Resources

Welcome to our December/ January issue and I am sure that you, as I am, are all wondering where this year has gone and feeling that each year seems to pass faster than the previous one! Is it a sign of our age or reflective of our lives being so busy that the days, weeks and months merge? At this time of year, I always find it useful to take a little time to reflect, asking myself what I have achieved over the past year, could I have aimed higher and what differences have I made to patients’ experiences. It really is a useful approach to take and drives/guides me into the coming year. Please try it — acknowledge the highs and the lows, plan for the coming year and stay strong. Our ‘Community matters’ feature follows a similar concept — it reflects on our NHS and community nursing, discussing previous plans and asking: are we fit for the future? Please take some time to read the summarised main points of our new 10 Year Health Plan — it may support your own reflective practice and drive you into 2026.

While rising energy costs, food inflation, and the ongoing effects of Covid-19 continue to affect daily life, recently it seems that government ministers are finally accepting that the NHS is in serious trouble and that there’s a need to address its difficulties.

Back in 2024, Wes Streeting, the new Labour government’s health secretary, expressed what most of us had been thinking for some time, stating that ‘this government will be honest about the challenges facing our country, and serious about tackling them. From today, the policy of this department is that the NHS is broken’ (‘The NHS is broken: health and social care secretary statement’ — www.gov.uk).

The government’s 10-Year Health Plan (GOV.UK, 2025) puts health inequity under the spotlight and wants to reduce disparities. But, what does this look like on the ‘shop floor’ and how can it be implemented?

Most previous guidance on the management of chronic constipation has focused on the use of medication. However, new guidance funded by the British Dietetic Association, and produced by a team of UK-based clinicians (Dimidi et al, 2025), gives the first comprehensive evidencebased dietary guidelines for the management of chronic constipation in adults. As well as the effect on the bowel, chronic constipation is prospectively associated with an increased risk of urgency and hesitancy among parous middle-aged women (Alhababi et al, 2021).

As of August 2025, half a million people in the UK have been diagnosed with dementia, according to NHS figures (NHS England, 2025). With numbers projected to rise to 1.4 million by 2040 (Alzheimer’s Society, 2024), innovative approaches to dementia care have never been more urgent. Dementia is now the leading cause of death in the UK and affects around 70% of care home residents (Alzheimer’s Society, n.d.). For families and caregivers, supporting loved ones through the challenges of the condition is a daily reality. Increasingly, attention is turning to sensory gardens — specialised outdoor spaces designed to engage the senses and promote wellbeing.

At JCN we would like to thank our industry partners for their support to the 2025 JCN study days and exhibition. To share what has been happening at these UK-wide events, we invited our partners to give an overview of the topics they presented, which offer some valuable insights into their areas of care and highlight the education provided to our delegates.

Chronic oedema of the lower limb arises when the balance between capillary filtration, venous return, and lymphatic drainage is disrupted. Venous hypertension, most often resulting from venous reflux or obstruction, increases capillary pressure and fluid extravasation into the interstitial space (Eberhardt and Raffetto, 2014). Sustained oedema impairs oxygen and nutrient diffusion, promotes inflammation, and contributes to skin changes such as lipodermatosclerosis, hyperpigmentation, and ultimately ulceration (Moffatt et al, 2017). The development of venous leg ulcers is therefore closely linked to the chronic cycle of venous hypertension, oedema, and tissue breakdown, with healing often delayed by persistent swelling and recurrent episodes of cellulitis (Guest et al, 2020).

Individuals experiencing homelessness and substance use disorders often present with complex, chronic wounds exacerbated by compromised immune systems and poor nutrition. Traditional healthcare models frequently fail to address their unique needs, leading to fragmented care and suboptimal outcomes. This paper advocates for the integration of wound care services into familiar, community-based settings, emphasising the role of traumainformed, nurse-led initiatives in improving engagement and health outcomes for this vulnerable population.

Recruitment and retention challenges in community nursing have exacerbated disparities in wound care outcomes, particularly among housebound patients. In response, University Hospitals Coventry and Warwickshire NHS Trust Wound Healing Integrated and Community Care Services developed the Coventry community wound healing team (CWHT) in 2022 to improve healing outcomes and relieve pressure on district nursing services. This paper outlines the development, structure and outcomes of the Coventry CWHT, which delivers specialist wound care in patients’ homes through a skill-mixed team led by a wound healing clinical nurse specialist (CNS). Findings indicate significant benefits in terms of patient outcomes, workforce effciency and staff wellbeing. The model presents a scalable solution to current challenges in community wound care delivery.

Moisture-associated skin damage (MASD) affects people of all ages and patient groups (Voegeli, 2019). It describes a range of inflammatory conditions that occur in response to prolonged exposure of a person’s skin to moisture, i.e. perspiration, urine, faeces, wound exudate and ostomy effluent (Gray et al, 2011). Prolonged exposure to these irritants damages the natural barrier function of the skin and, if not managed effectively, can lead to tissue damage and subsequent breakdown (Dykes and Bradbury, 2016).