AIMS The aim of the study was to evaluate the implementation and impact of the General Practice N... more AIMS The aim of the study was to evaluate the implementation and impact of the General Practice Nurse - Specialty Training (GPN-ST) programme across seven sites in one geographical location in the UK. The objectives were to understand, describe and evaluate: 1) the implementation of the 'proof of concept' training scheme; 2) the learning undertaken during the training; and 3) the impact of the training scheme on individual nurses. These objectives offer the opportunity to describe the potential return on investment for General Practices supporting nurses new to General Practice through the programme. BACKGROUND General Practice Nurses (GPNs) play a vital role in delivering primary and community care. In the UK there is a shortfall in the GPN workforce. Unlike training for other clinical professions there is currently no standardised training pathway or entry route for nurses wishing to work in General Practice. An ethnographic evaluation was undertaken of a one-year speciality training programme (GPN-ST). The programme, aimed at nurses new to General Practice, included formal higher education training and funded supported learning and mentoring whilst in practice. METHODS A qualitative ethnographic evaluation was undertaken. Observations were conducted of programme implementation, network and education meetings in the scheme. In-depth, semi-structured, interviews and focus groups were conducted with a wide range of professionals (n = 40) including nurse mentors, nursing students, academic providers, commissioners and the programme managers. These data were supplemented by documentary analysis of meeting notes, learning materials, internal student feedback and locally collected evaluation material in line with ethnographic approaches to research. Kirkpatrick's model for course evaluation and complimentary inductive emergent thematic analysis was used. FINDINGS There is evidence of learning at every level of the Kirkpatrick model from reaction through to changes in behaviour and results in practice for patients. The speciality training route offered opportunities for deep learning for GPNs. The scheme offered a comprehensive career pathway to General Practice nursing which in turn benefited General Practices. Practices benefitted from confident, independent nurses who were able to contribute to patient care, practice safely and also contributed widely in the long-term for example in research, workforce development and mentoring. CONCLUSIONS General Practice needs to invest in developing a workforce of GPNs, there are significant benefits to investing in the development of GPNs through a training pathway. This scheme provides scope for application in other clinical settings as well in other countries where there is a gap in career progression into GP practices. TWEETABLE ABSTRACT GPNs play a vital role in delivering primary and community care. Unlike training for other clinical professions there is currently no standardised training pathway or entry route for nurses wishing to work in General Practice. There are significant benefits to investing in the development of GPNs through a training pathway.
Background An extended role being explored globally is that of the advanced clinical practitioner... more Background An extended role being explored globally is that of the advanced clinical practitioner (ACP). In England this is an extended role for allied health professions, nurses and midwives. ACP education is organised by Health Education England (HEE) who organise an accredited training programme for ACPs alongside a multi-professional framework. This paper draws on research commissioned to evaluate the national implementation of the ACP role to inform the development of a Centre for Advancing Practice in the UK but has implications for others considering their ACP provision. This paper focuses on three key research questions: 1) What is the role of ACPs in England? 2) What are the barriers and facilitators to implementing the role? and 3) What is the contribution of ACPs to health services in England? Methods Semi-structured interviews were conducted in 2020 with 63 participants across a range of stakeholder groups and clinical areas. A purposive snowball sampling technique was u...
BackgroundUtilising skill mix in general practice is proposed as a solution to the demand-supply ... more BackgroundUtilising skill mix in general practice is proposed as a solution to the demand-supply issue. Pharmacists can play an important role in this context leading to an increase in training and funding for independent prescriber roles. A role for Pharmacists in General Practice was funded, piloted and evaluated by NHSE from 2015.AimWhat is the patient perspective of pharmacists in patient facing roles in general practice in the UK?Design & SettingFocus group interviews exploring patient perspectives on the pharmacist role.Method33 patients, five focus group interviews (January-December 2016). Data was iteratively analysed using the one sheet of paper technique.ResultsWhile public are aware of the primary care crisis, they are less well informed about potential solutions. Data showed patients primarily sought access to a clinician over expressing a preference for any type of clinician. Low awareness was shown about the role and there was initial confusion about pharmacist’s roles...
In recent years the UK has seen a significant change to the operationalisation, delivery and cult... more In recent years the UK has seen a significant change to the operationalisation, delivery and culture of primary care services, from GP-led healthcare to patient-centred care provided by a multidisciplinary team (MDT). This may include a wide range of professional groups including doctors, nurses and pharmacists working at a range of levels alongside other allied health professionals. This chapter reflects on notions of ‘conversation as learning’. As an educational ethnographer and consultant, I use Lave and Wenger’s (Situated Learning: Legitimate Peripheral Participation. Cambridge University Press, 1991) model of situated learning as an analytical perspective to consider how learning occurs in primary care settings. Within the broad communities of practice framework, it is acknowledged that ‘conversation and communication’ are key features which impact on social experiences and learning. This chapter highlights an empirically based approach to analysing real-life language data whic...
