More and more is being expected of practices in improving the management of diabetes – with initiatives such as the National Service Framework (NSF) for Diabetes and NICE guidance setting increasingly ambitious targets. The National Diabetes Support Team (NDST) has been set up to help support local services throughout the NHS and in meeting these challenges. In this issue, they share latest advice for practices and patients on disposing of used syringes and other sharps.
Running a successful cardiovascular clinic in general practice
The very good audit data for this practice has led to its winning awards. So how does the practice do it? This ‘day in the life of’ photo diary gives a step-by-step guide to the key elements of running a successful cardiovascular clinic in general practice.
Stop the clot: achieving effective anticoagulation in patients with heart disease
Thromboembolism is a common complication of heart disease – particularly in patients with atrial fibrillation (AF). Decisions to prescribe an anticoagulant are based on assessment of an individual patient’s risk of clotting and the side-effects of treatment. With growing numbers of patients with heart disease, the number of patients on anticoagulants is increasing and there is a shift to primary care-based anticoagulation clinics. Practice nurses have a central role in educating patients about anticoagulation therapy and in monitoring their ongoing care.
Diabetes care: maintaining glycaemic control during fasting for Ramadan
Fasting during Ramadan – lasting from 15th October to 12th November this year – is one of the five pillars of Islam. The experience of fasting is intended to teach Muslims self-discipline and self-restraint, and to help them understand a little of the plight of the less privileged. But what are the implications of fasting for patients with type 2 diabetes?
Expanding the role of health care assistants in primary care
As practice nurses take on a growing role in the organisation and implementation of chronic disease management, they need more help in many of the routine – but important – tasks this involves. Health care assistants (HCAs) are providing growing support in this capacity. This article explores what HCAs are taking on and issues regarding their training and regulation.
Atrial Fibrillation
Atrial fibrillation (AF) is one of those terms that we are hearing more and more in general practice. It is an important risk factor for stroke – particularly in older people – making it a good candidate for primary care teams to target in efforts to prevent cardiovascular disease.
Beta blockers
Beta blockers are well established drugs in the treatment of cardiovascular disease, after first being introduced 20 years ago. Today, they are used to treat patients with a range of cardiovascular conditions – hypertension, myocardial infarction, angina, heart failure and abnormal heart rhythms (arrhythmias). There is good evidence for beneficial effects with beta blockers and their use is recommended in many guidelines, including the recent British Hypertension Society guidelines. Prescribing of beta blockers in patients with heart disease is further encouraged as a ‘quality marker’ in the new GMS contract.
How to: create and maintain a Coronary Heart Disease
The aim of the National Primary Care Development Team (NPDT) is to develop healthcare professionals who have the knowledge and skills to apply quality improvement methods to local priorities. CHD is one such priority and has been within the focus of our work for almost four years. Working in partnership with other agencies who share our priorities is essential. Janet Potts, who leads on the work of the NPDT in West Yorkshire, joined forces with Adele Graham from the CHD Collaborative in West Yorkshire, to give the strongest possible support to local primary healthcare professionals. The CHD register ‘recipe’ was devised by this partnership.
Getting it right – how to measure BP in the surgery
It’s something that we do so often, but are we always doing it the best way? Check out how to measure blood pressure (BP) correctly, with latest advice from the National Institute for Clinical Excellence and the British Hypertension Society.
Bringing CHD management back to primary care
Managing heart failure effectively in the community Community-based nurses are at the forefront of vigorous efforts to improve the management of coronary heart disease. The Coronary Heart Disease Collaborative is spearheading 30 projects around the country to find practical ways forward. This issue reviews how Durham Dales PCT has brought the management of heart failure firmly back into primary care, with up-to-date registers of heart failure patients and regular clinics in the community.
Making sense of heart failure and its treatment
Heart failure is a high priority in primary care, with the National Service Framework for Coronary Heart Disease, the NICE Heart Failure Guidance, and the new General Medical Services contract quality indicators all setting clear standards for improving the management of patients with this increasingly common condition. This four-page pull-out supplement provides you with a need-to-know, need-to-keep guide.
Chest pain in Primary Care – would you and your team know what to do?
This article considers a possible scenario in primary care in which a patient presents with chest pain. Test yourself to see what you would do. Then check this against our recommendations, reflecting on your current procedures and policies within your practice.
