The Healthcare team within your Practice
The very nature of how healthcare services are delivered is changing across the United Kingdom and Wales. Recent challenges within your practice have allowed us to develop an enhanced healthcare team to ensure that you continue to receive the highest levels of quality and appropriate care.
Practice Nurses, including Triage Nurse
Practice nurses have become significantly more skilled over recent years and are now providing services to patients that were previously delivered by GPs. This is as a result of the training and development initiatives within the nursing profession, leading to the creation of roles such as nurse practitioners and independent nurse prescribers. Much of their work involves managing the care of patients with long-term
conditions and running a wide range of extended service clinics in the practice including:
long-term conditions – asthma, diabetes, blood pressure monitoring
childhood and travel vaccinations
General Minor illness
Non-urgent, Urine infections, Rashes, Sore Throats and Eyes (Think NURSE)
Advanced Nurse Practitioner (ANP)
The Advanced Nurse Practitioner is a Registered Nurse who has undertaken extra training to masters level who is able to provide complimentary services to GP’s, providing a high quality accessible service to patients.
Making autonomous decisions, having a broad in depth theoretical knowledge base, demonstrating clinical decision making and expert care for patients, being able to assess, diagnose, initiate treatment and evaluate care, which may include:
Undertaking clinical assessment, history taking and physical examination
Screening patients for disease risk factors and early signs of illness
Ordering investigations and providing treatment plans including counselling and health education
Prescribing of medicines
Referral of patients to secondary care and other health care professionals
Undertaking home visits
Working closely with GP’s and other members of our multi-disciplinary team
The role of the Health Care Assistant can vary depending on the number of services provided by practice nurses. They often provide assistance to nurses, as well as undertaking routine tasks such as phlebotomy, chaperoning and taking patient blood pressure and weight measurements for long-term conditions’ clinics.
A Physician Associate is a medical professional who supports Doctors in the diagnoses and management of patients.
A Physician Associate’s responsibilities include the following:
Take medical histories
Perform routine examinations
Analyse laboratory test results and X Rays
Treat minor injuries, which includes suturing and dressing wounds
Treat minor illnesses including prescribing the proper course of treatment
Administer First Aid
Administer medication, injections and IV
Develop management plans
Practices often have the support of a highly skilled Pharmacist who can deliver safe, high quality, effective and efficient care to patients. As experts in medicines and their use, they play a crucial role in supporting patients to take those medicines as part of a shared decision making process, as well as ensuring patients get the right medicines.
Having a pharmacist as part of the clinical team within a practice can relieve work pressure on GPs to free up time for the GP to spend with patients with complex medical needs. Pharmacists can play a significant role in managing patients with long term conditions such as asthma, diabetes and hypertension but can also be a resource in managing patients with complex medicines requiring frequent monitoring, patients with problematic polypharmacy or those with special medicine needs, for example in patients with poor kidney function.
A pharmacist can resolve problems with medicines by:
- Working closely with the GPs to resolve day to day medicines issues (similar to pharmacists working on hospital wards)
- Liaising with relevant hospital, community and primary care colleagues to en sure correct medicines follow up on transfer of care
- Working with practice teams providing clinical medicine advice to care homes and domiciliary care support
- Ensuring that problems highlighted during medicine use reviews in community pharmacies, particularly for those patients experiencing polypharmacy, are monitored
- Working closely with local community pharmacists to resolve problems with prescriptions
- Running chronic disease clinics and liaising with practice nurses on changes of medicines
Advanced Physiotherapist Practitioner
An Advanced Physiotherapist is able to help patients with the management of painful joint, ligament, tendon and muscle problems at your GP practice. Research has shown that 30% of GP consultations are related to musculoskeletal conditions (Eg: joints, ligaments, muscles, tendons or other soft tissues). If you have a painful or functional problem that is associated with your musculoskeletal system you can now see an Advanced Physiotherapy Practitioner (APP) instead of your GP. These professionals are experts in this field and will be able to assess, diagnose and give advice on how to manage your problem.
They are trained to identify possible serious pathology/conditions in the same way as doctors. If required, they can also refer you for investigations and can offer treatments such as injection therapy. The service is designed to give you the quickest possible access to a professional who can help you with your condition. If a referral to a hospital specialist such as an orthopaedic consultant or another health care professional is required, the APP can also organise this for you without you needing to see your GP.
This new service does not replace conventional physiotherapy services. Following assessment, if you require a course of rehabilitation, the APP will refer you to your local physiotherapy department. When you contact your GP practice, the administration team will ask about your problem. If it is associated with the musculoskeletal system, they will arrange for you to see an Advanced Physiotherapy Practitioner.
