GP practices link with a wide range of other primary care services (e.g., dental, pharmacy, physiotherapy, podiatry, audiology) to provide comprehensive services to their local populations. At the minimum, most employ nursing staff (e.g., Practice Nurses, Nurse Practitioners or Advanced Nurse Practitioners) and ancillary staff (e.g., Phlebotomists or Healthcare Assistants), as well as Receptionists and a Practice Manager (PM). The structure and organisation of practices can be variable. Primary care services are commissioned from a practice by geographically based ‘Clinical Commissioning Groups’ (CCGs) funded by the NHS. GPs operate as businesses and can either be partners in a practice or salaried employees. 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’. The NHS in each country are tax-funded services, and, although some policy differences exist, they share many similar goals and challenges. In the UK, health has been a devolved responsibility of its four countries (England, Scotland, Wales and Northern Ireland) since the late 1990s and each country has its own ‘National Health Service’ (NHS). 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. 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. System wide changes to ACP education and support are required to enable ACPs to realise their full potential in primary care in the UK.Īcross the world, health systems are increasingly challenged by the complex needs of ageing populations, health workforce shortages and escalating costs. 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. ![]() ![]() 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. The study found a high degree of acceptance of the ACP role and affirmation of the important contribution of ACPs to patient care. 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). This paper reports the findings of a qualitative evaluation of nursing ACP roles across General Practices in one region of the UK. Non-medical ‘advanced clinical practitioner’ (ACP) roles are increasingly being introduced to support service transformation. Escalating costs and changing population demographics are putting pressure on primary care systems to meet ever more complex healthcare needs.
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