This winter, GPs and Practices are working hard to find and visit members of the community who can’t come into Practice with the design of new home visiting services. They’re making sure the some of the most vulnerable people receive the same primary care nursing services as everyone else and are not disadvantaged due to being housebound.
Because every community is different, Primary Integrated Community Services is working with 11 small groups of Practices to design bespoke services tailored to local patient need. The small groups of practices are called Primary Care Networks (PCNs) and they can use funding from the NHS in different ways to improve the health and wellbeing of the residents of their neighbourhoods.
The teams are making sure that every contact counts by undertaking holistic assessments, including reviewing the management of patient’s long term conditions, checking if they are due immunisations and assessing whether there are at risk of falls or pressure damage.
While the roles and skills within each team are different, PICS provides training to ensure that every member of the teams listens to each person to find out what matters to them, making sure every contact with a patient counts. They are then are able to offer further support, referrals or signposting to other services. PICS also provides further induction, training, clinical supervision, mentoring, and operational support depending on the requirements of the PCN.
Spotlight on Mid Nottinghamshire…
Newark PCN: Back in 2021, Newark were the first PCN to work with PICS to recruit Nurse Associates, who visit patients in their homes and collect information to enable the GP team back at the practice to ensure long term conditions are being managed well. The Nursing Associates also provide support to the Newark care home team.
Rosewood PCN: The first in Mid Notts to recruit a Registered General Nurse. The team of three, a Community Practice Nurse, a trainee Nursing Associate and a qualified Nurse Associate, go out on home visits on behalf of five local practices to undertake assessments and collect data for monitoring long-term conditions. The team paused this programme in October to deliver 400 flu jabs to care home residents and housebound people.
Ashfield South PCN: have recruited new team of two prescribing nurses to manage long term conditions for the housebound patients registered at their eight practices.
Mansfield North PCN: have recruited two Community Practice Nurses and are recruiting for a Nurse Associate post.
Dr Thilan Bartholomeuz, Clinical Director of Mid Nottinghamshire Place Based Partnership and a local GP said:
“The housebound teams have been an invaluable service in visiting our most vulnerable patients and doing holistic reviews to address their health and care needs. Each Primary Care Network has designed services based on the needs of their communities, whether its reviewing of long term conditions, delivering flu vaccinations, community practice nursing or proactively assessing needs of housebound individuals and their frailty.”
Hazel Firmin, Deputy Chair of the Nottingham Nursing and Midwifery Council and Lead Nurse for Primary Care at PICS says,
“It’s really exciting work and an important opportunity to assess people who would not be able to attend an appointment at the GP Surgery. Every Practice works differently so we are learning a lot as we go to adapt to different ways of working, while also providing a consistent service across all the Practices. Working with the Practice teams, we are accomplishing much more than the task set, helping achieve wider goals such as identifying the risks associated with frailty, supporting carers and improving mental health.”
Focus on Nursing Associates
One of the new roles being recruited to is that of a Nursing Associate, or Trainee Nursing Associate. Often a stepping-stone toward becoming a Registered Nurse, the job is rewarding in itself, as Lisa Scott, Nurse Associate for Newark Primary Care Network explains below, and Hayley Pritchett, Trainee Nursing Assistant in Nottingham West Primary Care Network in Broxtowe describes in this video: https://youtu.be/CbepzndwM5E?t=469
Lisa Scott is a Nurse Associate employed by Primary Integrated Community Services on behalf of Newark Primary Care Network.
What do you do as a Nursing Associate?
I carry out phlebotomy, ECG, ear irrigation, observations, foot checks, cytology and I collect data for patient’s annual reviews if they have long term conditions such as Diabetes, Hypertension, Asthma, COPD, or Dementia.
My time is split equally between the GP practices in the Primary Care Network and the Care Homes that are linked to those practices. I mainly work in the community but do on occasion have a clinic in the surgery.
What difference does your role make for patients?
Our housebound and care home patients are now able to access services in the comfort of their own home or the care home. These are services which may have been difficult for patients to access if they were unable to get into the surgery, so we’re making NHS services more accessible for the most vulnerable patients. I also provide extra support for our Advanced Nurse Practitioners, Dieticians and GP practice staff by providing urgent services as and when needed, such as phlebotomy.
What advice would you give to anyone wanting to become a Trainee Nursing Associate or Nursing Associate?
I would say ‘go for it’! The University course is very good, and I found that gaining the underpinning knowledge was beneficial. It made me look at the patient holistically and improved the quality of care I was giving.
I found the placements were brilliant. I had placements in Emergency Departments, a Prison, and the community, which gave me a full insight into all the different areas of care.
The course takes hard work and determination to complete, but you get as much support as you need, and you make friends that will be with you for life.