HEALTH PROMOTION IN ADULT NURSING

Health promotion in adult nursing

Health promotion in adult nursing

Question 1

COPD and Other Long Term Conditions In Government Policy

There is an increasing policy focus on long-term conditions, in the UK. COPD is recognised as an important long-term condition, but there is limited policy relating specifically to this disease. The government has at long last recognised that there is the need to manage long-term chronic conditions more effectively within primary care. The new document Supporting People with Long-Term Conditions (Dijkstra 2003 340-346)outlines a model of care for patients with COPD and other chronic conditions. Such intervention not only has the potential to reduce the number of admissions to hospital but also will certainly have some impact on improving the quality of life of these patients. Within various parts of the UK the Department of Health has set up COPD collaborative teams as pilot schemes to assist general practices not only to raise the awareness of COPD but also to enhance patient management within primary care. Along with this, the government made a commitment to modernise general practice and to tackle some of the key issues in caring for patients within primary care. In April 2004 GPs opted to accept the General Medical Service (GMS) ( Kolt et al 2006 201-208 )Contract, which offered GPs and nurses the flexibility and opportunity to test different options for addressing primary care needs. The key part of the new contract is that GPs are paid on the quality of service provided to patients rather than the number of patients treated. This therefore allows practices greater freedom to design their services delivered to patients. Such a contract offers a greater incentive to practices to provide a fi rst class service to patients, particularly with chronic diseases such as COPD. Practices are now required to record clinical data on computer databases so that audit of clinical practice may be performed and validated(Ficke Farris 2005 1325-1330). 

In UK, the Strategic Framework for Respiratory Disease was published in 2005. This is a 10 year plan for developing services for all respiratory diseases in the province. Similarly in Wales, all respiratory diseases are included in the Service Development and Commissioning Directives which were published for consultation in October 2006. And in England, the Government announced in June 2006 that a new National Service Framework (NSF) for COPD would be developed, and the External Reference Group is due to submit its recommendations to the Department of Health by the end of 2007. 

 COPD is slowly progressive which means that patients presenting with severe disease stand a high chance of having had their symptoms 'missed' whilst their disease was less severe and at a stage where therapeutic interventions were most likely to be beneficial. Good care for COPD patients is well defined in guidelines from NICE and the British Thoracic Society, and there is agreement among healthcare professionals as to what should be included in the clinical standards(DiClemente Prochaska 1991 295-304). 

There is no requirement for Health Boards to implement current best practice recommendations which results in patch provision across the country. We believe that the development of clinical standards, on which Health Boards are assessed, will ensure adequate attention and resource is provided to respiratory disease ...