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Use advanced nurse practitioners to fill gap in GP workforce

Written by: | Published:

Crystal Oldman Crystal Oldman

In February 2015, the Migration Advisory Committee decided not to place nursing roles on the shortage list for recruitment overseas. This might be surprising when it is reported that many providers in the UK are relying on overseas nurses to fill vacancies.

Nursing has always relied on a supply of overseas nurses in the UK, and they bring a richness of experience and diversity to the workforce and the communities they serve. Generations of nurses from overseas have joined our community nursing teams since the 1960s and they have been essential to the delivery of NHS services.

In the UK, we also have a shortage of GPs and we are seeking to attract them back from the countries to which they emigrated. One of the ways in which this GP shortfall is being addressed is the recruitment of physician associates.

These healthcare practitioners have had two years of clinical training following a degree in a related subject, such as biomedical science. They work under the direction of a registered medical practitioner, in a hospital or a GP surgery. Physician associates are employed at band 7 – a level that would take nurses many years of education, development and experience to reach and is reflective of an advanced nurse practitioner (ANP) in primary care.

Physician associates cannot prescribe and are unregulated – although there are intentions to resolve the issue of professional regulation in the UK. They also appear to be without the well-defined career pathway that nurses and doctors enjoy.

Developing and employing more ANPs in primary care would directly address the shortage of GPs. ANPs are educated to undertake all the areas specified in physician associate training, such as taking medical histories; performing examinations; diagnosing illnesses; analysing test results; developing management plans. Moreover, ANPs can prescribe and are registered practitioners.

An opportunity is being missed for communities to be supported by skilled, experienced and knowledgeable nursing specialists within our nursing workforce.

The QNI will actively support the development of more ANPs in 2015 as a critical element of the primary care workforce.

We will also be seeking your views on this in our forthcoming survey of nurses working in general practice.

Crystal Oldman, chief executive,
Queen's Nursing Institute

What do you think? Leave a comment below or tweet your views to @IndyNurseMag

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Comments

Advanced Nurse practitioners have the skills and capability to work autonomously, Practice associates are not prescribing or request ion Chest X Ray's. In addition most come with the benefit of several years experiential learning.
Posted by: ,
I dare say there will be more than enough room for a diverse range of professionals to see patients. Whether PA's will take off is yet to be seen. I love my NP role and it has taken me every moment of five years to learn my craft and that's after (mumble mumble) many years at the bed pan end of the bed and I still learn every day. I have had to part fund my MSc course and I bet that a bio medical degree isn't a walk in the park either, my degree of course was nursing based, my MSc is also nursing based. My diploma was nursing based and my NVQ before that was care based, my mums a nurse, my aunties a nurse, I married a nurse. None of this allows me to be part of someones care, I have to be a member of the NMC and my membership gives me the honour of supporting someone through times of ill health until they no longer need me. My NMC registration looks like any other nurse on the register there's no special NP section although it is recorded that I prescribe. I have met lots of Np's who don't have any specialist qualifications so the PA's training likely trumps that scenario (on paper). It annoys me that although registered we have no specialist NP register; it allows anyone to put practitioner on the end of their nursing job title. I already work with pharmacists based in our surgery (registered) the midwife (registered), the skilled clinical specialist nurses (registered), kick ass management (registered) and who knows in the future I may well be working with paramedics who can also consult, diagnose, prescribe and treat (without an ambulance but also on a register). Our GPs work hard, they need the help from people with skills and competence. As long as people put GPs on a pedestal; 'we' are going to have problems, they worry just like us, only have two hands and 24 hours in the day. Carry on blindly thinking that financial incentives will cure the Gp figures and you miss the very idea of why any person goes into health care, status may inflate bank accounts, egos and dinner invites but a patient feeling better... priceless.
Posted by: ,
Working in primary care as an advanced nurse practitioner I read Crystals article and felt finally someone else sees what I see!there are many nurses who with a small amount of extra training could step up to this role and already have years of experience in the communities where they work and people skills in 'oodles'. Why make yet another tier and another title in primary care for people to misunderstand.
Posted by: ,
The clue is in the title advanced nurse practitioner not general practitioner, it takes ten years to complete the training to be a gp.this is highly academic and totally different from an advanced nurse practitioner.If anps can do the job of a gp why train a gp.I am an anp but understand the fundamental difference.I am concerned that employers patients and nurses do not.These are serious concerns that potentially could have serious consequences if the press propagate the view nurses can replace doctors.
Posted by: ,
The clue is in the title advanced nurse practitioner not general practitioner, it takes ten years to complete the training to be a gp.this is highly academic and totally different from an advanced nurse practitioner.If anps can do the job of a gp why train a gp.I am an anp but understand the fundamental difference.I am concerned that employers patients and nurses do not.These are serious concerns that potentially could have serious consequences if the press propagate the view nurses can replace doctors.
Posted by: ,
Nurses are often happy to take on more responsibility if they are paid appropriately and get the commensurate terms and conditions. Using nurses as a 'cheap fix' is not on. Pay and conditions need to addressed first
Posted by: ,
I have been fulfilling this role in general practice for 3 years, patients are extremely satsified with the quality care they receive and my GP colleagues are also incredibly grateful for the ANP role as it enables them to focus on more complex patients. If the ANP role was valued more in general practice it could totally transform Primary Care.
Posted by: ,
As a Practice Nirse I couldn't agree more with this idea. It makes sense on so many fronts and would help the career path of someone like myself who is becoming increasingly frustrated by the lack of structure to my career. I am a highly committed nurse with qualifications in COPD, Diabetes and Minor Illness, as well as a degree in Human Biology and am very interested in becoming an ANP yet am finding it hard to find funding / advice
Posted by: ,
huddersfield uni has been forced to stop training ANPs due to funding for backfil whilst students are in uni and doing clinical practice with GP or ANP mentors being withdrawn.
Posted by: ,
I really hope Crystal's comments are considered to be of really value. As a nurse working in advanced practice I would be extremely interested in this type of role. I think community matrons are well placed to assume this role.
Posted by: ,
So why is the funding for ANP training being diverted into training new practice nurses ?
Posted by: ,
I have said the following for a long time, to save the NHS millions.
Have only salaried GPs
Use ANPs and pay them correctly
Employ physiotherapists in general practice. All makes sence
Posted by: ,
I have said the following for a long time, to save the NHS millions.
Have only salaried GPs
Use ANPs and pay them correctly
Employ physiotherapists in general practice. All makes sence
Posted by: ,
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