Let’s talk about something that gets wildly overlooked: nostrils. It’s maddening how often clinicians ignore the nose—as if breathing isn’t fundamental.
Yes, those two little caves we often ignore unless they’re actively running like taps. As clinicians, we pride ourselves on thoroughness — we listen, we percuss, we palpate… but how often do we actually shine a light up the nose?
Here’s a case for the humble pen torch.
Courtney from the office walks in, clearly anxious. She’s been feeling like she’s choking at night. No sore throat. No obvious infection. Two clinicians have already told her there’s not much to do. Understandably, she’s frustrated.
I ask if I can take a quick look up her nose.
She agrees.
Torch out. Nostrils lit.
And there it is: both nasal passages red, swollen — possibly with a polyp in one. It took me seconds. No advanced tools, no ENT degree, just a £2 pen torch and curiosity.
I advised her to start a steroid nasal spray, use steam inhalation, and gave her a brief rundown of allergic rhinitis management.
Today, she bounced into the office to thank me: the doctor confirmed exactly the same. She felt heard, reassured — and validated.
So why do we keep skipping the nose?
Looking up the nostrils can help identify:
- Allergic rhinitis (turbinates pale or swollen)
- Infective rhinitis (red, inflamed mucosa)
- Nasal polyps
- Deviated septum
- Foreign bodies (especially in children)
- Chronic sinus issues
- And treatments like intranasal corticosteroids (e.g. fluticasone, mometasone) are backed by strong evidence.
✅ A 2020 Cochrane review found that intranasal corticosteroids significantly improve nasal congestion, rhinorrhoea, sneezing, and itching in allergic rhinitis.
✅ NICE also recommends a trial of intranasal steroids for 2–4 weeks for persistent symptoms.
Yet… we forget to look. So here’s the quirky clinical pearl:
When in doubt — torch it out.
Don’t underestimate the diagnostic power of a glowing pen and a good look up the nostril.
Let’s stop skipping the sniffers and start solving more cases in seconds.
Why Dad’s Care Fell Apart — And What We’re Doing About It
Somewhere on my shelf sits a dog-eared copy of Managing Long Term Conditions, printed in 1984. I bought it back when shoulder pads were power and avocado bathrooms were aspirational. The book smells like dust and quiet wisdom, but the message? Weirdly current.
Because here we are, in 2025, still chasing the same idea: that care should be joined-up, human, and actually about… people. Not bits of disease on a spreadsheet.
Appointments were missed, or duplicated, or lost in admin space-time
It’s something Jo and I talk about often. We’re co-founders of the Aligned Care Programme — not because we had a clever idea in a brainstorming session, but because life gave us both a not-so-gentle shove.
For Jo, it started with her dad. He was admitted with complex conditions, and somehow every part of the system knew a bit about him — but no one seemed to know him. The person. The story. Jo was left piecing it all together She had to piece it all together like a jigsaw puzzle — except half the pieces were from a completely different box
My family’s experience? Same jigsaw puzzle, different pieces. We’ve had care, yes — some amazing people along the way — but always in fragments. One clinic didn’t know what the other was doing. Appointments were missed, or duplicated, or lost in admin space-time. And at the centre of it all was a person who just wanted to be seen as whole.
This is what the Health Services Safety Investigations Body found in April 2025: fragmented care in the NHS isn’t just frustrating. It’s unsafe. People with long-term or complex conditions are at greater risk of harm because the system expects them (or us, their families) to stitch it all together.
And yet — none of this is new. The book on my shelf said it in 1984. The BMJ said it in 2024. Good general practice works because it’s holistic. GPs who know your history, your quirks, your cat’s name, even. But if we keep slicing up services — one bit for the acute flare-ups, another for the ongoing stuff, and another for anything vaguely social or mental — we break the thread that makes care feel, well, caring.
That’s why Jo and I started the Aligned Care Programme. Not to add another layer of jargon, but to get back to what people actually need: aligned, personalised, joined-up care that sees the full story — not just the diagnosis code.
Because here’s the truth: health is more than biology. It’s biography. And if care doesn’t fit around someone’s story, then it’s just noise.
So maybe — just maybe — the future of healthcare isn’t about reinventing everything. It’s about finally doing the things we’ve known for decades, with a bit of humanity, a bit of curiosity, and a lot more listening. The new NHS plan talks about integration, continuity, and person-centred care — and that gives us hope. But we know from experience that plans alone don’t fix things. People do. Programmes like Aligned Care are here to make sure that vision doesn’t just sit in a PDF — it becomes real for the patients and families who need it most.
“This isn’t a future plan. It’s already happening. And it’s exciting.”
The third snotty child by 10am, all with viral symptoms and a worried parent in tow… and meanwhile, I’ve got a diabetic foot ulcer in Room 3 and an undiagnosed wheeze in Room 4. There has to be a better way.
