Health / Introducing advanced nurse practitioners to out of hours service proving beneficial
A PROJECT which has seen advanced nurse practitioners (ANP) cover some weeknight and weekend shifts for out of hours GP care appears to be paying dividends.
A meeting of Shetland’s integration joint board heard last week that it is paying off not just financially but on a service level too.
The meeting was told that introducing ANPs to the service and only needing a locum GP for one weekend a month gives a cost reduction of around £215,000 a year.
NHS Shetland’s chief nurse Kim Anderson said between September and May the average cost for the weekend out of hours service had been reduced by 38 per cent a month.
She said there have been challenges with providing the out of hours GP care for “some time” due to recruitment difficulties, with a reliance on goodwill from salaried GPs as well as more expensive locum doctors.
As a result a new NHS Shetland project brought in ANPs to cover some weeknight and weekend shifts as part of a blended workforce model.
Anderson said this has resulted in a more consistent service for the patient and a “noticeable reduction in cost” due to less reliance on locums.
One concern from staff is working at night and then the next day, but Anderson said this will be considered when thinking about the long-term plan.
She also said other staff would be on hand to step in for any ANPs who feel too tired to work.
“We absolutely would be affording folk enough rest time to be safe practitioners within their roles,” Anderson said.
The initial aim of the project was to reduce the use of locum GPs in the out of hours service and cut the cost by 15 per cent per calendar month by April 2024.
Last week’s meeting heard that the focus was initially on the period between Friday evening and Monday morning.
Advanced practice lead Nova James described it as a “really successful test of change” so far.
The team has established ANP cover for two weekends per month.
From August a salaried GP is taking on one weekend a month, leaving just one weekend needing to be covered by a locum.
However a newly recruited ANP is set to start their role in November and is hoped that they will cover that last weekend from spring onwards – meaning locums will no longer be needed.
A review of data also highlights that there has been “no concern” about having ANPs in the role.
James said people are getting the same quality service, if not better, but in a more “cost-effective manner”.
NHS Shetland will also further develop the training plan to ensure appropriate skillsets are maintained.
IJB chair Natasha Cornick said the project was an “exemplar” of sustainable service redesign.
“You’ve not only reduced the cost by more than twice the savings you were looking for, you’ve improved and sustained the service,” she said.
“This is the kind of work that as an IJB that we’ve been looking for.”
Vice-chair councillor John Fraser sought assurance that there is a suitably qualified staff member who can deal with someone in police custody who may be suffering from withdrawal from alcohol and/or drugs, with Anderson confirming that is the case.
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