30th June - 2nd July 2004, Winchester

I have returned from a great conference held in Winchester. This year the 21^st Practice nurse conference was entitled ‘Innovate and Liberate’. A number of excellent speakers and workshops along with a brilliant social programme made the journey south worthwhile.

Day 1 focussed on Key Changes in Primary care.

Professor David Price provided an insight into the GOAL of asthma management.  He claimed that as few as 5% of asthma patients will achieve all the targets and that 45% of Asthma patient neither attended or wanted to attend asthma clinics. Shocking statistics but he suggested we have to be realistic. The GMS contract allocates 72 points for achieved asthma targets and suggested looking at the way we as nurses consult with our asthma patients, be patient orientated and not target focussed, consult by telephone more. Total control aim is worthwhile and follow up care can be effective.

Dr John Blenkinsopp’s topic centred on nurse prescribing, training issues, changes in self-treatments for example the impending introduction of Simvastatin 10mg and Omeprazole 10mg being available to the public as a pharmacy medication.

Angela Mawle suggested the increasing importance of the role Practice Nurses can play in public health issues, also stating that the area of addressing the public health agenda should return to the domain of the local authorities.

Dr Mike Baxter’s topic looked at the impact of Diabetes in the 21^st century claiming obesity as the biggest reversible causative factor followed by inactivity.

Medications such as statins should be prescribed for all diabetics. Lowering systolic blood pressure from 141 to 137 may reduce cardiac risk significantly. He suggested aggressive treatments early, however multi prescriptions do tend to reduce compliance.

Day 2 focussed on Innovations in Practice

Beverly Malone gave a rousing speech providing food for thought. Advising us that the GMS contract and Agenda for Change provides Practice Nurses a great opportunity in shaping the developing Primary Care if we work together.

Three nurses followed providing the delegates with an insight into particular projects that have had specific impact in practice.

• Eileen Munson from Wales described a project that developed nursing and patient care in a particularly deprived area.
• Debbie Harris From England provided an account about setting up a nurse bank in Haringey.
• Margaret Clubb explained the project in Lothian to provide an introduction to nursing course for nurses wishing to work in primary care mentioning the recent training course for experienced practice nurses to train new nurses. 

 Avril Macdonald, a consultant nurse, talked about her role as a nurse consultant in promoting quality care in stroke patients.

Day 3 focussed on Liberating our Future

Penny Humphries looked at leadership at all levels claiming we are all leaders in some way and that leaders are also followers. Leaders need to keep their feet firmly grounded in reality and that passion, courage, consistency with personal and professional values can help deliver results and high quality care. Leaders do not need to make huge changes quickly as small changes will provide a pathway to improvements too.

Josie Irwin stimulated a great deal of discussion and interest in Agenda for Change (AFC). This in reality is an enormous undertaking. The radical restructuring of the pay and conditions for all workers in the NHS should harmonise conditions. She claimed that financially AFC would focus on health need, practice workload and quality care in determining funding. There would also be funding for development as well as staff costs. There is however a problem in practice with an ageing workforce and the recruitment and retention issue.

Professor Debra Humphries gave an interesting talk on multi professional education. This included the involvement of patients and carers more as knowledge and understanding of chronic diseases through increased education and internet access.

Dr Andrew Bishop discussed Coronary Heart Disease and the role Practice Nurses can play in managing this condition.

The conference experience was completed with a trip to the theatre on evening one to see a comedy Dr Hammond try to save the Health service. The second evening was a gala dinner at a country house with Jo Brand as the after dinner speaker.

I would recommend these conferences to any one. The next is in Guilford 2005. Website address is www.pn22.co.uk.  It would be nice to see a small group of Scottish nurses next year.

Shelagh Mason

Fife