Practice nurse and health visitor management of acute minor illness in a general practice
Objective. To evaluate practice nurse (PN) and health visitor (HV) management of patients with acute minor illnesses, monitor the effect on general practitioner (GP) workload, and describe the range of conditions seen by nurses.
Design. Patients requesting ‘urgent’ appointments (within 24 hours) were offered consultations with a PN or HV trained in the management of acute minor illness. Comparative data were collected before and after the establishment of the acute minor illness service.
Setting. A general practice in Nottingham, England.
Main outcome measures. Patient satisfaction, consultation rate, prescriptions, investigations, referrals and urgent re-consultations for the same condition within 2 weeks.
Results. About 2056 urgent consultations were recorded in the study period, of which 332 (16·1%) were seen by PNs and 46 (2·2%) by a HV. High levels of patient satisfaction were reported for all health professionals. Patients seeing the HV reported higher levels of satisfaction than those consulting GPs (P=0·033) and PNs (P=0·010). There was no difference by health professional for prescription rates (P=0·76), re-consultations (P=0·14), or referrals to secondary care (P=0·07). General practitioners were more likely to initiate further investigations than the PNs or HV (P < 0·001).
Conclusion. With suitable training, PNs and HVs can successfully manage patients with a range of conditions. General practitioner workload can be reduced while maintaining high patient satisfaction levels.