Frailty is becoming increasingly recognised as a long-term condition associated with ageing that should be primarily managed in primary care. Diagnosing frailty identifies a high-risk population group and highlights areas of clinical importance that can be treated and managed. In 2017, NHS England introduced new elements into the GP contract, which require practices to identify moderately and severely frail patients, and to offer a clinical review to those who are severely frail (NHS England, 2017b). This review should include assessment of falls risk, medication review and seeking of permission to activate the enriched Summary Care Record (SCR). This article examines the general practice nurses’ role in the care and support of older people who live with frailty, and gives guidance on how to review medication, assess falls risk and use the SCR to ensure patients’ wishes and care preferences are recorded.
This article provides general practice nurses (GPNs) with a brief history of asset-based community development (ABCD). It considers how the principles of asset-based approaches are currently used and may be further developed to tackle modern challenges in health and social care. It considers one particular approach, ‘social prescribing’ — this is perhaps best known to GPNs. Social prescribing has emerged as an early asset-based solution to improve wellbeing. The article also explores some of the advantages and limitations of social prescribing and gives glimpses as to how asset-based nursing may evolve.
There is a variability and inconsistency in how GPs carry out cancer care reviews (Meiklejohn et al, 2016). Many people report feeling abandoned after treatment finishes (Scottish Cancer Experience Survey 2015/16). This article looks at an evaluation undertaken by NHS Lanarkshire as part of the Macmillan Transforming Care after Treatment (TCAT) programme to ascertain the acceptability and feasibility of general practice nurses (GPNs) taking on the role of delivering cancer care reviews using a Macmillan Holistic Needs Assessment Tool. After Macmillan cancer training, 10 GPNs invited people with a new diagnosis to a cancer care review. A concerns checklist was sent to the patients before the review. Four hundred people were invited, with 250 accepting the offer. People reported that the time afforded by the GPN was valued and they saw them as a point of contact in the future. Fatigue, pain and worry were the top three concerns raised. It was concluded that, with training, GPNs can offer quality-assured cancer care reviews and therefore shift some of the workload from GPs.
A project in Leeds is improving health outcomes for Gypsies and Travellers. Here, Liz Keat, outreach nurse, Leeds Community Healthcare NHS Trust and Queen’s Nurse, and Ellie Rogers, deputy CEO, Leeds GATE, discuss what they have learnt about primary care nursing and Gypsy/Traveller communities.
