The annual review of patients with cardiovascular disease (CVD) is a routine element of practice care. With an average practice having a coronary heart disease (CHD) register of around 5% of the practice population (Health and Social Care Information Centre, 2015), along with those living with other conditions that make up the spectrum of CVD (Figure 1), this accounts for a significant requirement of clinical time. The Quality and Outcomes Framework (QOF) lists a number of clinical indicators to be attained in this population and in most practices the nursing team delivers much of the routine care. This article looks at how to make the most of CVD reviews to ensure that the clinical benefits are optimal and patients receive a quality service.
Asthma is a common long-term condition affecting adults and children. Despite a number of evidence-based guidelines for treatment and new medications and inhaler devices, mortality rates remain static. Key findings from the National Review of Asthma Deaths (Royal College of Physicians [RCP], 2014) highlighted the importance of personalised asthma action plans (PAAPs) in good asthma care. This article looks at how healthcare professionals need to work with adults and children with asthma, involving them throughout the process, to produce a meaningful, useful plan that has been developed with the person, and parents or carers. The plan should be used as an educational tool to help understand how, when and why asthma medication should be used, what is meant by asthma control, and recognition of when control is slipping.
This article focuses on prevention in the Five Year Forward View (NHS England, 2014a) and the role of primary care, particularly the role of the general practice nurse (GPN). It will:
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