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Despite being largely preventable, oral diseases are the major contributor to chronic conditions nationally and globally. If left untreated, oral diseases have many harmful effects throughout life on our patients including pain and infection, and can lead to difficulties with eating, sleeping, socialising and wellbeing. Oral health inequalities exist across our population, and particularly affect vulnerable, disadvantaged and socially excluded groups in society. Oral health is a key indicator for overall health, and is inextricably interlinked with general health. Hence, existing health messages that community nursing teams provide contribute towards oral health. Community nurses are in an established position to provide and reinforce positive oral health messages to their patients, as well as signpost to available dental services. This paper aims to support community nurses with a practical resource for key evidence-based oral health preventative advice, and input into how their patients can access dental care. [ABSTRACT FROM AUTHOR]

This paper sets out to assess the evidence of the use of a case management approach when dealing with long term conditions in the UK. It draws on published papers, some of which emulated or adapted strategies that were used in the USA. The review found that despite there being a unified definition of case management, patients and carers reported benefits of being case managed. However, the wide differences in the factors relating to outcome measures resulted in inconclusive evidence about the effectiveness of case management. [ABSTRACT FROM AUTHOR]

This paper describes a ten-year journey in managing a district nursing service using caseload analysis as a method of workforce planning and performance management. Caseload management is at the heart of district nursing practice and the process of measuring and comparing caseload information can be used to improve the quality of care. However, it is crucial to assess the information provided by district nurses for reliability and validity. Allocating staff to teams on the basis of accurate information on patient case-mix, nursing need, and dependency can result in every member of the population gaining equitable access to a consistent quality nursing service. [ABSTRACT FROM AUTHOR]

Effective communication to ensure maintenance of a seamless quality service for patients being transferred to the community from the acute sector with negative pressure wound therapy (NPWT) is essential. This paper reports the findings of a focus group convened to explore the decision making process; controversy or conflict surrounding the decision-making process; perceived barriers to seamless discharge and potential benefits of developing a UK standardized NPWT discharge documentation. A proposed algorithm is presented as a template for practitioners to use when discharging patients to the community to enhance timely and effective transfer. [ABSTRACT FROM AUTHOR]

The Department of Health in England want to see NHS commissioners and providers capitalize upon the expertise of the independent sector for the benefit of NHS patients. In preparing for the future what does the sector have to offer NHS nurses and how will this benefit patient care? This paper examines the role of independent providers and the way they are helping NHS commissioners and providers to break new ground in delivering more accessible and convenient care for NHS patients at home. [ABSTRACT FROM AUTHOR]

Dry eye symptoms and watering eyes increase with age and are relatively common among older people. The conditions cause distress which can be ameliorated if patients are advised appropriately. Accurate diagnosis of the underlying cause provides the basis for management. This paper outlines key features of the conditions and the range of therapies available. [ABSTRACT FROM AUTHOR]

Progressive long-term neurological conditions are relatively rare, and policy attention has only recently been directed at community services for people with these conditions. This literature review draws together findings from 16 UK studies relating to the provision of care in the community for people with progressive long-term neurological conditions. The purpose is to identify elements of best practice which could be promoted at a national level to improve services. The findings point to the uneven coverage of services and their lack of flexibility. Multidisciplinary care delivery was considered essential and patients and carers highly valued the use of key workers. The studies also highlighted the potential for self-managed care. This evidence can be used to inform service developments for the delivery of community care for people with progressive long-term neurological conditions. [ABSTRACT FROM AUTHOR]

Nurse prescribing is a key government initiative which aims to enhance patient care. The aim of this study was to investigate the prescribing practice of specialist nurses working in cancer and palliative care and to explore the benefits of and barriers to uptake of nurse prescribing training. A national postal survey of 2252 Macmillan nurses was undertaken using a structured questionnaire with open-ended questions. Data were analyzed using thematic content analysis for 1575 respondents (70% response rate). Only 13% (203) had undergone prescribing training and of these 105 provided responses to the open questions concerning training and of the 87% (1372) who had not undergone the training, 423 provided details on barriers to nurse prescribing training. The data presented in this paper draw from this data. The findings indicate that those who prescribed gave the prospect of improving care as the main reason for undertaking nurse prescribing training. The main reasons why these specialist nurses did not undertake training were: resource issues particularly with respect to backfill while training, lack of medical support and mentorship, concerns about the relevance of prescribing as a nursing role and prioritizing other courses. If nurse prescribing is to be more widely available for cancer and palliative care patients it is important in both primary and secondary care to address the resource and support issues. [ABSTRACT FROM AUTHOR]

Digital health was given impetus by the COVID-19 pandemic and demonstrated its potential for the delivery of safe care in the community. Remote monitoring and virtual wards are becoming mainstreamed across the UK. Artificial intelligence (AI) software has the potential to transform healthcare delivery but its trustworthiness is a key challenge. Positive staff attitudes towards digital health and new ways of working require staff education and engagement. Continued attention is required to meet the needs of those without access to digital technology and its use. [ABSTRACT FROM AUTHOR]

