People don't use Practice Nurses/ANPs enough

[TheMustressMhor]

I am always reading threads from people who cannot get GP appointments and I wonder why they don't book to see the Practice Nurse or Advanced Nurse Practitioner instead.

I know that these HCPs also have a long waiting list in many surgeries but they can and do diagnose and prescribe. They can also refer you on to the GP if necessary.

AIBU to think that most people do not understand the rold of the Practice Nurse/Advanced Nurse Practitioner and that their services are not used as much as they could be?

In my own practice there is a very competent ANP, one full-time GP and two part-time GPs.

There is also a Nurse available for dressings/smoking cessation clinics etc.

The ANP is the person I go to first with most problems.

Where I live (West Coast of Scotland) there is never a wait time to see any of the HCPs. That includes the GPs actually. If you phone for an appointment you will see someone either that day or in two or three days' time.

The two times I've seen a practice nurse I've had to go immediately to the GP as she had no idea what was wrong. The second time (shortly afterwards, same issue (rare) just a bit developed) she couldn't remember the first time. Even when she read the notes.

I wasn't filled with confidence.

So many of us older people are used to being referred to a doctor in the first instance. I'd rather see an ANP. I think next time I need to see someone I will ask. Thanks for the information!

My practice doesn’t have an ANP. There’s a practice nurse and a healthcare assistant.

^^I suspect this is the case for many. Ours has 2 but it's enormous and they aren't any easier to get in with 🤷🏻‍♀️

Its really hard to book a nurse at our surgery. I had real trouble getting an appointment after surgery to pack a wound. So not as easy here to book .

I've tried this before with mixed success.
First, it's totally unclear what they can and cannot do, so aside from patients already knowing that (for example) a nurse does the smears, it's totally unknown.

Since every GP waiting area is a barrage of health posters, I've always wondered why they don't have one near the check in desk saying who can cover what.

Bad experience: I booked an apt recently with the GP to get a referral to a local hospital. It didn't need any diagnosis, just the referral (something similar to: I have a problem that can be solved by Drug A or Procedure B. I used a gp apt to try Drug A for a week, gp told me to come straight back for the referral to hospital for Procedure B if it didn't work, it was clear cut... it didn't work. So instead of me being able to follow up with someone less busy, I had to waste (waste) another gp appointment to literally get that refer.. I felt so stupid taking up the slot but the Reception told me it had to be a gp appointment.. surely nurses would be great in that situation?!).

Good experience: made a gp appointment for birth injuries. This was before the GP six weeks check. GP didn't know how to help so liaises with colleagues & rang me at home. Told me to see nurse of some sort, she wasn't just a nurse, prescribed drugs too. She was amazing! Saw women with the same problem "all the time",it took a couple of weeks and the issue was sorted. I never would have thought an apt with her would have been appropriate, so inadvertently wasted another gp apt slot then too!! Hence my suggestions that it's totally unclear what apt to make with who.. a poster, a leaflet, something to help would be great. And on the gp appointment booking website too maybe?

I asked to see the nurse for a standard pill review. The receptionist booked me in with a GP. I have no idea why and tried to query it but she didn't really respond.

From reading some of these responses two things stand out:

a) some practices don't have ANPs and

b) some people don't realise that ANPs have wide prescribing and diagnostic powers.

I saw a practice nurse when I had quinsy, she got me seen by the ENT department within an hour. I was very impressed.

Im a gp receptionist and we have 3 APN. They have alot of knowledge. But people dont seem to understand that.

@StrawberrySquash

Maybe she booked you with a GP because your practice hasn't got an ANP? Practice Nurses cannot prescribe much. But ANPs can.

ANPs are a bit hit and miss. I know some practices with good ones and others that are "so-so" and patients end up seeing the GP anyway creating more work for the GP.

My recommendation would be... ready for it... it's quite life changing.... (ha ha!)

Go to your local pharmacy and ask for a private consultation with the pharmacist. They have had more training than an ANP have better meds management skills than an ANP and if a pharmacist says you need to see a GP - then you REALLY do! If they tell you to buy something over the counter - that is ALL YOU NEED.

