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I am annoyed that I ’ m constantly hearing about the backlog in secondary care and not in general practice elderly or high-risk people have been at home for two years because they ’ ve been shielding . It ’ s hard to convince them to come in .’
Julie Carrick , director of nursing across a network of six sites at the GPS Healthcare practice in Solihull , says general practice is also dealing with pressures that overspill from hospitals . For example , she suggests patients are being discharged earlier than usual . ‘ We have to take down theatre dressings because the patients are being sent out so much quicker , which , historically , we ’ ve never done before . We ’ re seeing much more complexity in primary care .’
An anonymous nurse from London , who is also a PCN clinical director , agrees with this : ‘ I am annoyed that I ’ m constantly hearing about the backlog in secondary care and not in general practice . I am so fed up with work from secondary care being put on general practice – such as blood tests and prescriptions . Without a shadow of a doubt , it ’ s gotten worse . Not only are we dealing with our own backlog , but the fallout from secondary care as well .’
The nurses all highlighted to Nursing in Practice that care for people with long-term conditions – such as diabetes and cardiovascular diseases ( CVD ) – is an area that has been significantly impacted by the pandemic . Research in October from the University of Manchester 2 found there were 7.4 million fewer health checks for people with type 2 diabetes in UK general practices than expected between March and
December 2020 . The NICErecommended checks are essential to minimise the risk of developing long-term complications . Diabetes UK described the findings as ‘ incredibly concerning ’ and called for the backlog to be ‘ urgently dealt with to avoid people developing life-changing complications of diabetes that may have been preventable ’.
Ms Carrick says the blood tube shortage , which peaked in August and September 2021 and saw NHS England instruct practices to cancel all blood tests unless ‘ clinically urgent ’, came at ‘ the worst possible time ’, just as practices were starting to see more diabetes patients and needing to take their bloods . This forced Ms Carrick ’ s practice to prioritise high-risk diabetes patients and put others on a waiting list . ‘ With this , and also because of lockdown , people ’ s diabetes is not as well controlled . They haven ’ t been going to the gym or going out ,’ she says . Ms Berry agrees : ‘ Things have settled down and we ’ re getting basic reviews done and getting people in while we can . But we had a month or so where we restricted everything and could only deliver urgent diabetic care .’
Ben Scott , an advanced nurse practitioner and practice partner in Maltby , South Yorkshire , adds : ‘ There have been large amounts of weight gained during lockdown . People may have smoked more . All these are risk factors for some long-term conditions . To help these patients , it takes education , continuity and the expert approach that practice nurses do every day – but that hasn ’ t been as available during lockdown .’
For CVD , prevention work ‘ we would have previously undertaken routinely has inevitably suffered as a result of the pandemic ’, says Dr Jim Moore , president of the Primary Care Cardiovascular Society . During face-to-face appointments , nurses and other clinicians often take the opportunity to check pulse and blood pressure , but he says those opportunities were ‘ much diminished throughout the pandemic ’. He adds : ‘ Blood pressure that is uncontrolled
Winter 2021 nursinginpractice . com