Latest news from ARNS
10 point plan set out actions to delivery General Practice Nursing workforce for the future

10 point plan set out actions to delivery General Practice Nursing workforce for the future

England’s Chief Nursing Officer has today launched a ten point action plan to recognise and develop the roles that general practice nurses have which transform care and can help deliver the plan to make the NHS fit for the future.

Developing confidence, capability and capacity – the ten point action plan for General Practice Nursing brings together key actions which aim to meet general practice workforce challenges by attracting new recruits, supporting existing GPNs and encouraging return to practice.

The plan is backed by a £15 million investment and will help target and prioritise where improvements are needed most. It sets out key milestones which will allow progress to be measured across General Practice Nursing for the first time.

A growing and ageing population with multiple complex health conditions has led to increased pressure on the general practice workforce.

The action plan sets out the work needed to deliver more convenient access to care, more personalised care in the community and a stronger focus on prevention and population health driving better outcomes and experience for patients.

Actions include measures to:

  • Increase uptake and promote nursing in general practice – by raising the profile of nursing in General Practice through the ‘Image of Nursing’ programme, offering clinical placements for undergraduates and supporting additional routes into general practice nursing.
  • Support for existing GPNs – all nurses new to general practice will have access to an induction programme, training and mentoring and an expansion in leadership and career opportunities.
  • Encouraging GPNs to return to practice – The national return to practice programme will now include GPNs. Regional GPN Boards will provide a platform to share best practice.

Professor Jane Cummings, Chief Nursing Officer for England, said: “As the NHS transforms the way that we deliver care, treating more patients in the community, the importance of our general practice workforce will only increase.

“Nurses working in general practice may not have always received the recognition they deserve in the past but they are central to our plan to improve care for patients and ensure the NHS is fit for the future.

“That is why I am determined to ensure that there is a proper career development programme for those who choose this vital path and make it an attractive first choice for newly-qualified nurses as well as helping experienced staff take advantage of the flexibility it offers to re-enter the workforce.”

Arvind Madan, GP and NHS England Director of Primary Care, said: “General Practice Nursing teams are a vital component of the general practice workforce. They provide care and treatment across the life course and increasingly work in partnership with GPs to manage overall demand in practices and treat patients with complex conditions. This support plan will go a significant way in supporting general practice, helping deliver the care that matters most to patients.”

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: “Practice nurses are incredibly important members of the practice team, and highly valued by GPs and patients alike – but as patient demand has soared, numbers of practice nurses, like GPs, have not kept pace.

“The College has been calling for elements of this plan to be introduced for many years, so we’re really pleased to see wheels being put into motion. We now need all aspects of this plan to be implemented in full and as swiftly as possible – and we will play our part in ensuring it is a success.

“We look forward to welcoming, and welcoming back, as many practice nurses to the profession as possible.”

Wendy Preston, Royal College of Nursing,  Head of Nursing Practice, and Chair of ARNS said: “It’s time to raise the profile of primary care. This framework for action recognises the tremendous contribution and challenges faced by general practice nurses and their teams, and highlights their pivotal role in delivering care closer to home.

“With large numbers of the workforce set to retire in the next few years, we must not delay making general practice an attractive career for nurses.

“General practice nurses are well placed and indeed deliver high quality services, meeting the needs of their practice populations every day. We need to prioritise general practice and make it the ‘place to be’.”

ARNS responds to DoH Tobacco Control Plan for England

ARNS responds to DoH Tobacco Control Plan for England

Read the response from Wendy Preston, Chair of ARNS, following publication by the Department of Health  Tobacco Control Plan for England

‘We welcome the publication of the Tobacco Control Plan and had been campaigning as part of the Smoke-Free Alliance for the government to speed up its publication, as there had been a long period without a plan.

Whilst it’s aspirations are to be celebrated and there are clear targets, it is still unclear regarding the detail of how these will be met and there is missing substance around funding. Local authority funding for public health is consistently being cut and a report published by ASH in November 2016 showed that 59% had reduced or even in some cases stopped smoking cessation service. Whilst we know that smoking tobacco kills half of its users and has significant health burden, reducing access to essential smoking cessation treatment is not acceptable.’

Download the Department of Health Tobacco Control Plan for England here

UK Inhaler Group seeks replacement Chair

UK Inhaler Group seeks replacement Chair

We are looking for a replacement Chair for this important coalition of organisations whose aim is to promote the correct use of inhaled therapies in order to enable patients to have the best quality of life.
If you are passionate about improving the inhaler usage; a clinician with experience in respiratory disease and are prepared to dedicate approximately 10 hrs a month to our work we want to hear from you!

This is a voluntary position, but reasonable travel and other expenses will be reimbursed.

