In 2003 we introduced a Nurse Practitioner Triage. This is a system where appointments are available on the day. The aim of these triage appointments is to deliver a safe, appropriate and timely consultation.

The triage system of appointments is for both minor illnesses, which can be seen quickly and appropriate management instituted, and for more serious and complex cases where the nurse practitioner will co-consult with one of the GP's.

The Nurse Practitioner role combines advanced nursing skills with clinical, diagnostic and treatment skills. The role provides an alternative and complimentary source of primary healthcare alongside services traditionally provided by a General Practitioner.

Nurse Practitioner - Role Description

• Assumes a clinical workload dependant on the individual general practice population in collaboration with GP colleagues.
• Provides a holistic approach to healthcare, drawing from both the nursing and medical model of health and illness where appropriate in order to screen for the early signs of disease and diagnose acute problems.
• Demonstrates knowledge of the pathophysiology of acute and chronic conditions commonly seen in practice.
• Accepts referrals from other disciplines unsupervised.
• Undertakes the independent and autonomous assessment of undifferentiated and undiagnosed problems with attention to physical, emotional, social, cultural and mental health issues.
• Uses sound judgement in assessing conflicting priorities and needs.
• Formulates a diagnosis utilising medical diagnostic problem-solving skills including history taking, physical examination, invasive and non-invasive investigations which involves contact with potentially infectious biological substances on a regular basis.
• Initiates appropriate diagnostic strategies and therapeutic interventions including radiology and laboratory requests, with attention to safety, cost, invasiveness, acceptability and efficacy.
• Develops with the patient and family an on-going, evidence-based plan for health, with an emphasis on preventative measures.
• Interprets and evaluates diagnostic test results in liaison with the patient and their GP and initiates treatment accordingly.
• Evaluates the patientʼs condition and response to therapeutic interventions and modifies the plan of care accordingly for optimal outcomes.
• Utilises patient group directives (PGDʼs), as an integral component of treatment plans in accordance with clinical guidelines based on efficacy, safety and cost-effectiveness.
• Initiates independent and collaborative patient referral to statutory and non-statutory organisations including GPʼs, Secondary Care Consultants, other members of the PHCT, allied health professions and voluntary agencies.
• Makes use of computer technology using automated information systems in order to support decision making, improve the quality and co-ordination of care and services and to enable faster and more certain communication within the PCT.
• Maintains accurate records (including practice notes, computer and patient hand-held records, child protection records and records at Nurse Practitioner-led clinics) according to the Guidelines for records and record keeping (NMC, 2002).

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