Advanced Paramedic Practitioners
Advanced Paramedic Practitioners (APP) are Paramedics who are undertaking or have undertaken the “Masters in Advanced Clinical Practice”. This qualification enables the paramedic to assess and diagnose and where appropriate treat the patient. The APP cannot currently prescribe medication due to regulatory arrangement, however they will discuss your condition with the GP and the GP will prescribe based on the recommendation of the APP. We are using the APP in Ty Elli to see acute patients and to undertake home visits where the GP feels it appropriate for the APP to undertake. By using the APP to see urgent on the day patients, the GP will be able to see complex patients and provide continuity of care for patients with certain long term conditions/ ongoing medical issues. We have been using APP across the Health Board since 2015 and have had positive feedback from both Patients and GPs.
The Advanced Paramedic Practitioners in the practice will either be wearing Paramedic Uniform, utilising a Welsh Ambulance Rapid Response Vehicle or will be in non-uniform. Both are paramedics but we are working in collaboration with the Welsh Ambulance Services Trust in collaboration to utilise these roles within the Primary Care setting- these will wear the paramedic uniform. The Health Board has also directly employed APP and whilst working for the Health Board they will not wear Welsh Ambulance Uniform.
A General Practitioner (GP) is your family doctor and is the main point of contact for general healthcare for NHS patients.
GPs are highly skilled doctors who support patients throughout their lives. They help you to manage your health and prevent illness and are trained in all aspects of general medicine. This includes child health, mental health, adult medicine, the
diagnosis and management of acute medical and surgical problems and the management of long term health conditions such as diabetes and asthma, ophthalmology (eyes), ENT (ear, nose and throat) and dermatology (skin). Many GPs develop ‘special’ interests in specific disease areas.
GPs assess, diagnose, treat and manage illness. They carry out screening for some cancers and promote general health and wellbeing. GPs act as a patient’s advocate, supporting and representing a patient’s best interests to ensure they receive the best and most appropriate health and/or social care. GPs also provide the link to further health services and work closely with other healthcare colleagues to help develop those services. They may arrange hospital admissions and referrals to specialists and they link with secondary and community services about your care, taking advice and sharing information where needed. They also collect and record important information from other healthcare professionals involved in your treatment.
A locum or sessional doctor is a fully qualified GP who works at the practice on a temporary basis to cover the regular doctors when they are away from the practice, for example on holiday or on maternity leave.
Practice Business Manager
The Practice manager is involved in managing all of the business aspects of the practice such as making sure that the right systems are in place to provide a high quality of patient care, human resources, finance, patient safety, premises and equipment and information technology. They support GPs and other medical professionals with delivering patient services and also help to develop extended services to enhance patient care.
Often receptionists will refer to the practice manager or other management if they cannot help you with your enquiry or if you are upset about something and want to raise a concern. The practice manager is usually the first port of call for receiving written complaints.
Call Handlers and administrative staff
Receptionists provide an important link for patients with the practice and are your initial contact point for general enquiries. They can provide basic information on services and results and direct you to the right person depending on your health issue or query. Receptionists make most of the patient appointments with the GPs and nurses. They also perform other important tasks such as issuing repeat prescriptions and dealing with prescription enquiries, dealing with financial claims, dealing with patient records and carrying out searches and practice audits.
It is vitally important that you give as much information to this group of staff as possible, without sufficient information they can’t prioritise or direct your issues to the most appropriate clinician.
Receptionists work under strict confidentiality policies, information given to them is only used for the purposes intended.
A health visitor is a registered nurse who has received training particularly related to babies, children and pregnant women. Their role is to provide families with children under five years old with support and advice around the general aspects of mental, physical and social wellbeing.
District nurses are one of the many different types of nurses who manage care within the community, rather than in a hospital or private clinic. They visit patients in their homes and provide the necessary advice and care regarding wound management, continence care, catheter care and palliative care amongst others.
These professionals are key members of the primary healthcare team. They play a crucial role in ensuring that patients get the necessary treatment at home thereby keeping hospital admissions and readmissions to a minimum and ensuring that patients can return to their own homes as soon as possible. This helps avoid overcrowding at hospitals and also helps patients receive care closer to home.
Social prescribing, sometimes referred to as community referral, is a means of enabling GP's, nurses and other primary care professionals to refer people to a range of local, non-clinical services. Recognising that people’s health is determined primarily by a range of social, economic and environmental factors, social prescribing seeks to address people’s needs in a holistic way. It also aims to support individuals to take greater control of their own health.
Time credits are prescribed to a participant, in return for a pledge that you give your time to the community in the future which is linked to your skills and interests to improve health and wellbeing. A time credit can be spent on a whole range of different activities across the country. You will receive 5 time credits on your first session which is non-committal.
You can earn more time credits, encouraging greater involvement in community activity. The ultimate goal is for a practitioner in a supporting setting to be able to use a tested tool that encourages healthy lifestyles, greater social engagement, and confidence building. In return you get the chance to share your skills and knowledge in a setting of your choice.
We have two Social Prescribers at Ty Elli, they are Andrew Pompa and Tracey Roberts-Jones. For more information please go to www.justaddspice.org