NHS: Specialist nurses care for long-term conditions

EAST Cambridgeshire and Fenland PCT provide specialist nursing services for diabetes, heart failure and respiratory disease. Specialist nurses work closely with patients, carers, primary and social care to improve the care of people living with these long

EAST Cambridgeshire and Fenland PCT provide specialist nursing services for diabetes, heart failure and respiratory disease.

Specialist nurses work closely with patients, carers, primary and social care to improve the care of people living with these long-term conditions. The services aims to help individuals manage their own condition more effectively to improve their quality of life and reduce the occurrence of the complications associated with chronic conditions.

The services also aim to reduce the number of people with these conditions who require referral to hospital.

The specialist nurses provide clinics in some practices or will visit patients in their own home if they are unable to attend the surgery. They provide a service across the PCT, which also includes education and training for patients, carers and staff.


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The diabetes team has been established for nearly three years and now includes a diabetes care technician. This is a new role, which further enables the specialist team to provide ongoing education and support for those with diabetes, for both the management of their condition and for lifestyle change.

The British Heart Foundation (BHF) has recently funded a further two heart failure specialist nurses and the existing specialist nurse has been adopted by the BHF. This will allow a comprehensive service to be provided for patients and an increased level of support to primary care in the management of patients with heart failure.

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