Evaluation of an unscheduled care model delivered by advanced nurse practitioners in a primary-care setting

Abstract

Background Considering new models of delivery may help reduce increasing pressures on primary care. One potentially viable solution is utilising Advanced Practitioners to deliver unscheduled afternoon visits otherwise undertaken by a General Practitioner (GP). Aims Evaluate the feasibility of utilising an Advanced Nurse Practitioner (ANP) to deliver unscheduled home visits on behalf of GPs in a primary care setting. Methods Following a telephone request from patients, ANPs conducted unscheduled home visits on behalf of GPs over a six-month period. Service-level data collected included patient-facing time and outcome of visits. Practice staff and ANPs participated in mind-mapping sessions to explore perceptions of the service. Results There were 239 accepted referrals (total visiting time 106.55 hours). The most common outcomes for visits were ‘medication and worsening statement given’ (107 cases) and ‘self-care advice’ (47 cases). GPs were very satisfied with the service (average score 90%), reporting reductions in stress and capacity improvements. Given the low referral rejection rate, ANPs discussed the potential to increase the number of practices able to access this model, in addition to the possibility of utilising other practitioners (such as paramedics or physiotherapists) to deliver the same service. Conclusions It appears delivering unscheduled care provision using an ANP is feasible and acceptable to GPs.

Experiences of advanced clinical practitioners in training and their supervisors in primary care using a hub and spoke model

“…The development of a role was seen in previous research (Leask and Tennant 2019) and the role presented a useful addition to the knowledge and skills currently in the practice. Such roles may have had their genesis in past incarnations of the practice of the ACPiT but was identified and modified for use with the support of the GP.…”

Nurse practitioner work patterns: A cross‐sectional study

“…As with international development of NPs, Australia has developed a dynamic and flexible model of care, capable of adapting to changing community healthcare needs. NP models have been attributed to the provision of safe and effective healthcare delivery across several health service gaps (Fox et al., 2017) and are reported to practise in a variety of clinical settings including hospitals, community outreach, rural and remote health (Centre for International Ecomonics, 2013; Lowe et al., 2013) private practice (Helms et al., 2015) and primary care (Kelly et al., 2017; Leask & Tennant, 2019).…”