Time for a new approach? The primary care practitioner.

Abstract

The GP workload and workforce crises have led to a number of NHS-led initiatives to increase the number and variety of allied healthcare professionals (AHCPs) available in primary care.1–3 GPs and practice managers have sought to fill empty GP posts with AHCPs without determining first whether the AHCP had the clinical knowledge, skills, and experience to work competently and safely in this role, and without appreciating the limitations in working autonomously and in prescribing that some AHCPs have. At present, AHCPs and GPs work in parallel, and their training programmes reflect this. A shared role would lead to a shared curriculum in which the AHCP and GP would have clearly defined roles and their training would be integrated. This would enable the role of the AHCP and the GP to develop synergistically, rather than in isolation. This article explores the benefits to both AHCPs and GPs in adopting this approach. At present, AHCPs tend to be employed by the practice to perform certain tasks, such as seeing patients with minor illness, or performing home visits, and it is this that often determines whether a physician associate, nurse, or paramedic is recruited. For other tasks, a physiotherapist or clinical pharmacist might be more appropriate. However, a lack of familiarity with the training programmes and regulations that govern these different AHCPs can lead to practices assuming that the AHCP has the appropriate training, experience, and scope of practice to work in these roles competently and safely, which is not always the case. For example, …