The Development of Nursing in General Practice in the UK Anne Baird, RGN, MA. Nurse Practitioner, Porter Brook Medical Centre, Sheffield annebaird1@nhs.net

Introduction I have been a nurse for 34 years and worked in General Practice / Family Medicine for 23 years Work in a large practice, 30,000 patients, about half of whom are students at the local University 12 Doctors, 9 Nurses, 2 Health Care Assistants Team work essential – Doctors refer to Nurses and Nurses refer to Doctors as appropriate

Screening and Health Promotion “Nursing includes the promotion of health, the prevention of illness, and the care of ill, disabled and dying people” (ICN, 2002) Screening and health Promotion are a key part of all nurses roles Opportunistic or planned Definition of Nursing, International Council of Nurses, www.icn.ch

History of Practice Nursing First Practice Nurses mentioned in 1960s Range of duties included Assisting the doctor Basic examinations Injections and dressings Health promotion and advice Cartwright A and Scott R. The work of a nurse employed in a general practice. BMJ, 1961.

Development of the Practice Nurse in the UK Aging population with more complex health needs Much of the management of chronic disease moved outside of hospital into General Practice eg asthma, diabetes, cardiovascular disease More emphasis on prevention - Health Promotion and Screening activities In 2015, 23,600 qualified nurses working in general practice

The role today Nowadays nurses take on an extended role in General Practice in the UK Treatment room duties, including taking blood samples, dressings, blood pressure Contraception and sexual health Chronic Disease Management First contact role – diagnosis and prescribing General Practice Nursing. RCGP General Practice Foundation, www.rcgp.org.uk

Screening All Practice Nurses have a role in screening Opportunistic screening - Blood Pressure, Alcohol, Weight management, smoking status Cervical cytology programme (in UK) owes much of its success to Practice Nurses as the main sample takers

Health promotion All Practice Nurses have a role in Health Promotion Support with lifestyle changes, eg smoking cessation Support for people in managing their own long term condition, eg asthma, diabetes Vaccination programmes – childhood programme delivered almost exclusively by Practice Nurses

Workshop Yesterday, in the workshop, we considered how nurses can develop their role in screening and health promotion We considered what activities nurses are already involved in and how they might further develop these We explored techniques such as Motivational Interviewing to assist nurses in developing their skills

Posters TB screening and prevention Hypertension and CVD prevention Monitoring of pregnant women Women’s health Immunisations Diabetes screening and support Obesity management HIV screening and prevention

The Future Nurses in Ukraine are already involved in a wide range of health promotion and screening activities Nurses need to be supported by being given the right skills and opportunities to take this forward and build on what they are already doing

Doctors and Nurses Working Together Respect for Roles and areas of expertise Recognise in some areas nurse knows more than doctor – vaccinations Working independently but referring to each other Training together – e.g. training course for asthma Talking to each other about patients Listen to each other as we do to our patients