Making Best Practice, Every Day Practice
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This resource provides access to informative articles on the broad spectrum of obstetric and gynaecological issues managed in primary care including sexual and reproductive health.
These materials cover some of the most important topics in daily care including:
Contraception across different age groups
Early detection of gynaecological cancers
Pre-menstrual syndromes
Use of testosterone
Menstruation and abnormal uterine bleeding
Fertility treatment
and much more.
A 40-year-old woman with hot flushes, tearfulness and low libido could be going through early menopause. But there might be other explanations for her symptoms, and a careful history and investigation are essential to ensure that she receives the right treatment.
Hormone replacement therapy (HRT) is the most effective treatment for menopausal symptoms, but bad publicity means that women ask about other options. This article outlines practical steps to help to minimise mild symptoms, and assesses the evidence for complementary and prescribed alternatives to HRT.
For too long a Cinderella condition, osteoporosis has only recently been included in the GP contract as a Directed Enhanced Service. This article explains how the new FRAX tool can help practices to individualise risk assessment and target treatment to the patients most at risk.
All too many women with urinary incontinence are referred to secondary care when they could be assessed and successfully treated by their GP, practice nurse or local primary care continence advisor. This article explains how one PCT introduced a local pathway that has changed professional behaviour, and proved popular with both professionals and patients.
Despite NICE guidelines, long-acting reversible contraceptives (LARCs) remain little used in the UK, but this looks set to change with their inclusion in this year’s new Quality and Outcomes Framework contraception indicators. The author reviews the currently available LARCs, and discusses how to tailor choice to the needs and preferences of each woman.
In order to comply with NICE guidance and achieve new QOF indicators, general practices must offer women a choice of contraception, including long-acting reversible methods. But practices may struggle if GPs have not maintained their competencies in fitting these devices. The author explains how nurse-led clinics can both enhance services for women and help practices achieve targets.
A woman with faecal incontinence may have suffered for years before she finds the courage to ask for help. Such consultations can be a challenge for both patient and professional. But sensitive, careful assessment and simple, conservative measures will often improve bowel control and restore the patient’s quality of life
For anyone working in the NHS, it has been a tumultuous few months. We were all gearing up to the establishment of GP consortia by 2013. Now the pace of change has slowed following the Government’s acceptance of the NHS Future Forum’s recommendations. This gives us all time to pause and remember that meeting the needs of our patients should be our first priority, and that this depends critically on the knowledge and skills of all NHS professionals.
Coronary heart disease (CHD) affects over 2.8 million people and is the main cause of death in the UK.1,2 CHD is also economically damaging, imposing a huge annual burden, with healthcare costs estimated to be around £3.3 billion.2 Two-thirds of the population could reduce their risk significantly by lowering their cholesterol levels – the main modifiable risk factor. The Ultimate Cholesterol Lowering Plan (UCLP) is a revolutionary approach that provides the nation with a truly realistic and achievable dietary plan that can significantly reduce the current CHD epidemic.
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Until recently, there were two options for emergency contraception after unprotected sex or contraceptive failure: an oral progestogen-only tablet, and the copper-containing intrauterine device. These have now been joined by a new oral method, and this article reviews the three options in light of changing guidance on emergency contraception.
The NHS Cervical Screening Programme is universally lauded as a success story, preventing an estimated 2,000 deaths a year from cervical cancer in the UK. The programme continues to be refined in light of new evidence, and the latest development is the introduction of human papilloma virus (HPV) testing alongside cytology.
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