As an ANP, I see first-hand how much of our clinical time is taken up by minor childhood illnesses — often things that could be managed safely and well elsewhere. And when I say “elsewhere,” I mean: your friendly, accessible, ever-reliable local pharmacist.
Pharmacists and the NHS Long Term Plan: A Perfect Match
The new NHS 10 year plan (2025) places a clear focus on delivering more care in community settings. Pharmacists are front and centre in this shift. With more roles in Primary Care Networks (PCNs), expanded access to training, and growing responsibility in minor illness management, pharmacists are perfectly positioned to support children and their families directly.
This isn’t a future plan. It’s already happening. And it’s exciting.
“Pharmacists are already becoming the first point of contact for so many families. Why not equip you to handle more of what’s already landing on your counter?”
Why Pharmacists Are Perfect for Paediatrics
Parents trust pharmacists. Children are already brought into your consultation spaces for nappy rash creams, colic remedies, and advice on coughs and colds.
With the right training, you could:
– Spot and manage common conditions like conjunctivitis, otitis media, and viral rashes
– Offer safety-netting and know when to escalate
– Reassure anxious parents with confidence and clarity
What Our Course Offers
Our Paediatric Minor Illness Course was designed to meet you exactly where you are. Whether you’re a community pharmacist, IP, or part of a PCN team, this course gives you:
A structured approach to common paediatric presentations
Guidance on red flags and when to refer
Case studies and real-world scenarios
Practical advice for effective parent communication
CPD accreditation and confidence you can use right away
We’re not turning you into a paediatrician — just giving you the tools to safely manage what you’re already seeing.
From My Perspective: Why It Matters
Here’s the honest truth: when pharmacists are equipped to manage minor childhood illness, I can focus on the more complex stuff. And GPs can too.
We all know the pressure on primary care isn’t going away anytime soon. But when we share the load, everyone benefits:
Children get faster care
Parents get answers without the wait
Clinicians can focus where we’re most needed
“You take the sticky-fingered pressure off me and my GP colleagues — and we all win (especially the kids).”
Want to Know More?
This course is designed to fit around your busy schedule and evolving role as a pharmacist. It aligns with the NHS vision for more community-based, pharmacist-led care — and it’s practical, flexible, and built with you in mind.
We know release for training can be a challenge, so we’ve made it easy:
✅ Two live online half-days (no full days away from practice)
✅ 12-week interactive self-learning module, packed with real-world scenarios and clinical know-how
As one delegate recently put it:
“One of the best courses I’ve ever done.”
👉 Find out more about the course: Live Online – Paediatric Presentations: From Minor Ailments to Red Flags – MA Training Enterprise
Thanks for all you do — and for helping me keep my stethoscope free for the big stuff.
Have questions or want to bring this training to your pharmacy team or PCN? Get in touch — I’d love to chat!
There has been heartbreaking cases in this country where parents’ concerns about their children were not listened to, with some tragically ending in death.
Although the focus of the report was in Australia and was in hospital settings, I couldn’t help but think:
How often might this be happening in primary care here in England?
Over the years, I’ve seen similar stories shared on social media—parents dismissed, symptoms overlooked, and fragmented care failing to connect the dots. As a nurse and educator, this deeply unsettles me.
In our minor illness courses, we always stress to clinicians:
“Parents know best—listen to them.”
But after today, I’ll be saying it louder.
One particular part of the report struck me hard:
If a parent expressed concern, their child was nearly four times more likely to require intensive care—even when vital signs appeared normal.
Their recommendation? “Include parental concern as a vital sign.” That statement couldn’t be more powerful—or more necessary.
Recently in Bristol, a mother whose son was initially told he might have mumps later found he had leukaemia. Her message?
“Trust your gut instinct—no one knows your child like you do. Keep pushing.”
That really hit home.
As clinicians, we often talk about gut instinct—those quiet nudges that tell us something’s not quite right, even when the numbers don’t scream danger. We trust our own instincts.
So why wouldn’t we value a parent’s instinct just as highly?
This isn’t just about listening. It’s about changing the culture of care—one where we respect, document, and act on what parents are telling us. Not as an afterthought, but as part of our core clinical assessment.
Let’s teach this. Let’s practice this. Let’s make parental concern a red flag in its own right.
Because a gut feeling could save a life.
Live Online – Paediatric Presentations: From Minor Ailments to Red Flags – MA Training Enterprise
Despite everything I know, teach, and practice, my own mum—who lives with us—still falls. It’s a humbling reminder that even with the best support, falls can and do happen. It doesn’t mean we give up; it means we keep learning, keep adapting, and keep looking at the whole person, not just their checklist of risk factors.
