Of all the professionals working in the modern healthcare system, the role of general practice nurses and the work they do in delivering care is perhaps one of the most misunderstood, both in the perception of the general public and even among medical sector peers.
With the traditional responsibilities of a general practice nurse (GPN) spanning everything from Primary care services to social care, it has long been the case that GPNs have been fundamental to the provision of care. Today, with pressures from an ageing demographic and hospitals looking to return patients to their homes or to residential care as quickly as possible, GPNs are even more essential to the smooth running of the entire care process.
The role of the practice nurse
As current policy continues to shift care from hospitals to general practice, GPNs work alongside doctors, pharmacists and dieticians, as well as other specialists. In many cases the workload will be on a sole responsibility basis, although in larger practices several practice nurses may share duties and responsibilities on an ad hoc arrangement or employ a more formalised structure.
As might be expected of a role that covers so much ground, the skills and knowledge required make up an extensive list. Utilising a broad range of clinical and diagnostic skills will be an everyday occurrence, as is the need for certain non-medical prescribing solutions too. A significant breadth of expertise is required in order to support patients with all types of conditions, and this also means that understanding improvement methodology is a vital component too.
To work in general practice you need to be a qualified and registered adult, child, mental health or learning disability nurse, before then going on to take further training and education, or be willing to do so after being appointed. Experience in health promotion or working with patients with long-term conditions can be a bonus, although the first steps to becoming a general practice nurse can be taken without going to university straightaway. Entry points as a healthcare assistant or assistant practitioner are available for those with relevant experience and qualifications.
Out of hospital settings
Due to the wide-ranging nature of care that GPNs can be called on to provide, partners and delivery processes can vary by role and location. Qualified general practice nurses leading and delivering care within the community and ‘out of hospital’ settings can include being based at clinics and GP surgeries, or within residential and care home settings. Other circumstances can involve visits to patients’ homes and providing support for carers. The many and varied needs that arise from supporting patients with long term conditions mean that every contact counts, no matter the circumstances.
Modern everyday care
General Practice Nurse involvement in care delivery aims to improve the health and well-being of patients on a practice list. Although this can sometimes mean managing acute events, more often than not it is long term conditions requiring continuing care, medicines management and review that takes up the bulk of the work, with the overall aim of reducing avoidable hospital admissions.
The day-to-day work of a GPN would still be largely recognisable to a nurse from times past, but today's emphasis on a holistic package of care does have many more recent additions, as well as new technologies that improve communication, care management and multidisciplinary care structures. One thing that hasn't changed is the positioning in the local community of a GPN which enables the development of a lifelong relationship with patients. This means that services can be tailored to individual needs.
Another major aspect of the work of a general practice nurse that is time-honoured is a commitment to maintaining the highest possible levels of professional standards. Safe, high quality care is the hallmark of a successful system and that means adapting to circumstances by designing ongoing support for people on a bespoke basis. With long-term care needs increasingly becoming a shared responsibility – whether that includes NHS healthcare professionals, non-professional carers or third party private sector help – services need to be responsive to patients on a case by case level, as well as reflecting the needs of the wider community as a whole.
The future of care delivery
To actually understand the role of general practice nurses in care delivery, there is a need to look forward to the next set of challenges on the horizon. While no amount of planning can ever fully cover all eventualities, increasing life spans, the desire for people to stay in their own homes as long as possible, and the financial arrangements of how the cost of care will be covered, all play into an ever-changing scenario of possibilities. However, one thing is certain – the importance of the role that GPNs currently play is likely to become even more significant and wider ranging as more responsibility continues to fall on their shoulders.