In October 2008 the National Institute for Health and Clinical Excellence issued guidance supporting the use of spinal cord stimulation for people with chronic neuropathic pain, considering it to be a cost-effective use of resources within the NHS. This paper will provide an overview of chronic neuropathic pain. Spinal cord stimulation (SCS) will be explained, including the physiological mechanism and technology behind this treatment. The recent NICE guidance will be discussed along with information relating to the potential impact the guidance will have on Primary Care Trusts, GPs and community practitioners. A guide is provided for clinicians in primary care regarding access to this treatment and routes for referral. [ABSTRACT FROM AUTHOR]

Community matrons have a key role to play in the management of patients with long-term conditions. With the expected increase in prevalence of Chronic Obstructive Pulmonary Disease (COPD), largely due to cigarette smoking, the management and care of patients with COPD is a priority for the NHS. This paper examines the current and future role of community matrons in the management of patients with COPD. Community matrons have a potential role in providing evidence based care and could fill a gap in the implementation of effective interventions to help patients and family members stop smoking. A family focused approach to assessment and case management are important to achieving quality care and management of these patients. Recommendations are made with respect to the improvement of service provision for individuals and families with COPD. [ABSTRACT FROM AUTHOR]

Part VI. Looks at some of the key issues that need to be considered when preparing research findings for dissemination in Great Britain. Importance of writing for a specific audience; Guidelines on how to report qualitative and quantitative research; Outline of some of the key criteria editors use when reviewing a paper for publication.

Advanced practice nursing (APN) roles have developed partly to address demand and workforce issues. In community care settings and general practice, an advanced nursing practitioner is generally understood to mean a nurse who has undertaken additional education and training in clinical assessment, including history-taking and physical examination, clinical reasoning and independent prescribing, so they can safely manage patients presenting with undifferentiated and undiagnosed conditions. Capabilities in the Skills for Health framework cover everything from communication and consultation skills, practising holistically and personalised care, to working with colleagues and in teams. The framework is intended to ensure advanced nursing practitioners work to an advanced level. It is also designed to support them to demonstrate and evidence their capabilities to service commissioners, employers, people accessing healthcare and the public. [ABSTRACT FROM AUTHOR]

To meet the challenges of an increasingly ageing and multimorbid population, patients must be fully engaged to work in partnership with their health professional (HP) in the management of their condition(s). The NHS Long Term Plan (2019) outlines goals to manage the increasing demands on the health service—hospital admission avoidance, shorter length of hospital stays through enhanced recovery pathways, increased management of patients within primary care and ensuring a person-centred approach to care provision. Meeting these goals is predicated on HPs being equipped to activate patients using the skills of motivational interviewing, person-centred care and a willingness to share decision making. This article presents a range of psychological theories that could explain the everyday challenges faced in care delivery. Awareness of these theories may help HPs target their approach to care delivery more effectively, to understand patient responses and, therefore, optimise the provision of person-centred care. [ABSTRACT FROM AUTHOR]

The article focuses on community health nursing services in Great Britain. The Department of Health has set out targets, reconfigurations and ambitions for the future. There are however much restatement of previously published policies with commitment to give priority to prevention. A health assessment is expected to promote healthy lifestyles.

Highlights the conference on wound care held on November 15-17, 2004 in Great Britain. Estimated number of delegates attended; Topics discussed in the meeting; Presentation of works in the practice of wound management.

Public health services will need to cope with additional demands due to an ageing society and the increasing prevalence of chronic conditions. Lower-limb ulceration is a long-term, life-changing condition and leg ulcer management can be challenging for nursing staff. The Lindsay Leg Club model is a unique partnership between community nurses, members and the local community, which provides quality of care and empowerment for patients with leg ulcers, while also supporting and educating nursing staff. The Leg Club model works in accord with core themes of Government and NHS policy. Patient feedback on the Leg Club model is positive and the Leg Clubs provide a service to members which is well accepted by patients, yet is more economically efficient than the traditional district nursing practice of home visits. Lindsay Leg Clubs provide a valuable support service to the NHS in delivering improved quality of care while improving efficiency. [ABSTRACT FROM AUTHOR]

The article discusses the implementation of a package of reform program of a health service in Great Britain. The implementation of the reform program has been affected by the impact of the financial crisis in many primary care trusts. The main focus of the program is to develop accessible services closer to patients.

