Nuffield calls for extended roles for health professionals in primary care
May 18 2016
Extending the primary care roles of nursing, community and support staff will be the best way to increase NHS capacity, the Nuffield Trust has proposed. Doing so will be “vital to enable the NHS to cope with changed patient demand in the future.”
However, it has warned that expanding workforce skills “presents big organisational challenges for NHS Trusts, and will not be easy to achieve in the current financial context. Despite this, changing staffing should be considered an urgent, ‘must-do’ priority for Trusts,” it said in a new report looking at new models of care.
The report is one of a number that have been published in recent months advocating the greater use of health professionals such as nurses, pharmacists, physiotherapists and paramedics to help ease the burden on medics across the NHS. Such a move will help increase the ability to manage more effectively the growing burden of chronic disease, it said.
The report, ‘Reshaping the workforce to deliver the care patients need’, includes a number of case studies, including the role of ‘paramedic practitioner’ (PP) created by South East Coast Ambulance Service in 2006 in response to the shift from providing solely an emergency service to mainly dealing with patients with long term conditions. “The PPs train on an 18-month part-time course and an eight-week GP placement, assess and treat patients with chronic illness, and treat patients with minor illness and injury – often in their own homes,” said Nuffield.
Another case study is the Haxby Group Practice of 10 GP surgeries across Hull and York. They found that a pharmacist could achieve in 35 hours what would take 60 hours to achieve regarding management of prescriptions.
The Group practice now employs three pharmacists for all 10 surgeries, whose main role is medicines management, “either remotely (over the telephone) or face to face. They also have a role in conducting prescribing audits and dealing with regulatory issues.”
Benefits include an improvement in the quality of medicines management with quicker, more reliable prescribing, reduced polypharmacy, and more patient and professional education. “Medication errors or adverse incidents have not increased.”
Launching the report, Candace Imison, report author and Nuffield Trust Director of Policy, said: “Our research shows that reshaping the NHS workforce can offer huge opportunities -for patients, through improved health outcomes, and for staff, through more rewarding roles and better career pathways. But we stress in our report that this is not simply a ‘nice to do’ - it is urgent, and essential if the Health Service is to find a sustainable balance between available funding, patient needs and staff needs, and deliver services fit for the 21st century.”
Dr Mark Porter, BMA chair of council, described the report as “a sensible assessment of the current situation that the NHS workforce is in. “The only way it will be possible to support doctors with their current workload in the short to medium term is to boost the support they have around them so they can manage patient demand.
“However, while we support the upskilling of the existing workforce and the introduction of new roles to assist with patient need, this should not be done at the expense of good quality training for doctors or, indeed, doctors themselves. It takes doctors many years to learn how to provide the best care for their patients, and there is no substitute for this kind of expertise and experience. There should be more staff support for doctors to help them coordinate the best possible care for their patients.”