Abstract
Escalating costs and changing population demographics are putting pressure on primary care systems to meet ever more complex healthcare needs. Non-medical ‘advanced clinical practitioner’ (ACP) roles are increasingly being introduced to support service transformation. This paper reports the findings of a qualitative evaluation of nursing ACP roles across General Practices in one region of the UK. Data collection involved telephone interviews with 26 participants from 3 different stakeholder groups based in 9 practice sites: ACPs (n = 9), general practitioners (n = 8) and practice managers (n = 9). The data was analysed thematically. The study found a high degree of acceptance of the ACP role and affirmation of the important contribution of ACPs to patient care. However, significant variations in ACP education, skills and experience led to a bespoke approach to their deployment, impeding system-wide innovation and creating challenges for recruitment and ongoing professional development. In addition, a context of high workforce pressures and high service demand were causing stress and there was a need for greater mentorship and workplace support. System wide changes to ACP education and support are required to enable ACPs to realise their full potential in primary care in the UK.
Highlights
Across the world, health systems are increasingly challenged by the complex needs of ageing populations, health workforce shortages and escalating costs [1,2]
This paper reports on a project that aimed to explore how advanced clinical practitioner’ (ACP) nursing roles were being implemented within General Practitioners (GPs) practices in primary care in a single region of the UK
There were a total of 26 individuals in the sample: 8 GPs (4 male, 4 female), 9 ACPs (7 female, 2 male) and 9 Practice Manager (PM) (7 female, 2 male)
Summary
Health systems are increasingly challenged by the complex needs of ageing populations, health workforce shortages and escalating costs [1,2]. Amidst these challenges, there is a pressing need to develop effective and efficient primary health services to contribute to the global goal of universal health coverage [3]. In many countries, including the UK, current debates focus on achieving the optimum skill mix within primary care and the optimum models of service provision [4,5]. The NHS in each country are tax-funded services, and, some policy differences exist, they share many similar goals and challenges [6]. Primary care in the UK has traditionally been heavily dependent upon General Practitioners (GPs), medical doctors who work on their own or in groups/hubs referred to as ‘Practices’ or ‘General Practices’
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