There is no denying that 2020 has been an unusual year. Across professional and personal lives, plans have had to be changed or cancelled—the features list I developed for 2020 at the end of last year was turned on its head as guideline after guideline was delayed, and our focus shifted to coverage of the COVID-19 pandemic and its impact on primary care. At least hope is now on the horizon as the first COVID-19 vaccines are being administered this month, although mass rollout of the vaccination programme is yet another challenge that primary care will have to face over the coming months.

COVID-19 has had an impact on almost every aspect of primary care because many consultations are now held remotely. Dr Anne Connolly explores how to manage patients with abnormal uterine bleeding, including remote management and when examination and investigations are required. After reading the article, you can test how you would apply your knowledge in a clinical setting using the hypothetical patient case studies.

Another article in this issue that considers the impact of COVID-19 is a top tips piece on learning disabilities. Dr Claire Davies highlights the impact of COVID-19 on this group, and provides tips on identifying patients with learning disabilities, making the practice learning-disability friendly, and conducting effective annual health checks. Test your updated knowledge using the multiple-choice questions after you have read the article.

Also in this issue of Guidelines in Practice:

  • Dr David Stephens explores recent strategies for assessing fragility fracture risk and introduces a consensus guideline to assist primary care in the assessment, management, and treatment of osteoporosis. A useful summary algorithm from the consensus guideline is included, as well as specific guidance for use during the COVID-19 pandemic
  • Dr Aisling MacCormac describes the symptoms of sicca syndrome and provides top tips for diagnosis and management in primary care. The article includes a helpful summary table of potential underlying causes of sicca syndrome, including their differing pathophysiologies, clinical features, and diagnoses

Younger man applying eye drops

Top tips: sicca syndrome

Dr Aisling MacCormac

  • in the View from the ground, Dr Abbie Brooks explains how social media has proved to be a valuable tool for the practice to communicate important information to patients throughout the pandemic.

Last month, we held our first exclusively virtual Guidelines Live conference. The event was a great success; over 1000 healthcare professionals attended on the day to watch expert speakers deliver presentations around guideline implementation on a range of clinical topics, including COVID-19. In this issue, we cover the highlights of the event. It’s not too late to get involved—all of the sessions are available to watch on demand until 17 January 2021 at:

Looking ahead to next year, it’s likely that COVID-19 will remain a focus for Guidelines in Practice for at least the start of the year—articles on the COVID-19 vaccination programme and long-term COVID-19 symptoms will feature in our January 2021 issue. We will continue to cover new guidelines on a range of topics as and when they are published, including NICE guidance on chronic pain, atrial fibrillation, and acne vulgaris. If you have any suggestions for topics you would like to see covered in Guidelines in Practice, please get in touch.