Practice matters: In each issue of the Journal of General Practice Nursing we investigate a hot topic currently affecting our readers. Here, Binkie Mais looks at patient participation groups (PPGs) and asks the question...Are clinicians taking patient involvement seriously enough?
Last year 80,000 people died prematurely because they smoked. Today it will kill 200 people (Health and Social Care Information Centre [HSCIC], 2015). Despite progress in driving down smoking rates, it is still the leading cause of preventable death. For every person who dies from smoking, 20 more are living with life-limiting illnesses (Centers for Disease Control and Prevention, 2010). Recent Action on Smoking and Health (ASH, 2014) research estimates that smokers need the care of friends, relatives or social services on average nine years earlier than a non-smoker.
A childhood immunisation programme like no other seen before.
Pauline MacDonald gives her views on the groundbreaking national programme to vaccinate more children against flu.
If you don’t protect your vaccines, they won’t protect your patients.
Vaccines save lives — but the cost procured by the Government is over £300 million a year. Last calendar year, vaccines wasted through incidents in primary care had a value at list price of £3.7 million. This figure represents vaccines that were disposed as a result of both avoidable and non-avoidable incidents, including failure to store them properly. This does not include any flu vaccine wastage (other than vaccines from the children’s programme), or any other centrally procured vaccine which Public Health England (PHE) supply and do not collect data on (e.g. rabies vaccine) (personal communication with Chris Lucas, vaccine supply team, PHE).
Stephen Gaduzo explains how the PCRS-UK can help you deliver high value patient-centred care and support professional development.
Nurse revalidation is now likely to start in less than six months’ time and it has never been more important for general practice nurses (GPNs) to ensure that their skills and knowledge are up to date.
Leg ulcers present a common clinical problem for general practice nurses (GPNs). The need for assessment and maintenance can take up a great deal of time and issues such as pain, exudate volume and poorly applied compression bandaging have a serious effect on patients’ quality of life. The ‘gold standard’ treatment for venous leg ulcers has long been multilayer compression therapy (National Institute for Health and Care Excellence [NICE], 2012). However, as with any other technique, expertise can vary, meaning that clinicians sometimes do not apply the necessary sub-bandage pressures. Patients can also find multilayer compression ‘bulky’ and uncomfortable, and thus may not concord with treatment (Wicks, 2015).
Diabetes care takes up around 10% of the total NHS budget (Diabetes UK, 2015), and as type 2 diabetes mellitus (T2DM) makes up around 90% of all diabetes, it could be argued that prescribing for this largely preventable condition is the main culprit responsible for these costs. However, most of the money spent on treating diabetes is for managing its complications (Kerr, 2011). The key to preventing these complications is through effective prescribing aimed at reducing them. Possibly as a result of more clinicians thinking this way, prescribing costs for diabetes have been rising steadily (Health and Social Care Information Centre [HSCIC], 2014). So, how can clinicians be sure that newer and more expensive therapies are both clinically and financially effective? And crucially, how do clinicians ensure that patients are kept at the centre of all consultations and are fully involved in the decision-making process?
Respiratory disorders, in particular asthma and chronic obstructive pulmonary disease (COPD), have been recognised for many years and remain among the most common chronic long-term conditions that are seen in primary care. Despite the development of guidelines, standards and effective treatments, both diseases continue to carry a high morbidity and mortality, a significant societal cost in terms of lost school and work days, and high consultation and admission rates.This article follows the development of our knowledge of these common disorders and looks at how far we have progressed in our diagnosis, knowledge and treatments, as well as what the future may look like in terms of care management and treatment options.
Atrial fibrillation (AF) is the most common sustained adult cardiac arrhythmia with over one million people diagnosed with AF in the UK (Health and Social Care Information Centre, 2014; Information Services Division [ISD] Scotland, 2014; Department of Health, Social Services and Public Safety, 2014; Stats Wales, 2014). Many more people are thought to have undiagnosed AF (National Institute for Health and Care Excellence [NICE], 2014) and the true UK prevalence is currently estimated to be 2.4% (Public Health England [PHE], 2015). The number of people with AF could significantly rise due to the growing elderly population and the increasing prevalence of those living longer with associated long-term conditions. Clinicians working in primary care can expect to see a growing demand to provide high-quality care for people with or at risk of developing AF. This includes checking for it, treating people who are newly-diagnosed and providing onward monitoring of people with an established diagnosis of AF. This two-part series looks at how to improve the provision of AF management in primary care.
Frailty is a clinical syndrome which focuses on loss of reserve, energy and wellbeing. Currently, older people with frailty tend to present late and often in crisis to health and care services so their care may be hospital-based, episodic, and unplanned. There is a need to reframe frailty as a long-term condition that can be mainly managed within a primary and community care setting, with timely identification for preventative, proactive care underpinned by supported self-management and person-centred care. General practice nurses (GPNs) will play a vital role in this new paradigm for frailty as key workers, coordinators of care, and supporters to patients and their carers at all stages of the frailty trajectory.
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