The National Institute for Health and Care Excellence (NICE) has released its updated guideline on preventing falls in older adults and in those aged 50 and over who are at higher risk. The guidance, published on 29th April 2025, focuses on early identification, tailored care, and multidisciplinary support to reduce preventable injuries, hospital admissions, and long-term loss of independence.
updated guideline on preventing falls in older adults and in those aged 50 and over who are at higher risk
Falls: Not Just a “Whoops” Moment
Let’s start with the hard truth. Around a third of people aged 65+ will fall this year. That’s not just garden-variety clumsiness; it’s 210,000 emergency hospital admissions in England alone. If you’re over 80, the odds are even worse—like betting on the weather staying dry at a British barbecue.
But it’s not all doom and gloom. The new NICE guideline zeroes in on early intervention, comprehensive assessments, and joined-up care. And here’s where primary care professionals—and training —can genuinely shift the narrative.
primary care professionals—and training —can genuinely shift the narrative.
What NICE Is Saying
The guidance recommends tailored care plans for anyone over 50 at higher risk, including those who:
- Have fallen recently and live with frailty
- Injured themselves or lost consciousness during a fall
- Needed help getting up afterward
- Have taken more tumbles than your average toddler learning to walk
It’s also big on:
Prevention through strength and balance training (Tai Chi, anyone?), medication reviews, and home safety checks
Where Training Steps In—Without Tripping Over Itself
Here’s the kicker: many of these preventable falls link back to modifiable risk factors. And guess what? You’re already tackling them in your day-to-day care—or could be, with a little extra support.
Our training doesn’t just tick CPD boxes—it’s practical, clinical, and yes, a bit quirky. We cover things like:
- Anticholinergic burden: Because meds that fog the brain or dry out the body are basically banana peels in tablet form.
- B12 deficiency: Subtle signs, big consequences—think “brain fog meets jelly legs.”
- Whole-person care: Managing long-term conditions while spotting the little signs that a patient might be heading for a fall (figuratively and literally).
Non-medical prescribers, GPs, practice nurses, and care coordinators all have a front-row seat to the lives of patients who might be falling through the cracks—often literally. That’s why our sessions are designed to give you the confidence and know-how to intervene early, adjust medications thoughtfully, and see the person, not just the polypharmacy.
The Bottom Line (And Let’s Keep It Upright)
Falls aren’t just accidents—they’re loud, clanging signals of unmet needs. NICE’s update is a timely reminder that the answers lie not only in multidisciplinary coordination but also in skilled, attentive, well-trained primary care teams.
So whether it’s adjusting a prescription, spotting early frailty, or just asking, “Have you had any slips recently?”—your role is vital. And with the right training, you’ll be even better equipped to stop the fall before it starts.
Let’s keep older people upright, independent, and dancing in their kitchens a little longer. That’s a cause we can all get behind.
I’m talking about learning that sticks—because it’s alive, memorable, and rooted in reality
Let’s be honest – things feel pretty unstable in the NHS at the moment. We have the NHS 2025/26 operational policy – and a new 10-year plan on the horizon – I’ve been thinking about what this next chapter means for training. And more importantly, what kind of training actually works when the pressure’s on, resources are tight, and morale is generally low.
The existing plan is ambitious: reduce wait times, streamline urgent care, digitise systems, and—thankfully—keep the spotlight on workforce productivity and retention. But underneath all the policy and percentages is something simpler: people. People who need to feel supported, skilled, and confident in what they do. Just like the MA slogan says: “we teach because you care.”
That’s where good training makes the difference. Not box-ticking. Not death-by-PowerPoint. And definitely not another muted webinar while people catch up on emails (we’ve all done it).
I’m talking about learning that sticks—because it’s alive, memorable, and rooted in reality.
This year, I’ve seen again how the right kind of training can lift people. The kind that makes tired nurses laugh, helps a new clinician spot something serious, or gives a community paramedic the confidence to shift into primary care. It’s not about slick platforms or perfect metrics—it’s about connection, story, and trust.
One of my favourite stories? A nurse who joined our minor illness training. During a role play, I wore a very dodgy wig, and when she asked, “What’s brought you here today?” I said, “A Volkswagen Golf.” She was learning to listen to chests.
Two years later, she emailed me. She’d recognised signs of a pneumothorax in her son—and got him straight to A&E. It possibly saved his life. Not because she clicked through slides and passed a quiz. But because something stuck.
It possibly saved his life
That’s the point. Training should energise, not patronise. It should respect the brilliant professionals who show up every day to do the hard stuff.
So as the NHS asks even more from its people—with fewer resources and rising pressure—I’m determined to continue to provide real learning. Human-centred, creative, and grounded in practice. And yes, I’ll keep bringing the wigs, the oddball scenarios, and the laughter.
If this new strategy has you rethinking how you train, build resilience, or get the best from your team—I’d love to chat. Whether it’s swapping stories, solving challenges, or creating something bespoke, I’m here for it.
Let’s make training that doesn’t just fill time—but fuels capability.