Episodes

  • Podcast - NICE 2026 Hypertension Part 3 Starting Treatment and Targets

    Podcast - NICE 2026 Hypertension Part 3 Starting Treatment and Targets
    May 20 2026
    The video version of this podcast can be found here: · https://youtu.be/ab9q6W0B1OUThis episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE.NICE stands for "National Institute for Health and Care Excellence" and is an independent organization within the UK healthcare system that produces evidence-based guidelines and recommendations to help healthcare professionals deliver the best possible care to patients, particularly within the NHS (National Health Service) by assessing new health technologies and treatments and determining their cost-effectiveness; essentially guiding best practices for patient care across the country.My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I review a section of the NICE guideline on Hypertension in adults, always focusing on what is relevant in Primary Care only.I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The NICE clinical guideline on Hypertension in adults: diagnosis and management [NG136] can be found here: · https://www.nice.org.uk/guidance/NG136 TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I’m Fernando, a GP in the UK. Today we are reviewing the NICE guideline on hypertension in adults, always focusing on what is relevant in Primary Care only. In the last two episodes we covered the diagnosis and the criteria for urgent referral.Today we will focus on initial management, when to start drug treatment and how to monitor hypertension.Right, let’s jump into it.And let’s remember that the recommendations in the hypertension guideline apply to all adults, including those with type 2 diabetes. However, in some situations, management differs, and NICE recommends referring to other relevant guidelines, including those on chronic kidney disease, type 1 diabetes, and hypertension in pregnancy.Now let’s look at lifestyle interventions.We should offer lifestyle advice and continue to reinforce this periodically.We should ask about diet and exercise patterns, because a healthy diet and regular exercise can help reduce blood pressure.We should ask about alcohol consumption, and encourage a reduced intake if the person drinks excessively, as this can lower blood pressure and has broader health benefits.We should discourage excessive consumption of coffee and other caffeine rich products.We should encourage people to keep their dietary sodium intake low, either by reducing salt or using substitutes, as this can also reduce blood pressure.However, salt substitutes containing potassium chloride should not be used by older people, people with diabetes, pregnant women, people with kidney disease, or those taking certain antihypertensive drugs, such as ACE inhibitors or angiotensin receptor blockers.In these groups, we should focus on reducing salt intake ...
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    8 mins
  • Podcast - NICE News - April 2026

    Podcast - NICE News - April 2026
    May 13 2026
    The video version of this podcast can be found here: · https://youtu.be/35Yog27dOoAThis episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE.NICE stands for "National Institute for Health and Care Excellence" and is an independent organization within the UK healthcare system that produces evidence-based guidelines and recommendations to help healthcare professionals deliver the best possible care to patients, particularly within the NHS (National Health Service) by assessing new health technologies and treatments and determining their cost-effectiveness; essentially guiding best practices for patient care across the country.My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I go through new and updated recommendations published in April 2026 by the National Institute for Health and Care Excellence (NICE), focusing on those that are relevant to Primary Care only. I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The Full NICE News bulletin for April 2026 can be found here: · https://www.nice.org.uk/guidance/published?from=2026-04-01&to=2026-04-30&ndt=Guidance&ndt=Quality+standardThe updated guideline on acne vulgaris: management [NG198] can be found here:· https://www.nice.org.uk/guidance/ng198The updated guideline on suspected cancer: recognition and referral can be found here:· https://www.nice.org.uk/guidance/ng12/The updated guideline on Menopause: identification and management[NG23] can be found here:· https://www.nice.org.uk/guidance/ng23 The recommendations by the British Menopause Society on the management of unscheduled bleeding on hormone replacement therapy (HRT) can be found here:· https://thebms.org.uk/publications/bms-guidelines/management-of-unscheduled-bleeding-on-hormone-replacement-therapy-hrt/ The updated quality standard on ovarian cancer [QS18] can be found here:· https://www.nice.org.uk/guidance/qs18The updated guideline on Ovarian cancer: recognition and initial management [CG122] can be found here:· https://www.nice.org.uk/guidance/cg122 TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the episode description.Hello and welcome! I’m Fernando, a GP in the UK. In today’s episode, we’ll look at the NICE updates published in April 2026, focusing on what is relevant in Primary Care only. This month, we have a lot to cover and the areas are wide ranging: acne, the menopause and cancer, in particular endometrial and ovarian cancer and weight loss as a symptom of concern. Right, let’s jump into it.And let’s start with acne. The update does not change how we manage it. It’s still structured, stepwise, and based on severity.We should explain that there is no strong evidence for specific diets for acne.For mild to moderate acne, we should give a 12 week course of a...
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    9 mins
  • Podcast - NICE Hypertension Guideline Part 2: Investigations & Emergencies