AIMS The aim of the study was to evaluate the implementation and impact of the General Practice N... more AIMS The aim of the study was to evaluate the implementation and impact of the General Practice Nurse - Specialty Training (GPN-ST) programme across seven sites in one geographical location in the UK. The objectives were to understand, describe and evaluate: 1) the implementation of the 'proof of concept' training scheme; 2) the learning undertaken during the training; and 3) the impact of the training scheme on individual nurses. These objectives offer the opportunity to describe the potential return on investment for General Practices supporting nurses new to General Practice through the programme. BACKGROUND General Practice Nurses (GPNs) play a vital role in delivering primary and community care. In the UK there is a shortfall in the GPN workforce. Unlike training for other clinical professions there is currently no standardised training pathway or entry route for nurses wishing to work in General Practice. An ethnographic evaluation was undertaken of a one-year speciality training programme (GPN-ST). The programme, aimed at nurses new to General Practice, included formal higher education training and funded supported learning and mentoring whilst in practice. METHODS A qualitative ethnographic evaluation was undertaken. Observations were conducted of programme implementation, network and education meetings in the scheme. In-depth, semi-structured, interviews and focus groups were conducted with a wide range of professionals (n = 40) including nurse mentors, nursing students, academic providers, commissioners and the programme managers. These data were supplemented by documentary analysis of meeting notes, learning materials, internal student feedback and locally collected evaluation material in line with ethnographic approaches to research. Kirkpatrick's model for course evaluation and complimentary inductive emergent thematic analysis was used. FINDINGS There is evidence of learning at every level of the Kirkpatrick model from reaction through to changes in behaviour and results in practice for patients. The speciality training route offered opportunities for deep learning for GPNs. The scheme offered a comprehensive career pathway to General Practice nursing which in turn benefited General Practices. Practices benefitted from confident, independent nurses who were able to contribute to patient care, practice safely and also contributed widely in the long-term for example in research, workforce development and mentoring. CONCLUSIONS General Practice needs to invest in developing a workforce of GPNs, there are significant benefits to investing in the development of GPNs through a training pathway. This scheme provides scope for application in other clinical settings as well in other countries where there is a gap in career progression into GP practices. TWEETABLE ABSTRACT GPNs play a vital role in delivering primary and community care. Unlike training for other clinical professions there is currently no standardised training pathway or entry route for nurses wishing to work in General Practice. There are significant benefits to investing in the development of GPNs through a training pathway.
Background An extended role being explored globally is that of the advanced clinical practitioner... more Background An extended role being explored globally is that of the advanced clinical practitioner (ACP). In England this is an extended role for allied health professions, nurses and midwives. ACP education is organised by Health Education England (HEE) who organise an accredited training programme for ACPs alongside a multi-professional framework. This paper draws on research commissioned to evaluate the national implementation of the ACP role to inform the development of a Centre for Advancing Practice in the UK but has implications for others considering their ACP provision. This paper focuses on three key research questions: 1) What is the role of ACPs in England? 2) What are the barriers and facilitators to implementing the role? and 3) What is the contribution of ACPs to health services in England? Methods Semi-structured interviews were conducted in 2020 with 63 participants across a range of stakeholder groups and clinical areas. A purposive snowball sampling technique was u...
BackgroundUtilising skill mix in general practice is proposed as a solution to the demand-supply ... more BackgroundUtilising skill mix in general practice is proposed as a solution to the demand-supply issue. Pharmacists can play an important role in this context leading to an increase in training and funding for independent prescriber roles. A role for Pharmacists in General Practice was funded, piloted and evaluated by NHSE from 2015.AimWhat is the patient perspective of pharmacists in patient facing roles in general practice in the UK?Design & SettingFocus group interviews exploring patient perspectives on the pharmacist role.Method33 patients, five focus group interviews (January-December 2016). Data was iteratively analysed using the one sheet of paper technique.ResultsWhile public are aware of the primary care crisis, they are less well informed about potential solutions. Data showed patients primarily sought access to a clinician over expressing a preference for any type of clinician. Low awareness was shown about the role and there was initial confusion about pharmacist’s roles...
In recent years the UK has seen a significant change to the operationalisation, delivery and cult... more In recent years the UK has seen a significant change to the operationalisation, delivery and culture of primary care services, from GP-led healthcare to patient-centred care provided by a multidisciplinary team (MDT). This may include a wide range of professional groups including doctors, nurses and pharmacists working at a range of levels alongside other allied health professionals. This chapter reflects on notions of ‘conversation as learning’. As an educational ethnographer and consultant, I use Lave and Wenger’s (Situated Learning: Legitimate Peripheral Participation. Cambridge University Press, 1991) model of situated learning as an analytical perspective to consider how learning occurs in primary care settings. Within the broad communities of practice framework, it is acknowledged that ‘conversation and communication’ are key features which impact on social experiences and learning. This chapter highlights an empirically based approach to analysing real-life language data whic...
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Papers by Claire Mann