Nurse home visits help ease pressure on GPs

Using advanced nurse practitioners for home visits helps reduce pressure on GP surgeries

Friday 9th August 2019

Advanced nurse practitioners could deliver home visits to patients to help reduce pressures on GPs, according to a new study.

A new model for delivering unscheduled primary care was launched in November 2017 as part of Aberdeen City’s Health & Social Care Partnership’s programme of activity.

Before, when a patient requested a home visit from their doctor’s surgery during the day, a GP would typically visit themselves.

Under the new scheme, the GP referred such calls in the afternoon to the Grampian Medical Emergency Department (G-MED) and an advanced nurse practitioner (ANP) would instead be sent to the patient’s home.

The most common referral reasons include vomiting, chest infections, abdominal pain, urinary tract infections and falls. Certain cases, such as illness related to pregnancy and psychiatric symptoms, were excluded and still seen by GPs.

In the first six months, there were 239 referrals to ANPs, with GPs reporting reductions in practice staff stress and having more time to see other patients.

GP practices spoke of time being saved, particularly through not having to leave the surgery. One said: ‘If we start our afternoon surgery and a request for a house call comes in, it’s very disruptive either to leave what we’re doing and leave the patient sitting for us to go and come back or leave the patient at home and delay the home visit ‘til after surgery’.

The ANP visits resulted in outcomes ranging from self-care advice and medication, to attendance at A&E and hospital admissions.

One issue raised was the issue of trying to recruit ANPs, but feedback suggested that other health professionals such as paramedic practitioners and district nurses could be trained up to deliver the service.

An evaluation study, led by Dr Calum Leask of Aberdeen City Health & Social Care Partnership, published in the Journal of Research in Nursing, has found it is feasible to use ANPs for unscheduled home visits instead of a GP.

It concluded: ‘Future work should look to embed this model on a larger scale and determine its cost-effectiveness compared to the traditional model.’