If you are interested in finding out more about the UK Inhaler Group, or the vacancy of Chair, please get in touch with our current Chair Monica Fletcher:

The deadline for applications is 15th July 2017 – for more details, please visit:

Results of COPD and Malnutrition Questionnaire

Results of COPD and Malnutrition Questionnaire

At the ARNS 20th Anniversary Conference last month, delegates were invited to complete a questionnaire on COPD and Malnutrition.  The results of the questionnaire are shown below:

Thank you for taking the time to complete the questionnaire at the ARNS 2017 Conference in Loughborough.  We had 47 responses in total.

Just over half of respondents (52%) said that they carry out a nutritional assessment at every visit with 42 % only doing assessments if they had concerns.   BMI is still the most common recorded assessment being used by 75% of HCP to assess Nutritional status with 59 % completing a full MUST score.

See full results of the questionnaire here COPD and Malnutrition Questionnaire Results from ARNS conference 2017 (002)

Nutricia is holding a study day on 24th Jully 2017 at Nutiricia offices in Chiswick Park, focusing on the ffects of malnutrition.  If you would like to attend please contact Jo Lessells emial:   or call her on 07500 577889



Education for Health celebrates its 30th anniversary

Education for Health celebrates its 30th anniversary

Education for Health is celebrating 30 years of improving the lives of people with long term conditions.

The education charity will mark this important milestone by sharing the stories of 30 people involved in its success on its website and social media channels – one each day in June.

It is also offering healthcare professionals the opportunity to apply for 30th anniversary bursaries and attend a number of its workshops for just £30

Chief Executive, Monica Fletcher OBE, said thanks to the ambition, passion and hard work of its staff, Trainers, Trustees and partners that the charity has grown from humble beginnings into a highly respected leader in providing education for health care professionals.

“It’s time to celebrate, to thank those who have contributed to our success, reflect on our achievements and make ambitious plans for the future,” she said.

“Over the years we have empowered many thousands of health care professionals, not just in the UK but around the world, to improve the lives of their patients. This is something we are immensely proud of.
“And while we have grown and evolved significantly over the past 30 years we have remained true to our founder’s vision, which is that we exist to improve the lives of people with long term conditions.”
Greta Barnes MBE founded the Asthma Training Centre in Stratford-upon-Avon in 1987 as she was aware that too many patients with asthma in the community (and secondary care) were being seen in an emergency, and sometimes life threatening, situation.

She believed route to improved management lay in organised preventive care, personally tailored treatment and the giving of practical advice as well as regular follow up and review.
In the early days students attended a three-day course in Stratford-upon-Avon and were awarded the Diploma in Asthma Care. Within two years of being set up a regional training network had been established to cope with demand.

Today Education for Health delivers education and training across a wide range of long term conditions including respiratory disease, cardiovascular disease and diabetes. In 2016 it educated more than 4,800 individuals and ran 340 courses ranging from workshops to level 5, 6 and 7 modules. The charity also delivers bespoke training to meet the specific needs of commissioners in
the NHS and other organisations, and provides a number of free-to-access online resources. Advocacy, influencing and research activities are an integral part of Education for Health’s activities. All of the charity’s education leads and trainers are practising clinicians who sit on a wide range of specialist networks, advisory boards, voluntary, NHS and professional bodies, and guideline development groups.
Education for Health believes in taking a collaborative approach and works with many partners in industry, the NHS and other charities.

Monica explained: “We work hard to raise awareness of the importance of an educated workforce and impart our knowledge and expertise to influence key reports, policies and guidelines.
“By doing so we are able to share our knowledge more widely to contribute to the body of science in long term conditions, a key area of activity for us and one we are very proud of.”

As for the next 30 years, Education for Health has ambitious plans for the future. “The charity’s role in helping to create a well informed and well-educated workforce will be
more important than ever and we will explore new ways of working to have a positive impact on the lives of even more people with long term conditions,” explained Monica.
“Above all, we will remained focussed on improving the lives of many more patients and doing the best we can to empower, encourage and support with long term conditions to look after themselves, manage their conditions and navigate health services.”

Find out more about Education for Health at or find the charity
on facebook and twitter @EdforHealth

Clinicians urged to use new guidance on emergency oxygen to save lives

Clinicians urged to use new guidance on emergency oxygen to save lives

Health professionals from across the NHS and beyond are being urged to adopt the latest version of the world’s first evidence-based guideline on the use of emergency oxygen, published today (Monday 15 May).

The updated guidance is based on new evidence about how effective prescribing and delivery of emergency oxygen for patients can both improve health and save lives.

The updated British Thoracic Society (BTS) Guideline for Oxygen Use in Adults in Healthcare and Emergency Settings, first published in 2008 and endorsed by over 20 clinical societies and colleges, advises health practitioners when prescribing oxygen to always specify a safe ‘target range’ of oxygen in the blood, which can then be monitored.   This vital action is designed to ensure that patients are not given too little, or too much, oxygen which can result in greater illness and, in rare cases, even death.