Pharmacies are open from early til late and all over the weekend so you will ALWAYS get a same day appointment.

This is actually getting rolled out nationally and GP practices will book you to see the local pharmacist first - it really works. People who have been referred have said it is fab and convenient.

Yeah, you'll still get those who say, "I'm not telling you what's wrong with me" - fine, as YOU don't think it's important to tell us, we don't know how important your symptoms are and you can wait a week for a routine appointment. Thanks for wasting time cause you think you deserve to see a GP for your wart!

I'd def take an appointment with an ANP and/or pharmacist so I don't waste precious GP resources with trivial minor ailments.

@TaliZorahVasNormandy

Do you find that patients refuse to make appts. with your ANPs?

DH didn’t realise that a practice nurse was a person that you could see until last week. He had a number of nasty cuts that were starting to look infected. I suggested he called the doctors and ask to see the nurse. He was seen the same day and the wounds cleaned a dressed.

I'd def take an appointment with an ANP and/or pharmacist so I don't waste precious GP resources with trivial minor ailments

Same here. .

I don't care who I see, just to get an appointment is an achievement. Nurses are as hard to book in with as doctors at my surgery.
I needed a doctor last time i went but accepted the only appointment which was with a nurse. She didn't have a clue about my condition, spent the appointment moaning about how overworked she was, didn't examine me and misdiagnosed me, so they're not always the most appropriate to see.

I don't agree that pharmacists have had more training than ANPs though, @Tistheseason17

I think the training is just different.

Our local pharmacist is a nasty piece of work and I wouldn't ask him anything. I've tried in the past and given up with him.

Even the language used to describe the service is misleading.. I call mine "the GP surgery" but it's really a health centre isn't it? It has some GPs, nurses of various kinds, a blood place (I'm not sure what they do - tests maybe? It's just a room), a midwives room, and a social services room for elderly/child stuff too.

So even calling it the GP surgery isn't accurate

@TheMustressMhor I've seen nurses there before for pill and smear. I've no idea what was going on. In the end I called back another day, got another person who told me to get the GP to do it in an appointment I had already booked for another issue.

In general I'd like some (non hectoring) advice about how and what to book from the practice.

There’s no ANP at my GPs’ practice (London, 6 GP partners).

There are two practice nurses who do the following, according to the website:

Practice nurses can help with health issues such as family planning, healthy living advice, blood pressure checks and dressings. The practice nurses run clinics for long-term health conditions such as asthma or diabetes, minor ailment clinics and carry out cervical smears.

@IronicalCallSign

You're right about its being a Health Centre rather than a GP practice.

@LarkDescending

You're missing out at your practice, unfortunately.

It seems that there is a shortage of ANPs in the country.

People who have been referred [to pharmacist instead of nurse] have said it is fab and convenient.

Are you on commission??

Around here the experience is almost universally negative, the exception being the only independent pharmacist in the area. At best they are described as tick box exercises and worst innapropriate.

Our GP practice has employed their own part time pharmacist to do these reviews because patients were refusing to use the service in the chains (which have taken over high street pharmacies here). The pharmacist they employ used to be an independent and patients trust her. She gave up her own business because she simply couldn't compete with the likes of Boots.

I really wouldn't want to see a pharmacist instead of a nurse or doctor.

Funnily enough my GP practice has just started a trial of an in house pharmacist, because the local one is so shit that people aren't getting basic medication on time/accurately. I know because I've had to complain (massive delay to getting repeat prescriptions filled, I can't wait 2 weeks ffs between dropping it off and them deciding to fill it) and when I refused to have my prescription auto sent there in future, the GP reception lady said to her colleague "that's another one Margaret, can we update her notes so it's not sent to our pharmacy, this is the third refusal this week!" Then proceeded to reveal I'm not the only one with this ridiculous problem and I'd rather drive 15 mile to the next town to get it within a day or two, usually same day.

So,not a fan of my pharmacy locally, it's shit, and despite asking why so many delays for something they literally have in stock on the shelf, they confirmed it at dropping off,no real answer. I think they forget , going by the piles of papers everywhere, and bags and boxes tripping up staff near the service area... Just basic disorganisation..