Glasgow hosted the most recent NIP event last week and it was a welcome day away from work. I had two hats on that day, manning the Scottish Practice Nursing Association stand between sessions and attending presentations as a delegate.
I enjoyed Dr Kassianos' presentation. He gave an insight into the HPV vaccination and I found this interesting, particularly as the programme is due to start in September and I have already had parents and young people enquiring about it. I am now much more informed and able to answer their questions.
Another highlight of the day was Professor Tom MacDonald from Ninewells Hospital who clearly has missed his true vocation as a comedian. I have never heard anyone who can make hypertension so interesting. There was, however, a serious message in his presentation, entitled "10-year achievements in hypertension". He spoke about the way treatment of hypertension has changed and the importance of treating lifestyle issues as well as current drug treatments.
In spite of the proven beneficial effects of treating hypertension, Professor MacDonald spoke about the underdiagnosis and undertreatment of hypertension. Practice nurses have an important role to play in the management of hypertension and patient education. Many are now independent prescribers and well placed to treat hypertensive patients effectively with the appropriate training.
This is the time of year when I wish I could take a couple of week's holiday and that when I got back to work it would be a new year for the GP contract. The last gasp effort to get poor attenders in for their blood pressure or diabetic reviews is on and it is a very busy time. The workload for myself and my colleague has increased over the last couple of years and speaking to other practice nurses most are feeling the same. And it is not only practice nurses who are feeling the strain - in my own practice come this September we will have had three GPs retired in the last 18 months, all early retirements. None of them had planned to retire early. The latest "negotiations" over opening hours have done little to improve morale.
How do we tackle the problem of nonattendance? During our practice visit last year it was commented on that we had a much lower than average rate for excluding people on chronic disease registers. I feel this is partly due to a reluctance to "give up on" reluctant patients. Appointments are now available from 8am, and while it would suit me to see 10 hypertensive patients on a particular afternoon, I have found that a more flexible approach has improved attendance.
My own practice has worked hard to improve access and a recent patient satisfaction survey was quite positive regarding appointment time availability. In spite of this we are likely to find practices having to stay open in the evenings soon and I do not feel this will improve uptake of services by current nonattenders. It is more complex than simply appointment availability.
Your comments: (Terms and conditions apply)
"My asthmatic husband is a regular nonattender for his asthma check-ups as the only appointments on offer are during the working day. As he works at some distance from our GP he is understandably unwilling to have to take annual leave for a check up. More work-friendly opening hours would certainly encourage him to attend." - Name and address supplied
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