Resources

I hope you are enjoying the summer months and have managed to take some time away from work for yourselves. As always, this issue is filled with information to support your learning and development, challenge your practice and keep you up-to-date with current issues. Our ‘Community matters’ piece discusses how vitally important it is to support patients to take responsibility for their own health and to self-care. By educating, advising and working in partnership with patients, we can support them to make informed decisions and choices about their own health and promote self-care, ultimately enhancing health outcomes and reducing NHS pressures.

Self-care or self- management of health has become essential for sustainability of health and social care services but can be challenging to engage with for several reasons. Frustration can arise when people are unable to self-manage, perhaps through lack of confidence, willingness, outside influences (such as family members), lack of knowledge about a particular condition or procedure, disease symptoms, or even issues with digital inclusion. It can become difficult to work with people where there are barriers to self-management due to lack of time or resources to fully explore and address these alongside the person, or lack of access to professional training for skills such as coaching, which are essential to achieving effective self-management.

Malnutrition (or undernutrition) is a state of nutrition in which a deficiency or excess (or imbalance) of energy, protein and other nutrients causes measurable adverse effects on tissue/body form (body shape, size and composition) and function and clinical outcome (British Association for Enteral and Parenteral Nutrition [BAPEN], 2025). Malnutrition affects at least three million people in the UK, with 93% of these living in the community (BAPEN, 2025). Malnutrition has an estimated cost of £23.5 billion in the UK (Managing Adult Malnutrition in the Community, 2021), and can lead to adverse effects if unidentified and untreated, such as increased wounds, infections, complications and mortality, resulting in greater healthcare use through more hospital admissions, longer hospital stays, more GP visits and a rise in prescription costs (Stratton et al, 2018).

During World Continence Week, ERIC, The Children’s Bowel & Bladder Charity, met with key figures from the children’s health, education and social care sectors in Parliament to discuss the importance of potty training children a year earlier.

Potty training children a year earlier could solve a host of issues in the education and health service and improve children’s overall health and wellbeing — so why aren’t policymakers pushing forward measures to support families doing it sooner?

In July, Steph Lawrence MBE became the Queen’s Institute of Community Nursing (QICN) new chief executive, succeeding Dr Crystal Oldman CBE. Steph has been a nurse for more than 37 years, with the last 22 spent working in the community. She is both an adult and children’s trained general nurse, and a qualified district nurse. Steph is a Queen’s Nurse and fellow of the QICN and in 2022 was awarded an MBE for services to district nursing.

Steph was previously chief nurse at Leeds Community Healthcare NHS Trust and also spent three years at the Care Quality Commission as the national professional adviser for community services. She led the national trailblazer group for the district nurse apprenticeship standard, and co-chaired the clinical reference group for the national community nursing plan. She therefore brings a huge amount of experience and expertise to the QICN at a time when the NHS is adapting rapidly to meet new challenges

Like many skin conditions commonly encountered in primary care (e.g. dermatitis, psoriasis and acne vulgaris), hidradenitis suppurativa (HS) can be both difficult to spell and pronounce. HS can also be difficult to identify, despite being an inflammatory skin condition that affects as many people as psoriasis (Penzer Hick, 2022). As a consequence, it can sometimes take several years for patients to get a diagnosis; approximately 35% of people with HS reported it taking three to 10 years to be diagnosed (Nicolle, 2022).

To help address this by improving recognition of HS, JCN and GPN in partnership with Mediq, have produced a poster for clinicians to use in practice settings to raise awareness among both healthcare professionals (HCPs) and patients.

Good skin integrity is essential for overall health and wellbeing. The skin is the body’s first line of defence against external threats such as infection, injury, and fluid loss. Maintaining skin integrity is crucial, especially for patients in their own homes where skin observation may be less frequent than in in-patient settings. Any damage to the skin can increase the risk of complications, such as pressure ulcers, infection and skin tears. This article examines the importance of assessing risk and maintaining good skin integrity for patients, and explores the role of nurses in maintaining good skin health, outlining evidence-based interventions.

Lymphoedema is a chronic condition that can lead to pain, reduced mobility, and significant emotional and psychosocial burden. While standardised patient-reported outcome measures capture physical and psychological impacts, they may overlook important aspects of the lived experience. This service evaluation aimed to explore patient experiences of lymphoedema at first contact with the service by analysing open-text responses from LYMPROM© submitted to a single lymphoedema service, and to identify concerns not captured by fixed-response items. A retrospective thematic analysis was conducted on 229 anonymised open-text responses submitted via LYMPROM© for patients newly referred to the Swansea Bay University Health Board (SBUHB) lymphoedema service between November 2020 and December 2022. Data were analysed using Braun and Clarke’s six-phase framework, with coding and theme development undertaken collaboratively by three researchers to enhance rigour. Four overarching themes were identified: the burden of multiple comorbidities, disrupted sleep often linked to pain and discomfort, the emotional toll of lymphoedema, and behaviour changes related to social withdrawal and diminished confidence. Patient narratives revealed experiences not easily captured through structured assessment alone. The findings support the integration of narrative data to inform more holistic, person-centred care.

As lymphoedema prevalence continues to rise causing increasing demand for services, optimising patient self-management is vital. In the UK, lymphoedema treatment models have traditionally followed the ‘four cornerstones’ approach, including skin care, compression therapy, physical activity, and lymphatic drainage massage. These address the physical manifestations of lymphoedema yet neglect the psychological and emotional impact. Since the establishment of the psychology service within the Lymphoedema Wales Clinical Network (LWCN) in 2023, a more holistic model of care has been introduced into clinical practice. This development reflects a growing recognition of the psychological burden associated with lymphoedema and the need for integrated support services. The introduction of the lymphoedema COMPASS treatment model represents a significant advancement in routine care delivery, combining physical and psychological interventions to support patients to live as well as possible with lymphoedema. The COMPASS model is designed to place individuals at the centre of their care, promoting active engagement and self-management. It supports and encourages patients to take ownership of their condition, including the emotional and psychological challenges that often accompany lymphoedema.

The trial without catheter (TWOC) procedure aims to assess an individual’s ability to void effectively without the use of an indwelling urinary catheter. Prolonged catheterisation increases the risk of catheter-associated urinary tract infections (CAUTIs), sepsis, and hospital readmissions. Traditionally, TWOC procedures have been conducted in hospital settings, which can be costly, resourceintensive, and inconvenient for patients, particularly those with mobility issues or chronic conditions. This article evaluates the implementation of a commercial clinical nurse specialist (CNS)-led community-based TWOC service, highlighting its cost-effectiveness, improved patient outcomes, and positive patient experience. It aligns with national healthcare priorities, such as the NHS Long Term Plan, by promoting care closer to home, reducing hospital admissions, and optimising NHS resources. The findings support the case for expanding community-based urology services to enhance patientcentred care and achieve better health outcomes.