Several inquiry reports have shown that there is still a need to further improve health and social care and strengthen public confidence in these services. The reports have particularly emphasized the need for stricter regulation of health and adult social care providers and the need to use statutory powers to ensure compliance with quality and safety standards. This article outlines how the provisions of the Health and Social Care Act 2008 aim to address this need to further regulate quality and safety standards in health and social care. [ABSTRACT FROM AUTHOR]

Apomorphine hydrochloride infusion therapy is used by approximately 1000 people with advanced Parkinson's disease in the UK (Britannia Pharmaceuticals Ltd, 2008). Subcutaneous nodules that develop as a result of these infusions can cause discomfort and may impact on the effectiveness of the drug therapy. Community nursing teams have a key role in supporting patients on apomorphine; they may be responsible for administering the drug, or supporting and empowering the patient or their carer to administer the infusion. A recent randomized controlled pilot study by a research group at the University of Hertfordshire investigated the use of therapeutic ultrasound for the treatment of apomorphine nodules. A number of observations about apomorphine nodules and the technique used to site infusions were made which may help to promote safe and effective management of apomorphine therapy. This article is a collaboration between one of the researchers and a Parkinson's disease nurse specialist from the University College of London Hospitals NHS Foundation Trust. It draws on best practice observations from both research and clinical experience and puts them in context of published research. It summarizes best practice considerations for administering infusions, identifies the current treatment and management options that participants from the trial reported using on their nodules, emphasizes the need for standardized documentation and suggests a rating system that may be useful to document nodule severity. [ABSTRACT FROM AUTHOR]

Highlights the Wounds UK 2003 conference. Poster presentations; Increase in the number of papers submitted for consideration; Developments in wound care; Information on products ranging from wound dressings and pressure relieving equipment, to advanced wound care technology.

Seventy six percent of people feel that the main healthcare priority should be to involve people in decisions over the treatment of their illness. One group of users in primary care that are likely to have diminished choice are the heaviest users: the elderly. Modernization of the NHS has placed the user as a consumer, thus creating a more user-friendly service that not only takes into account the role of the consumer, but actively engages with them. Increased patient choice provides a context for meeting patient expectations. Patient choice and patient centred care are evident within the NHS Plan, which outlines a vision of health services designed around the patient. This article will review the extent to which elderly patients have real and meaningful choices in the 'Choose and Book' system which operates within the primary care setting. [ABSTRACT FROM AUTHOR]

Part 1 provided an overview of enteral tube feeding and management in the community. Due to the limited evidence base there are many aspects of the practical management of patients on home enteral tube feeding (HETF) that has as yet not been standardized, particularly around issues such as the type of syringes and water that should be used in HETF. There are also some areas where the guidelines are clear but difficult to apply in the community (such as with maximum feed ‘hanging times’) or where further guidance is required (such as for confirming the position of nasogastric tubes in patients on acid-reducing therapy). Finally, as NHS trusts look at further ways to save money, enteral feeding is being increasingly scrutinised and needs to be carefully managed, with the involvement of healthcare professionals who understand patient needs and the commercial HETF market. This article is based on personal views and local discussions about the issues in question and, until further research and national standards are available, are subject to local interpretation. [ABSTRACT FROM AUTHOR]

Standard precautions are imperative for staff and patient safety and provide a basis for sound infection control practice in all health-care settings. One key element of these precautions relates to the safe handling and management of sharps to prevent occupational acquisition of blood-borne viral infection. Many inoculation injuries could be avoided by following standard precautions whenever contact with blood or body fluids is anticipated. However, evidence suggests that compliance with standard precautions is inadequate. With the modernization of the health service in the UK, community health care is becoming more complex, potentially increasing the risk of inoculation injury to community nurses. Although compliance with standard precautions in hospitals is well documented, there is limited research specific to community nurses. This review examines compliance with standard precautions by community nurses and discusses some strategies aimed at improving compliance with one of the key elements of standard precautions, i.e. sharps management. [ABSTRACT FROM AUTHOR]

2020 Vision - focusing on the future of district nursing (QNI in press) is a new report from the Queen's Nursing Institute (QNI), timed to coincide with the 150th anniversary of district nursing in the UK. Launched this month, the report draws on the history of district nursing to identify the core values and skills of nursing in the home, and visualizes the role of district nurses in the very different healthcare world of the next decade. This article reports the findings of the joint BJCN/QNI survey which informed part of the report. [ABSTRACT FROM AUTHOR]

This article, brought to you in association with Help the Aged, highlights the Charity's Spotlight report, which provides an annual snapshot of the concerns and preoccupations of the UK's older people. [ABSTRACT FROM AUTHOR]

The article discusses the occupational roles of community health or district nurses in medical care in Great Britain. The authors comment on quality medical care, the history of district nursing, and education and training of district nurses. Other topics include the National Health Services and medical policy.

The author reflects on reports from the Commonwealth Fund, Care Quality Commission, and Organisation for Economic Co-operation and Development (OECD) on the quality of health care services in Great Britain.

The author looks at the potential for improvements in wound prevention and care in community health services in Great Britain, citing the British National Health Service's (NHS's) planning document "Five Year Forward View." Topics include how cost reductions can be achieved in the area of wound care, the move toward patient self-directed care, and the need for multidisciplinary cooperation among medical care personnel.