Chronic urticaria is a relatively common complaint in clinical practice. It often has an unknown aetiology or a difficult-to-avoid trigger and although rarely life-threatening, it has a profound impact on quality of life, reaching beyond the
impairment directly related to physical symptoms. All these aspects make its management complex and often frustrating both from a patient and professional perspective. Most patients with urticaria will be seen first in primary care, often by practice or community nursing staff. With good knowledge on diagnosis and management, up to 80% of these patients can be managed adequately in primary care.
When I first started in general practice in 1990 I worked with a general practice nurse (GPN), a health visiting team, a district nursing team, a community psychiatric nurse (CPN), a social worker and a benefits advisor, and we were accountable for the 24/7 expert generalist cover for our registered list of 8,500 people.
I entered general practice after a decade of training and experience as a general and vascular surgeon and it took me some while to adjust to the shock of realising that my mindset, attitudes and beliefs, drummed into me through medical school and beyond, had to be reframed: I had to become an expert generalist.
Success!