Analysis

Primary care nurses receive training to take on more of GPs' roles

A partnership of GP practices is funding two-year master's programmes to train nurses 
Northern Ireland
  • Nurses on the programme are employed by a federation, not an individual GP
  • Nurses will be trained to take on 75% of GP roles
  • The scheme will be reviewed to assess its success

A cohort of five primary care nurses are being trained on a unique two-year masters programme in Northern Ireland.

Since starting in September 2017, the nurses have been studying one day a week at Ulster University, spending three days a week working in GP practices and the other day in tutorials.

Unusually, the nurses have been employed and funded by a partnership of GP practices called Federation of Family Practices Down a community interest company. Instead of being attached to one practice the nurses can spread their expertise and skills across GP surgeries in County Down, Northern Ireland.

Extended skills

...
  • Nurses on the programme are employed by a federation, not an individual GP
  • Nurses will be trained to take on 75% of GP roles
  • The scheme will be reviewed to assess its success

Picture: iStock

A cohort of five primary care nurses are being trained on a ‘unique’ two-year master’s programme in Northern Ireland.

Since starting in September 2017, the nurses have been studying one day a week at Ulster University, spending three days a week working in GP practices and the other day in tutorials.

Unusually, the nurses have been employed and funded by a partnership of GP practices called Federation of Family Practices Down – a community interest company. Instead of being attached to one practice the nurses can spread their expertise and skills across GP surgeries in County Down, Northern Ireland.

Extended skills

‘When we finish the course we’ll be trained to do 75% of things that GPs do,’ says advanced nurse practitioner Nicky Brown. ‘That means assessing, diagnosing and treating.’

Federation chair and GP Tony Ross says of the remaining 25%: ‘Nurses are not legally allowed to do things such as signing death certificates and may not have the same knowledge of mental health issues as GPs.’

The scheme, which is a trial and will be evaluated, also offers a new career pathway for primary care nurses, adds Dr Ross. ‘It will help promote nursing in general practice. It will help patients because they will be seen more quickly but it also brings a nursing element into the GP role. Nurses tend to deliver patient-centred care and focus on the holistic needs of patients. This will improve the quality of patient care.’

GP shortages

The strategy also aims to tackling severe GP shortages, set to worsen because one quarter of GPs in Northern Ireland are over 56 years of age.

The federation is funding the training programme using part of the Department of Health’s £30 million Transformation Fund, set aside in 2016 for ‘innovation, collaboration and prevention’. The programme will cost about £750,000 in total over the two years.

Dr Ross adds: ‘Nurses will be working autonomously and will bridge the gap between GPs, district nurses and nurses in nursing homes, bringing their individual skills. They will work across a group of practices under the supervision of GPs whereas in the past they were attached to individual practices. As far as I know, it’s unique.

‘We have a historical problem in Northern Ireland with funding of primary care. It’s always been at a low level, and it’s always been lower than other UK countries as a proportion of spending on NHS care overall.’

'We’re not trying to create mini-doctors'    

Ms Brown acknowledges that some doctors believe the NHS is cutting costs by getting nurses to fill the gaps in GP staffing on the cheap – and that patients will ultimately lose out because nurses cannot reach the same level of training. But she insists that GPs in the region are supportive of the strategy. ‘We believe more regions will follow us and the role of GPs and advanced practice nurses will become interchangeable. Other federations will come on board.’

Recognition

Ms Brown says the nurses on the course have been working at a high level of practice ‘in silence’ for many years and the course will provide formal recognition of their skills.

There are no conditions with the course and the nurses do not have to commit to work for any fixed time for the federation.

Ms Brown says that studying to such a high level is academically and emotionally challenging, but that GPs and senior nurses are supportive. ‘There’s always someone to go to if you’re struggling.’

Dr Ross adds: ‘We’re not trying to create mini-doctors. The scheme will allow practice nurses to realise their potential.’


About the author

Christian Duffin is a freelance writer

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