Assessing the effectiveness of advanced nurse practitioners undertaking home visits in an out of hours urgent primary care service in England.

Abstract

To measure the effectiveness of advanced nurse practitioners (ANPs) against national quality requirements for out-of-hours (OOH) care, to compare ANP effectiveness with that of doctors working in the same service, and to evaluate the impact of ANPs on the service. There is little documented evidence of ANPs undertaking urgent home visits in the OOH setting. This study advances current knowledge of this aspect of the OOH service and makes recommendations for the management of the ANP urgent home visiting service. Analysis of 1,539 ANP home-visit patient electronic case notes over a 12-month period, a focus group of eight GPs, and interviews with six ANPs. Advanced nurse practitioners are as effective as GPs in undertaking urgent home visits. Their documentation is more consistent and their refer-on rate to secondary care is less than that of GP colleagues. Advanced nurse practitioners can provide equivalent clinical outcomes to GPs when undertaking urgent home visits. This study adds to the body of evidence for the positive impact of ANPs on OOH service delivery and managers can be assured that they are practising at a level that makes them effective and safe to undertake this role.