Resources

Welcome to our spring issue of the JCN. I am sure that many of you are looking forward to the longer and warmer days. In this issue, our ‘Community matters’ feature focuses on the new cancer plan and it is certainly worth taking some time to read. It examines concerns relating to our cancer services, including performance targets, and draws comparisons with neighbouring countries. The ambition of the plan is discussed and, due to there being so many recommendations, themes are highlighted to support your awareness and understanding. While innovations specifically for the community are considered, the challenges associated with delivering these in practice are also acknowledged.

When it comes to health, nobody likes to hear the worst, but in your role as a community nurse you’ve probably grown used to delivering bad news. However, in the long list of conditions and diagnoses that you might have discussed with your patients, few engender
as much anxiety than what is often euphemistically referred to as the ‘C word’.

Urinary tract infections (UTIs) are among the most common bacterial infections managed
in community and primary care, with around half of women experiencing at least one episode during their lifetime (Foxman, 2014). The estimated prevalence of recurrent UTI in women in the UK is approximately 6% (Sanyaolu et al, 2023; 2024).

Foam dressings were among the earliest modern wound dressings introduced in the mid-1970s and represented a significant advancement at a time when limited options were available to  effectively manage the wound environment, particularly exudate control (Sussman, 2010; Hargis et  al, 2024). Today, foam dressings are widely used in clinical practice and are manufactured using  materials such as polyurethane (PU), polyvinyl alcohol (PVA) or silicone-based formulations (Hedger, 2014; Wakefield, 2025).

A venous leg ulcer (VLU) as defined by the National Institute for Health and Care Excellence (NICE) is a perforation in the skin in between the knee and ankle, which has not  resolved within a two-week period with the added complication of venous insufficiency (NICE, 2024).  VLUs are the most common type of leg ulceration with a 60–80% incidence rate (Atkin et al, 2024). The annual prevalence per population  of VLUs in the UK is estimated at 1.08% (Guest et al, 2020).

The Leadership Education and Progress Scheme (LEAP, developed by the clinical
education department at Advancis Medical) involved six specialist clinicians in podiatry and tissue viability from five National Health Service trusts across the Northwest of England. The one-year scheme comprised soft skill modules, including leadership and management.

Sepsis is life threatening and life changing, around 20% of people who develop sepsis do not survive and 40% of those who survive have significant cognitive or functional impairment  (Burki, 2018; Prescott and Angus, 2018). The 2024 National Institute for Health and Care Excellence  (NICE) guideline focused on enabling clinicians to identify those who were sickest and to ensure  that they received prompt treatment. The guideline advised clinicians to take a little more time to  diagnose those who were less acutely ill and to prescribe an appropriate antibiotic rather than a  broad spectrum one (NICE, 2024).

Cancer is more likely to be underdiagnosed and undertreated in people
with disabilities compared to non-disabled people, as shown by the Cancer Patient Experience Survey  (NHS England, 2021). Disabled people are more likely t experience stigma, discrimination and inaccessibility in  healthcare, including inequalities within cancer services such as physical inaccessibility and invalidation.

Not only is the UK’s population increasing, it is also ageing (Barton et al, 2024). Men make up 45.8% of the current population in England and Wales, which is approximately  62 million. In 2022, 19% of the population were aged over 65, but this figure is projected to double over the next 50 years. By contrast, 50 years ago, those aged  over 65 made up 13% of the population (Office for National Statistics [ONS], 2025).

The recent deaths of people with learning disabilities, directly as a result of constipation, have been highlighted in the media  (Devereux, 2023) and the issue persists for people with learning disabilities. It is important to remember that deaths from constipation are avoidable and it is a treatable and manageable condition. No person with a learning disability should die as a result of constipation.