosed with it (Asthma + Lung UK, 2024). However, according to the British Thoracic Society (BTS, 2024), asthma affects around 12% of the UK population, with 160,000 people being newly diagnosed each year. This article focuses on the importance of finding the right inhaler to meet patient needs and lifestyle, while exploring the concepts of shared decision-making within respiratory reviews.

Urinary tract infection (UTI) is a term that describes an infection anywhere within the urinary system where the commonest cause is Escherichia coli, which accounts for 80% of infections and is usually found in the urinary tract (Vasudevan, 2014). Women are more susceptible to UTIs than men as their urethra is shorter, which means that infection can easily ascend the tract (Vasudevan, 2014; John et al, 2016). However, as men age, the risk becomes equal to women (Harrington and Hooton, 2000; Rowe et al, 2014) and accurate diagnosis and management of UTIs in men using guidelines is poor (Isberg et al, 2024). This article considers the risk factors for UTI in men, how they present, and how UTI can be managed in primary care.

Patient safety can be considered similarly to safeguarding, something which is everybody’s responsibility. Indeed, the Nursing and Midwifery Council (NMC) ‘Code of Conduct’ states that risk and escalating concerns form a key part of the nurse’s role to preserve safety (NMC, 2018). Nurses have the most regular contact with patients and therefore play an important role in the identification, recognition and reporting of risk and incidents, the response and escalation of potential harm, and the ongoing patient support throughout and post incident. This article discusses the importance of being familiar with the ‘NHS Patient Safety Strategy’ and how it incorporates risk, incidents and education. And essentially, how it relates to nursing and the need for all nursing interactions to be considered from a patient safety perspective. The topics covered include incident reporting, risk management,  learning from harm, quality improvement, and information sharing. The piece also highlights the significance of record-keeping.

Bullous pemphigoid (BP) is a rare, chronic, inflammatory, subepidermal, blistering disease that primarily affects older people (Chan, 2020). The blisters are usually filled with clear fluid and the surrounding skin is often red and inflamed. These blisters can appear anywhere on the body but are typically found on the lower abdomen, groin, upper thighs and arms.
The prevalence of BP has doubled in 20 years, due to population ageing and other factors (Persson et al, 2021a). This article provides details of the latest guidelines, explains what can trigger BP, and how it is diagnosed and treated.

This article critically analyses the process of clinical decision-making (CDM) and associated theories that contribute to safe clinical judgement, allowing trainee advanced clinical practitioners (tACPs) to expand their knowledge, skills and attitude to CDM at an advanced level. The case included is from the author’s own clinical practice and is a reflective
piece involving CDM which embraces the four pillars of advanced practice. The relevant professional, legal and ethical issues that assist tACPs to follow the ‘Code of Conduct’ (Nursing and Midwifery Council [NMC], 2018) are also discussed in relation to this complex CDM case.

I’ve overheard several people say that was the fastest summer yet — I am not sure what makes a summer pass faster than most, but I do agree it passed at lightning speed. As I try and settle into a routine for the autumn, I find myself busy reviewing our long-term condition lists, planning quality improvement projects and mentoring the nurses who are newer to our team but developing fast. The opportunities in general practice nursing are widening all the time and it’s a privilege to be supporting some nurses through their long-term condition modules and others to develop advanced practice skills, such as prescribing and clinical examination and assessment. Like the summer, everything seems to happen much faster these days. It is always stimulating to work with new nurses, it helps keep me up to date and to seek better ways of managing our increasingly busy GPN role.

Whenever scientists try and imagine what the future will look like, they invariably get a little carried away. If past predictions were anything to go by, by this point in the 21st century
we should all be whizzing about in driverless cars, feasting on laboratory grown meat and living to improbable ages, our life expectancy artificially extended by stem-cell implants.

At NHS Charities Together, we want everyone in the UK to experience the best healthcare possible.

Right now, the NHS is facing immense challenges. Pressures continue to grow, NHS resources are stretched, the aftermath of the Covid-19 pandemic is still starkly felt and budgets are squeezed so only the crucial elements of care are delivered. Patients’ needs
are changing — the population is growing and more people are living longer, often with more or multiple long-term conditions. We depend more on technology. Staff must be properly supported to provide a positive, personal experience to patients.