Resources

When most people, professionals or media discuss the NHS, it is more often NHS England that they think about. However, due to devolution, each country has its own form of NHS system. While the goal of any NHS system is to provide an excellent service for health
provision to their population, how it is delivered can vary greatly. This article examines how the initial NHS was set up, how devolution in Wales has changed how services in Wales are commissioned, and how this has impacted on continence/bladder/bowel care in Wales.

This article, the second in a three-part series on Long Covid (LC), focuses on how one community-based NHS LC clinic developed and now delivers a 10-week group-based virtual rehabilitation programme (VRP), which aims to provide persons with Long Covid (PwLC) concepts on current thinking in LC, alongside self-management education and support. It highlights the role of embedded clinical research fellows (CRF), and their role in an in-depth service evaluation of the VRP, using established research methods and being peer reviewed/supervised by a research team to support best practice in an evidence poor field.

It is estimated that there are currently 944,000 older people living with dementia in the UK, and that 593,200 of those people are living with advanced symptoms. People living with advanced dementia have a significantly higher prevalence of pressure ulcers (PUs), compared to those living without dementia with similar comorbidities. The care and support required to prevent pressure ulcers in people living with dementia needs to be individualised, following a holistic and person-centred assessment of the person and their unique circumstances. An improved understanding of the increased risk and causal factors of developing pressure ulcers in high risk groups, such as people living with advanced dementia, can support practitioners to conduct a more through and person-centred risk assessment and management plan, including choosing the most appropriate products to meet a person’s needs.

Use of the revised National Early Warning Score (NEWS) 2, a tool
used to measure acute deterioration in hospital, is mandatory in acute
NHS hospitals and ambulance services. Community staff who wish
to escalate acutely unwell people to ambulance or acute services need
to be able to use NEWS. This article outlines the uses and limitations
of NEWS and how it can aid identification and escalation of people
who are acutely unwell in community settings, including those with
suspected sepsis.

Due to increased media attention that the menopause continues to receive, awareness has thankfully been raised around its possible effects and potential to have a negative impact on wellbeing. Many trusts are now providing information sessions that staff can attend to
improve their knowledge and how to access support, alongside sessions for managers to ensure awareness and that support is offered. I recently attended one and gained a great
deal from it, but on reflection was alarmed by how little I had known! So please, do take some time to read the ‘Community matters’ piece in this issue (pp. 8–11), as I am sure you will find it full of really useful information.

Most people who work in health care would imagine that they have a basic grasp of the menopause and its main symptoms. They’d probably be able to tell you about hot sweats, anxiety and mood swings. Some of them might even impress you with
their knowledge of period cessation or hormone depletion.

For many women, however, including those working in health care, the realities of
living with menopause are still shrouded in misinformation and embarrassment. Not to mention sexism. Often lumped together under the dismissive term ‘women’s problems’, it’s an often-repeated joke that if men experienced the menopause there would have already been years of well-funded research, a host of treatments, or even a ‘cure’.

As we are all aware, the protection and regulation of everyone’s personal data is a legal requirement and a framework within which we must work every day. To support you to embrace the challenges surrounding this, do read this issue’s ‘community matters’
feature (pp. 8–11). It is all about GDPR and manages to simplify the subject and make it easily relatable.

As a community nurse, how much information should you know about a patient?
You might say it’s important to know the condition they have and their medical history. It might be reasonable to enquire if they are on any medication, or even ask for some
details about their lifestyle, such as their smoking habits or alcohol consumption, or how many sugars they take in their tea.

IF YOU FEEL CONFIDENT, YOUR PATIENTS FEEL CONFIDENT
In order to instil confidence in your patients, you yourself need to feel confident in the care you’re providing — including the products you use.

The Queen’s Nursing Institute (QNI) has published new Standards of Education and
Practice for community practice teaching. This is the seventh in a series of standards developed and published by the QNI since 2015.