The aim of this two-part article is to highlight an area of cancer which holds promise in the form of overall reduction in incidence and mortality rates dependent on a few factors. These factors include education of the general public about the causes of skin cancer and preventative measures to reduce skin cancer, identification of high risk groups, and finally how to respond appropriately to the first signs of skin cancer. This first part identifies known causes and highlights signs and symptoms of skin cancer and why early detection and treatment is essential for improving overall survival outcomes. The second part in the series will focus on individuals within the population who are at higher risk of developing skin cancer and look at how education can enable people to make informed choices about their exposure
to ultraviolet (UV) radiation to reduce their chances of developing skin cancer.
Celebrating 30 years of improving lives
Welcome to this issue of GPN. We are delighted to share the latest news in the world of Education for Health, especially at the start of this very special year — we are celebrating our 30th anniversary!
This is an important milestone in our charity’s history and one we are looking forward to celebrating in 2017. During the year we will thank those who have contributed to our success, reflect on our achievements and make ambitious plans for the future. We plan to mark our anniversary with a number of activities in May and June.
In each issue of the Journal of General Practice Nursing we investigate a topic currently affecting our readers. Here, Binkie Mais, considers patient care and asks...
Toby Capstick highlights why healthcare professionals and patients need the new UK Inhaler Group standards.
Teaching correct inhaler technique has long been known to be key in the management of respiratory conditions; the British Thoracic Society (BTS) and Scottish Intercollegiate Guidelines Network asthma (BTS/SIGN, 2016) and National Institute for Health and Care Excellence chronic obstructive pulmonary disease (COPD) (NICE, 2010) guidelines give almost identical advice to healthcare professionals; namely, that inhalers should be prescribed only after patients have received training in the use of the device, and have demonstrated satisfactory technique, which is repeated regularly thereafter. This recommendation is emphasised in the NICE asthma and COPD quality standards (NICE, 2013; 2016).
Kathryn Evans gives her views on what needs to be done to provide high value wound care.
I have always been passionate about wound care and, as a practising district nurse, I learnt by experience and training to measure wounds, take photographs and undertake Doppler assessments (a noninvasive method to identify arterial insufficiency in the leg). This helped me to establish the treatment that each wound needed.
What I did not know was the effectiveness of my prescribed care and how my healing rates compared with another nurse’s care. I also could not say with any accuracy how quickly a patient could expect their wound to heal. I wish I had known…
So, my questions to you would be: Do you know? And, why is it important?
Malnutrition (undernutrition) affects three million people in the UK (Brotherton et al, 2010) and is responsible for health and social care costs exceeding £19 billion annually in England alone, half of which is due to people over 65 (Elia, 2015). While it is accepted that good nutrition is important to maintain health, there is a general lack of responsibility and ownership around the problem of undernutrition in primary care. Lack of understanding, including how to identify and treat it is also widespread. Despite National Institute for Health and Care Excellence (NICE) guidelines stating that all healthcare professionals should be involved in nutritional screening and treatment (NICE, 2006), there are barriers stopping primary care nurses from screening, i.e. challenges of organisational culture and competing priorities (Green and James, 2013; Green et al, 2014).
The 21st September 2016 saw the launch of the latest version of our national asthma guideline, published jointly by the British Thoracic Society and the Scottish Intercollegiate Guidelines Network (BTS/SIGN, 2016).
The original BTS guideline was published in 1990, and SIGN’s own version dated back to 1996. In 1999 the two organisations recognised the need to develop a joint guideline, the result of which was the 2003 BTS/SIGN asthma guideline (SIGN/BTS, 2011).
This is the seventh version of this guideline, which has been produced in conjunction with a range of stakeholders including the Royal College of Physicians (RCP), Primary Care Respiratory Society (PCRS), Asthma UK and Health Improvement Scotland (HIS).
The ‘General Practice Nursing – Leadership for Quality’ (GPNLQ) programme was developed by Judi Thorley and Sally Rogers (both chief nurses and directors of quality and safeguarding at NHS South Cheshire and NHS Vale Royal clinical commissioning groups [CCGs] and NHS Eastern Cheshire CCG respectively), after local discussions within their CCGs around the need for further support and learning opportunities for general practice nurses (GPNs).
They felt that GPNs were unintentionally professionally isolated, and had to work in a climate that did not support personal development, with some GPNs not being released for clinical training, let alone training for personal development in an area as ‘non-clinical’ as leadership.
Judi and Sally invested a significant amount of their own time in scoping out the programme, planning and, indeed, delivering the training. They also networked assiduously and gained the support of key individuals promoting the role of GPNs on the national stage.
Over the past five years, NHS commissioners have started to practise outcomes-based commissioning. Many of the new provider-led models of care heralded in the Five Year Forward View (NHS England, 2014) build on the concept of ‘accountable care organisations’ (ACOs). The ACO model is predicated on payment for outcomes.
While still in its infancy, our understanding of outcomes that matter most to people and families is growing — and those outcomes may be different to the clinical biomarkers we have traditionally measured.
Accounting for person-centred outcomes would fundamentally change conversations with patients and the focus of clinical practice, because we would worry less about the numbers and more about supporting people to live full, productive lives. Let’s imagine how that might work.
Success!