Developing New Roles
The primary care sector is beginning to deal with a serious shortfall in the number of GP consults. This puts a huge load on existing GPs and nurses, which in turn makes it harder to attract new doctors and nurses to the sector. By developing new roles, we are able to re-allocate tasks that might otherwise be done by GPs and nursing staff.
In this way, we can ensure that patients are receiving care in a timely fashion, from the right person first, while freeing up time for clinical staff to do what they’ve been trained for — as well as upskill. It also makes for an efficient business model, ensuring all clinicians are working at the top of their scope.
See below for some of the roles we’re developing
A complementary, qualified medical role that adds clinical capacity, efficiently. An increasing number of practices are employing physician associates to supplement the clinical team members, especially when there are GP and nursing recruitment issues. Physician associates typically have spent two years in training at medical school following a health-related profession or degree. They support GPs in patient diagnosis and management, taking of tasks such as test analyses, taking medical histories, performing examinations, and developing management plans. They work under the direct supervision of a doctor and are valuable when it comes to supporting timely unplanned care and chronic disease.
Medical Centre Assistants
These play a pivotal role in releasing nurse time for clinical care and improving patient flow.
Our current practices all value the role of the Medical Centre Assistant and is often cited as enabling some of the biggest change. These are unregistered staff who undergo accredited training to support clinical staff by taking on lower-level nursing and administrative tasks. These roles have no component of diagnosis or clinical judgement but have a large role to play in supporting clinical care, allowing nurses especially to spend more time on direct patient care.
Thanks to the Patient Access Centre increasing their capacity, most practices employ and develop Medial Centre Assistants from their existing reception staff.
Medical Centre Assistants can perform roles such as:
- Greeting patients as soon as they enter the practice and taking core health measurements, such as blood pressure, height and weight before the doctor or nurse consultation
- ECGs and spirometry
- Providing smoking brief advice
- Urine testing and phlebotomy
- Planning and organising records and equipment for the following day’s procedures
- Assisting at minor surgery
- Preparing and stocking consulting rooms
- Changing linen
- Ordering stock and clinical supplies
- Leading the morning huddle
Our practice pharmacists bring a depth and breadth of pharmaceutical knowledge and experience to patient care and the clinical team.
These add a much-needed specialist skill set to the primary care team. A clinical pharmacist works with the clinical team to target
patients with complex health and social care needs who are on multiple medications, ensuring that they maintain an optimal
drug regime. They complement the role of the community and hospital pharmacist.
They work to support medicine reviews, compliance and education and are integral to the Year of Care approach for patients with
In addition, they may also:
- Consult with patients, either face-to-face or over the phone,
- To review medications and answer any questions; these
- Review all hospital discharge notes to check that patients have been given the correct medication and dosage
- Follow up discharged patients to avoid any potential problems that could lead to re-admission to hospital
- Order blood tests and refer patients for a GP consultation if necessary
We are actively developing the Nurse Practitioner role as a key member of a Health Care Home team. As registered nurses who have specialist training in certain skills and many being prescribers, they complement the skills of the GPs. Not only does this add specialist expertise to the team, it means that patient care can be delivered by the right professional first time. Nurse Practitioners are invaluable in leading the Year of Care programme within a practice, supporting the nursing team in managing patients with more complex needs, expand the nursing expertise, skills and leadership that underpin our proactive care.
Community Health Workers
This is a new role we have introduced to some of our Health Care Home practices. Critical to supporting health and wellness, improving access and engagement and improving the outcomes of individuals the Community Health Worker is a trusted member of the team and has a close understanding of the local community served. This trusting relationship enables the Community Health Worker to serve as an advocate and conduit between the practice clinical team and patients, supporting behavioural lifestyle changes as part of an overall goal-centred care plan. We are seeing better clinical outcomes such as lower blood sugar levels, weight loss and improved exercise tolerance, engagement in preventative care and medicine compliance from those not using traditional services and patients reporting improvement in mental health and wellbeing.Much of this work occurs in other settings such as the marae and workplace and in peer group consultations rather than the traditional one to one.
We are piloting the role of a practice based social worker in the Coromandel. There is much evidence to show that this role adds another important dimension to the clinical team and the care a practice can provide, especially in areas of high need. Working alongside the GPs and nurses this role will help to support the greater social determinants of health and aimed at improving access and addressing health inequalities.