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.

Pressed post too soon!

Soó since they can't even fill a prescription, I wouldn't trust them to offer holistic health advice!

My local pharmacy have to dispense some medication for me weekly, on Mondays.

Needless to say, the pharmacy is often shut on Mondays due to bank holidays.

Last week they were shut on Monday because the whole of the Highland Region medical service was closed for training.

She could have rung me on Saturday and let me know so that I could have picked up the medication then. Did she? No.

So I have changed my collection day to Friday now, as the pharmacist is incapable of letting me know that the pharmacy is once again shut on a Monday.

Would I go there with medical problems? Would I fuck.

The ANP at my surgery is always my first call she’s brilliant!

I actually think her predecessor as village pharmacist was worse, though.

He would often let me come in to collect my medication, only to tell me that he hadn't received the prescription.

I then had to go to the surgery and beg a prescription from them. Why couldn't he have let me know in advance that he hadn't received the prescription?

Because he was a complete bastard, basically. So I wouldn't be falling over myself to discuss the fact that I had vaginal thrush with him.

Are you on commission

Nope - don't work for a Pharmacy - just stating the feedback we have received from patients who have seen the highly trained, experienced pharmacist.

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

Whilst views do not change, access to a GP/nurse appointment will be tough. Nurse and GP recruitment has plummeted and the older populations are retiring.

Who really needs to see a GP for a cough (unless they have had it for 3 weeks as per NHS guidance)? And purleeeeeease - the amount of people who want an apppointment for a sore throat that started "this morning". neither a nurse nor GP should be seeing that.

I suspect the people on this thread would never ask to see a GP for a cough/cold/sore throat they have had for 1-2 days but I can assure that over the next 6 months 80% of requested appointments will be for just that!

If they went to see the Pharmacist, they can be checked out for Sepsis without delay - referred to GP for same day appointment if needed or get over the counter remedies and self care advice.

We need to change attitudes towards highly qualified pharmacists, too. If it is good enough for them to work in a GP practice they are good enough working at your local independent pharmacy or Boots, Tesco etc

Well, no.

Because my local pharmacy is staffed by morons (see above). The part time GP surgery one on trial has been fine.

Different people, different experiences.

If my local pharmacy can't organise prescriptions effectively, why would I trust that one with my other health needs?

I think most people view pharmacists as people who dispense medicines, though, @Tistheseason.

I accept that they have a lot of training but in my case, I would rather see the ANP over anyone at the surgery, as she knows me very well and understands my family circumstances.

They are rolling out Paramedic Practitioners here in the South West, working in Primary Care at health centres/GP surgeries. They are also now training them to prescribe.

Another way to be seen if no GPs available, some people don't realise just how knowledgeable and skilled nurses/paramedics are.

I absolutely agree with IronicalCallSign that some pharmacists are disorganised pricks.

Some are very good. When I lived in London there was a lot more competition between pharmacies so I could choose one I had confidence in.

Here, in a small village, there is no choice, and I do not trust my pharmacist.

If my local pharmacy can't organise prescriptions effectively, why would I trust that one with my other health needs

Did you know you can set up online patient access and request yourself and remove the morons out of the equation?

I do live in the real world - not all people of any profession is 100% excellent. There are crap GPs, nurses and doctors surgeries out there, too.

Most supermarkets have a Pharmacist as well as Boots and other smaller non brand pharmacies - you don't have to use your usual pharmacist.

@ChimpyChops

The rolling out of paramedics is a brilliant idea.

Far better than the thought of people going to pharmacists for advice IMHO.

@ChimpyChops

I'm in SW and it's working really well by us - there are 4 pharmacies to choose from so people have choice.

TBH if the pharmacist is crap they will refer the patient back for a same day GP appointment anyway so it is still in the best interest of the patient instead of waiting for an apptmt!

There are crap GPs, nurses and doctors surgeries out there, too.

Yes.

And a huge number of crap receptionists, who cause untold misery to patients, with their inflated egos.

@Tistheseason17

What a wonderful surgery you work in, where people can get same-day appts. due to the pharmacists taking so much of the burden off the ANPs and GPs.

For most of us (and this doesn't include me BTW) there is no possibility of seeing a GP any sooner than in four weeks.

We're lucky to have an ANP at our surgery but sadly she only works part time as her main job is working at the local OOH centre. She's incredibly kind, really clued up as to what the local trust are recommending for treatment and I'm always really pleased to get an appointment with her. But it's harder to see her than a GP as she only takes the emergency appointments and you can't book a routine one with her.

I've never heard of an ANP who doesn't take routine appts.

We used to have an appalling GP at our Health Centre and thankfully she has retired.

Nobody even made a collection for her when she went.

@TheMustressMhor

I don't disagree with you. Our practice does have one of the best ratings in the country. We spend our funding on recruiting staff rather than taking large salaries. Basically our GPs are poor but patients can get an appointment quickly!

And, I do know some appalling receptionists that I would love to "develop" into caring empathetic individuals.

I also acknowledge that we are in the minority but I can also see us going this way in the future as further expected funding cuts will mean we cannot afford GPs/Nurses so wait times will increase, patients will (rightfully) become more upset, and receptionsist will become more frustrated.

It is a sad state of affairs, really. Most GP practices really do want to do their best but they can't work 7 days weeks (as govt wants) - it's just not safe.

At our surgery, we are asked what the problem is before they allocate an appointment. The idea being that the receptionist can give you an appointment with the most suitable clinician. We’ve seen the Advanced nurse practitioner for things like ingrowing toe nails, throat/ear infections, shingles diagnosis, and I’ve been quite happy with that. When it has been more serious, ie, a lump or mental health issues I have been directed to the GP. our surgery seem to have this covered really well.

patients who have seen the highly trained, experienced pharmacist

And maybe that is your problem. Poor consistency and its only relatively recently that pharmacists have had some of the extra training to consider them as any form of practitioner.

Pretty much all the local pharmacies now belong to one of the major chains. Even the medical staff at my GP practice complain about them - appalling service, poor advice and lack of clarity in the branch as to who is actually qualified. Frequent changes of staff mean no continuity.

The big name which bought the pharmacist text to my GP has refitted the place to be open and echoey and the only private "consultation" area is a small section with a low partition meaning everyone in the shop can hear what is being said. They are also piss poor at patient data privacy.

I wouldn't rely on them to feed my cat let alone assess my medication.

This experience is way too common when I talk to colleagues and friends. Poor quality or inconsistent advice, poor communication skills and on occasion entirely inappropriate questioning.

I know there are good pharmacists - my GP has one in house now. However the reason she is in house is because of inconsistent and poor service from chains using the scheme to make money.

It sounds like your surgery is better than most then, Maryann1975.

And the more I think about it, the more I disagree that pharmacists are best placed to see patients.

And the more I think about it, the more I disagree that pharmacists are best placed to see patients

I agree, not ALL patients. Minor ailments, yes.

But we are likely going to have to agree to disagree on this - no offence.

Our local pharmacy advise you to see the GP for everything but very trivial problems where they can obviously sell you a box of lemsip or something. I've had discussions with one of the GPs who accused me of time wasting when the pharmacist had said they can't help. Turned out DS needed medication so I was not over anxious, nervous mum etc.

No ANPs at our large busy surgery, 10 GPs and 4 practice Nurses, the Nurses only see minor illness such as sore throats etc they have some limited prescribing skills, cannot see children, and definitely can’t do hospital referrals. I’m struggling to even get an appointment with a nurse for my smear test, it’s overdue by months now.