    Podcast - NICE Hypertension Guideline Part 2: Investigations & Emergencies
    May 6 2026
    The video version of this podcast can be found here: · https://youtu.be/Ybf2fuw880YThis episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE.NICE stands for "National Institute for Health and Care Excellence" and is an independent organization within the UK healthcare system that produces evidence-based guidelines and recommendations to help healthcare professionals deliver the best possible care to patients, particularly within the NHS (National Health Service) by assessing new health technologies and treatments and determining their cost-effectiveness; essentially guiding best practices for patient care across the country.My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I review a section of the NICE guideline on Hypertension in adults, always focusing on what is relevant in Primary Care only.I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The NICE clinical guideline on Hypertension in adults: diagnosis and management [NG136] can be found here: · https://www.nice.org.uk/guidance/NG136 TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I’m Fernando, a GP in the UK. Today we are reviewing the NICE guideline on hypertension in adults, always focusing on what is relevant in Primary Care only. In the last episode we covered the diagnosis and initial assessment and then, we said that we would cover the investigations for target organ damage and the criteria for urgent referral in this episode.So let’s go through that now.Right, let’s jump into it.For all people with hypertension, we should offer the following investigations for target organ damage.We should test for protein in the urine by sending a urine sample for albumin to creatinine ratio, and test for haematuria using a reagent strip.We should take a blood sample to measure glycated haemoglobin, electrolytes, creatinine, eGFR, total cholesterol, and HDL cholesterol.We should examine the fundi for hypertensive retinopathy.And we should arrange a 12-lead ECG.Examples of target organ damage include left ventricular hypertrophy, chronic kidney disease, hypertensive retinopathy, or an increased urine albumin to creatinine ratio.Now let’s move on to identifying who to refer for same day specialist review.We should consider this when a person has severe hypertension, defined as a clinic blood pressure of 180 over 120 or higher. However, referral depends on more than just the blood pressure reading.So, we should refer people for same day specialist assessment if they have a clinic blood pressure of 180 over 120 or higher together with specific high-risk features.These include signs of retinal haemorrhage or papilloedema, which indicate accelerated hypertension. Accelerated hypertension refers to a severe increase in blood pressure to 180 over ...
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    8 mins
  • Podcast - NICE 2026 Hypertension Part 1 Diagnosis

    Podcast - NICE 2026 Hypertension Part 1 Diagnosis
    Apr 29 2026
    The video version of this podcast can be found here: · https://youtu.be/8QEsYYKKGu0This episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE.NICE stands for "National Institute for Health and Care Excellence" and is an independent organization within the UK healthcare system that produces evidence-based guidelines and recommendations to help healthcare professionals deliver the best possible care to patients, particularly within the NHS (National Health Service) by assessing new health technologies and treatments and determining their cost-effectiveness; essentially guiding best practices for patient care across the country.My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I review a section of the NICE guideline on Hypertension in adults, always focusing on what is relevant in Primary Care only.I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The NICE clinical guideline on Hypertension in adults: diagnosis and management [NG136] can be found here: · https://www.nice.org.uk/guidance/NG136 TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I’m Fernando, a GP in the UK. Today we are reviewing the NICE guideline on hypertension in adults, always focusing on what is relevant in Primary Care only. Today, we are focusing on the diagnosis and initial assessment.In subsequent episodes, we will cover the other sections. Right, let’s jump into it.And let’s start about the measurement of blood pressure. Because automated devices may not measure blood pressure accurately if there is pulse irregularity, for example due to atrial fibrillation, we should palpate the radial or brachial pulse before measuring blood pressure.If pulse irregularity is present, we should measure blood pressure manually using direct auscultation over the brachial artery.When measuring blood pressure in the clinic or in the home, we should standardise the environment and provide a relaxed and temperate setting, with the person quiet and seated, and their arm outstretched and supported.Furthermore, we should make sure that we use an appropriate cuff size for the person’s arm.Now, let’s look at postural hypotension.In people with symptoms of postural hypotension, including falls or postural dizziness, we should measure blood pressure with the person lying on their back, although we can consider a seated position if it is inconvenient to measure blood pressure with the person lying down.We should then measure blood pressure again after the person has been standing for at least one minute.If the person’s systolic blood pressure falls by 20 millimetres of mercury or more, or their diastolic blood pressure falls by 10 millimetres of mercury or more after standing for at least one minute, we should consider likely causes, including ...
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    7 mins
  • Podcast - NICE 2026 Type 2 Diabetes Guideline – Part 5: Insulin Treatment and Complications

