The urgent need for review, rationalisation and consolidation of NHS patient safety organisations.

John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, looks at two annual reports dealing with patient safety issues, which clearly show there is room for consolidation of patient safety agencies.

Ways to boost the healthcare support cohort.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers proposals to increase support worker numbers, which include taking a more co-ordinated approach and better training.

Raising the voice of specialist stoma care nurses: a call for a national strategy in stoma care.

Specialist stoma care nurses (SSCNs) are highly educated professionals who play a critical role in the care of people living with a stoma. However, they experience some unique challenges. Currently in the UK, stoma care has no national standards, targets or best practice pathway, resulting in significant variation and an undervalued service. As members of an evidence-based profession, SSCNs need to demonstrate their value. Specialist nurses in cancer care and inflammatory bowel disease are supported by nationally, with pathways, targets and standards of care, as well as career and education frameworks. This system could be used for SSCNs. A national approach is needed to develop an evidence-based best-practice pathway, commissioned and implemented across the UK for all stoma patients and with SSCNs at its heart. SSCNs need to demonstrate their value through data and evidence. Working with Getting it Right First Time, a taskforce aims to review the evidence and establish minimum standards of care for all stoma patients. SSCNs should be co-ordinators and drivers of change at the highest level of national innovation, policy and decision-making. The work of SSCNs should be is recognised and valued because what they do matters.

Legal aspects of dying and the community nurse.

In this month's Policy column, Iwan Dowie explores the legality behind caring for those approaching end of life.

The use of PICO™ single-use negative pressure wound therapy in the community settings.

The prevalence and incidence of wounds is predicted to rise due to an ageing population, that is also likely to have an increasing number of comorbidities (Dowsett et al, 2017). This trend will invariably result in increased costs to the NHS. The estimated annual cost of wound management in 2017/2018 was £8.3 billion. The cost of managing 70% of wounds which healed was £2.7 billion while it cost £5.6 billion managing only 30% of unhealed wounds (Guest et al, 2020). In view of these figures, it is important that health professionals (HPs) recognise wounds that are not progressing to healing at an early stage and implement all available treatment modalities to ensure that the wound does not become non-healing or stalled. Therefore, this article defines non-healing wounds, how to identify wounds at risk of becoming non-healing and the timely implementation of advanced treatment modalities, such as single use negative pressure wound therapy (sNPWT).

Exploring General Practitioners' Management of Self-Harm in Young People: A Qualitative Study.

BACKGROUND: General practitioners (GPs) are key to the frontline assessment and treatment of young people after self-harm. Young people value GP-led self-harm care, but little is known about how GPs manage young people after self-harm. AIM: This study aimed to understand the approaches of GPs to self-harm in young people and explore their perspectives on ways they might help young people avoid repeat self-harm. METHODS: We conducted semi-structured interviews with GPs from the National Health Service in England in 2021. GPs were recruited from four geographically spread clinical research networks and a professional special interest group. Data were analysed using reflexive thematic analysis. The study's patient and public involvement and community of practice groups supported participant recruitment and data analysis. RESULTS: Fifteen interviews were undertaken with a mean age of participants being 41 years and a breadth of experience in practice ranging from 1 to 22 years. Four themes were generated: GPs' understanding of self-harm; approaches to managing self-harm; impact of COVID-19 on consultations about self-harm; and ways to avoid future self-harm. CONCLUSION: Negative attitudes towards self-harm within clinical settings are well documented, but GPs said they took self-harm seriously, listened to young people, sought specialist support when concerned and described appropriate ways to help young people avoid self-harm. GPs felt that relationship-based care is an important element of self-harm care but feared remote consultations for self-harm may impede on this. There is a need for brief GP-led interventions to reduce repeat self-harm in young people. PATIENT AND PUBLIC CONTRIBUTION: A study advisory group consisting of young people aged 16-25 years with personal experience of self-harm and parents and carers of young people who have self-harmed designed the recruitment poster of this study, informed its topic guide and contributed to its findings.