The rationale for giving emergency oxygen treatment is to treat low blood oxygen levels (hypoxaemia) where the body’s cells are starved of oxygen, which can cause damage to vital organs which can lead to death.  Oxygen can be used to help treat a number of lung diseases, such as pneumonia or deteriorations in asthma or chronic obstructive pulmonary disease (COPD). Oxygen is also used with other diseases such as heart failure and sepsis, which do not directly involve the lungs.

The updated Guideline now covers:

  • Emergency oxygen use, and most other oxygen use, in healthcare settings
  • Short-term oxygen use by healthcare workers outside of healthcare settings

The new areas included are:

  • Endoscopy (for example, gastroscopy) and other procedures requiring sedation
  • Care before, during and after operations including patient-controlled analgesia
  • Palliative care settings like hospices
  • Use of oxygen mixtures, like Entonox (‘gas and air’) – widely used in childbirth
  • Use of high-flow humidified nasal cannulae (a relatively new method for oxygen delivery)
  • Use of oxygen by healthcare professionals in patients’ homes
  • Use of oxygen by voluntary rescue organisations and other non-NHS first responders

Evidence of the Guideline’s effectiveness has been increasing since it was first launched in 2008.

Among a number of studies in support of its impact, one randomised controlled trial and two observational studies have supported decades of evidence that giving high concentration oxygen to patients with severe exacerbations of COPD can increase the likelihood of death, often associated with critically high levels of carbon dioxide in the blood. These studies support the case for the BTS Guideline’s recommendation of a lower safe ‘target range’ of 88-92% oxygen saturation for patients with COPD.

Another example of evidence spotlights the issue of patients with heart attacks with normal blood oxygen levels being given high concentration oxygen – this was common practice until very recently but probably increases the size of the heart attack due to constriction of the blood vessels in the heart in response to high doses of oxygen.  There is also mounting evidence which indicates that very high blood oxygen levels in intensive care unit (ICU) patients are also associated with increased death rates.  These recent studies support the effectiveness of the BTS Guideline-recommended ‘target range’ for improving patient outcomes.

Dr Ronan O’Driscoll, Consultant Respiratory Specialist at Salford Royal NHS Foundation Trust, and first author of the British Thoracic Society’s Guideline for Oxygen Use in Adults in Healthcare and Emergency Settings, said:

“Oxygen is a very important drug and should always be prescribed and monitored like any other medication.  It is very beneficial to many patients, but can be harmful if misused.

We urge all clinicians to adopt the updated BTS Guideline so that emergency oxygen is always used in an optimal and safe way.

We’re delighted that a new body of evidence is confirming how effective following the Guideline can be in improving patient outcomes and reducing avoidable deaths.

The Guideline has now been extended to include more uses of oxygen ranging from procedures requiring sedation such as endoscopy, through to use of oxygen mixtures like ‘gas and air’ widely used in childbirth, to benefit an even greater number of patients.”

1 in 7 patients in UK hospitals receives oxygen therapy for their condition on any given day, according to the BTS Emergency Oxygen Audit report (2015).  Yet more than 4 in 10 of these patients (about 6,000 on an average day) are receiving oxygen with no prescription or other written order to help ensure that staff deliver and monitor oxygen use safely and effectively. Furthermore, over half of hospitals don’t provide sufficient training in oxygen provision and monitoring for doctors or nurses.

However, the 2015 audit also reflected some real progress in the UK:

  • 85% of hospitals have implemented an oxygen policy
  • 100% used pulse oximeters to measure a patient’s oxygen levels on all nursing observation rounds
  • 72% recorded the patient’s oxygen levels in a dedicated oxygen section on the monitoring chart consistent with the BTS oxygen guidelines

BTS won a National Patient Safety Award in 2011 for its campaigning work in the area of safe oxygen use, which has included the delivery of Guidelines, educational resources and audit to help hospitals provide oxygen safely and effectively.

The BTS Guideline for Oxygen Use in Adults in Healthcare and Emergency Settings can be downloaded here:

The BTS Guideline for oxygen use in adults in healthcare and emergency settings has been endorsed by: Association of British Neurologists, Association of Chartered Physiotherapists in Respiratory Care, Association for Palliative Medicine, Association of Respiratory Nurse Specialists, Association for Respiratory Technology and Physiology, British Association of Stroke Physicians, British Geriatrics Society, College of Paramedics, Intensive Care Society, Joint Royal Colleges Ambulance Liaison, Primary Care Respiratory Society UK, Resuscitation Council (UK), Royal College of Anaesthetists, The Royal College of Emergency Medicine, Royal College of General Practitioners, Royal College of Nursing (endorsement granted until April 2020), Royal College of Obstetricians and Gynaecologists, Royal College of Physicians London, Royal College of Physicians of Edinburgh, Royal College of Physicians and Surgeons of Glasgow, Royal Pharmaceutical Society and The Society for Acute Medicine.

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