    Podcast - NICE 2026 Type 2 Diabetes Guideline – Part 5: Insulin Treatment and Complications
    Apr 22 2026
    The video version of this podcast can be found here: · https://youtu.be/URcxCjFEFRMThis episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE.NICE stands for "National Institute for Health and Care Excellence" and is an independent organization within the UK healthcare system that produces evidence-based guidelines and recommendations to help healthcare professionals deliver the best possible care to patients, particularly within the NHS (National Health Service) by assessing new health technologies and treatments and determining their cost-effectiveness; essentially guiding best practices for patient care across the country.My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I review the NICE guideline on Type 2 diabetes in adults: management, always focusing on what is relevant in Primary Care only.I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The NICE clinical guideline on Type 2 diabetes in adults: management [NG28] can be found here: · https://www.nice.org.uk/guidance/ng28 TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I’m Fernando, a GP in the UK. Today we are looking at the new updated NICE guideline on type 2 diabetes in adults, always focusing on what is relevant in Primary Care only.The diabetes guideline is a comprehensive document, so I am breaking it down into clear and practical sections.Today, we are focusing on insulin-based treatment and the management of complications.In recent episodes, we covered the earlier sections.Right, let’s jump into it.First, let’s look at insulin-based treatments.When we start insulin in adults with type 2 diabetes, we should provide structured education. This education should cover aspects like injection technique, self-monitoring, dose titration, fitness to drive advice, managing hypoglycaemia, and managing acute changes in glucose.When initiating insulin, we should continue metformin in people already taking it.We should stop any other medicines used solely to manage hyperglycaemia.And we should discuss the risks and benefits of continuing medicines that have other benefits, for example cardiovascular protection or weight management.As initial insulin therapy, we should offer a basal insulin intended for once or twice daily use.If HbA1c is very high, especially 75 mmol per mol or higher, we should consider starting with basal insulin plus a short or rapid acting insulin. This can be given as separate injections, or as a premixed, biphasic insulin preparation.When choosing the insulin preparation, we should take into account whether the person needs help with injections, whether there is concern about nocturnal hypoglycaemia, and whether once daily injections would be preferred.If more than one basal insulin type is equally suitable, we ...
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    7 mins
  • Podcast - NICE 2026 Type 2 Diabetes Guideline – Part 4: Introducing Medicines and Treatment Escalation

    Podcast - NICE 2026 Type 2 Diabetes Guideline – Part 4: Introducing Medicines and Treatment Escalation
    Apr 15 2026
    The video version of this podcast can be found here: · https://youtu.be/dp6d3yH7AJsThis episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE.NICE stands for "National Institute for Health and Care Excellence" and is an independent organization within the UK healthcare system that produces evidence-based guidelines and recommendations to help healthcare professionals deliver the best possible care to patients, particularly within the NHS (National Health Service) by assessing new health technologies and treatments and determining their cost-effectiveness; essentially guiding best practices for patient care across the country.My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I review the NICE guideline on Type 2 diabetes in adults: management, always focusing on what is relevant in Primary Care only.I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The NICE clinical guideline on Type 2 diabetes in adults: management [NG28] can be found here: · https://www.nice.org.uk/guidance/ng28TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I’m Fernando, a GP in the UK. Today we are looking at the new updated NICE guideline on type 2 diabetes in adults, always focusing on what is relevant in Primary Care only.The diabetes guideline is a comprehensive document, so I am breaking it down into clear and practical sections.Today, we are focusing on how to introduce medicines, how to review them, and what to do when further treatment is needed after the initial regimen.In recent episodes, we covered the earlier sections of the guideline. In future episodes, we will move on to insulin-based treatment in more detail and the management of complications.Right, let’s jump into it.First, let’s look at introducing medicines.We should introduce medicines one at a time and check tolerability and effectiveness before moving on.When starting initial therapy with modified release metformin and other medicines, we should begin with metformin and confirm it is tolerated.If we are using an SGLT 2 inhibitor, we should start it once metformin is at the maximum tolerated dose.If we are also planning to use a GLP 1 receptor agonist or tirzepatide, we should introduce this once the SGLT 2 inhibitor is at the maximum tolerated dose.So even though the initial plan may involve more than one medicine, we still introduce them sequentially one at a time and monitor carefully.Now, let’s look at preventing diabetic ketoacidosis with SGLT 2 inhibitors.Before starting an SGLT 2 inhibitor, we should assess the risk of DKA.Risk factors include a previous episode of DKA, acute illness, dehydration, or following a very low carbohydrate or ketogenic diet.We should address modifiable risks before starting treatment. For example, if someone is on ...
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    7 mins
  • Podcast - NICE News - March 2026

    Podcast - NICE News - March 2026
    Apr 8 2026
    The video version of this podcast can be found here: · https://youtu.be/-kla7F8yibMThis episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE.NICE stands for "National Institute for Health and Care Excellence" and is an independent organization within the UK healthcare system that produces evidence-based guidelines and recommendations to help healthcare professionals deliver the best possible care to patients, particularly within the NHS (National Health Service) by assessing new health technologies and treatments and determining their cost-effectiveness; essentially guiding best practices for patient care across the country.My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I go through new and updated recommendations published in March 2026 by the National Institute for Health and Care Excellence (NICE), focusing on those that are relevant to Primary Care only. I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The Full NICE News bulletin for February 2026 can be found here: · https://www.nice.org.uk/guidance/published?from=2026-03-01&to=2026-03-31&ndt=Guidance&ndt=Quality+standardThe new guideline on Kidney cancer: diagnosis and management [NG256] can be found here:· https://www.nice.org.uk/guidance/ng256The guideline on suspected cancer: recognition and referral can be found here:· https://www.nice.org.uk/guidance/ng12/TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome! I’m Fernando, a GP in the UK. In today’s episode, we’ll look at the NICE updates published in March 2026, focusing on what is relevant in Primary Care only. This month, none of the updated guidelines were relevant to primary care. Only one new guideline had some relevance: kidney cancer: diagnosis and management.We will cover this briefly, focusing mainly on diagnosis and referring to the relevant section of the NICE guideline on suspected cancer, recognition and referral.Right, let’s jump into it.Before we go into kidney cancer itself, let’s briefly set the scene by looking at the NICE suspected cancer guideline. It is designed to help us recognise when symptoms may represent cancer and when to refer patients urgently.In urological cancers, we need to be aware that many cancers, including kidney and bladder cancer, may present with relatively non-specific symptoms.However, one symptom stands out as particularly important: that is, haematuria.Visible haematuria is the single most important red flag symptom for urological cancers.NICE recommends that we should make an urgent suspected cancer referral for bladder or renal cancer in adults aged 45 and over with unexplained visible haematuria, either without a urinary tract infection, or if it persists or recurs after treatment of a urinary tract ...
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    6 mins
  • Podcast - NICE 2026 Type 2 Diabetes Guideline – Part 3: Medicines Management and Initial Treatment

    Podcast - NICE 2026 Type 2 Diabetes Guideline – Part 3: Medicines Management and Initial Treatment
    Apr 1 2026
    The video version of this podcast can be found here: · https://youtu.be/7LiKkriN9tcThis episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE.NICE stands for "National Institute for Health and Care Excellence" and is an independent organization within the UK healthcare system that produces evidence-based guidelines and recommendations to help healthcare professionals deliver the best possible care to patients, particularly within the NHS (National Health Service) by assessing new health technologies and treatments and determining their cost-effectiveness; essentially guiding best practices for patient care across the country.My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I review the NICE guideline on Type 2 diabetes in adults: management, always focusing on what is relevant in Primary Care only.I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The NICE clinical guideline on Type 2 diabetes in adults: management [NG28] can be found here: · https://www.nice.org.uk/guidance/ng28 TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I’m Fernando, a GP in the UK. Today we are looking at the new updated NICE guideline on type 2 diabetes in adults, always focusing on what is relevant in Primary Care only. The diabetes guideline is a comprehensive document, so I am breaking it down into clear and practical sections.Today, we are focusing on medicines management, including sick day rules and choosing initial medicines.In recent episodes, we covered the initial sections of the guideline and in future episodes, we will move on to further drug treatment and the management of complications.Right, let’s jump into it.When discussing medicines, we should go through the benefits and risks of each option. This includes:· The effect on HbA1c and weight.· The effect on cardiovascular and renal outcomes.· Whether there are contraindications, such as pioglitazone in heart failure or metformin when eGFR is below 30.· Practical issues that might affect adherence.· And cost. If two medicines from the same class are equally suitable, we should use the least expensive option.If a person has more than one comorbidity, for example atherosclerotic cardiovascular disease and obesity, we should make a shared decision about which condition to prioritise. When discussing GLP 1 receptor agonists or tirzepatide we should explain the guidance on use in pregnancy and breastfeeding. We should explain that weight loss may improve fertility and that effective contraception must be used while taking these medicines. And if pregnancy is planned, contraception should continue for a period after stopping treatment.Now let’s move on to sick day rules.We should include clear sick ...
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    7 mins