An investigation into why patients chose to attend two, nurse-led, minor injury units (MIUs) to access primary healthcare services rather than attend their GP practice | International Emergency Nursing
Patients with non-urgent conditions are increasingly attending urgent care providers in the UK.
Consumerist notions of choice and expediency influence healthcare decision making.
Patients seem to be acting rationally in response to healthcare policy promises.
Providing treatment establishes precedent and expectation for future care.
Co-located primary care, working alongside ENP services, offer benefits for local communities.
Beam, C. et al. Journal of Emergency Nursing. Published online: 21 July 2016
Concern about antibiotic overuse has become heightened as bacterial resistance to antibiotics continues to increase. Patients experiencing respiratory symptoms frequently present to urgent/emergent care settings such as fast-track emergency care departments and primary care retail settings with the expectation that they will be prescribed antibiotics.
The Centers for Disease Control and Prevention (CDC) reports that approximately 2 million people will become ill with bacteria that are resistant to at least one antibiotic, approximately 23,000 people die as a direct result of these infections, and many others die as a result of complications related to antibiotic-resistant infections.
Objective: Urgent care centres (UCCs) co-located within an emergency department were developed to reduce the numbers of inappropriate emergency department admissions. Since then various UCC models have developed, including a novel general practitioner (GP)-led UCC that incorporates both GPs and emergency nurse practitioners (ENPs). Traditionally these two groups do not work alongside each other within an emergency setting. Although good teamwork is crucial to better patient outcomes, there is little within the literature about the development of a team consisting of different healthcare professionals in a novel healthcare setting. Our aim was therefore to describe staff members’ perspectives of team development within the GP-led UCC model.
Design Open-ended semistructured interviews, analysed using thematic content analysis.
Setting: GP-led urgent care centres in two academic teaching hospitals in London.
Participants: 15 UCC staff members including six GPs, four ENPs, two receptionists and three managers.
Results: Overall participants were positive about the interprofessional team that had developed and recognised that this process had taken time. Hierarchy within the UCC setting has diminished with time, although some residual hierarchical beliefs do appear to remain. Staff appreciated interdisciplinary collaboration was likely to improve patient care. Eight key facilitating factors for the team were identified: appointment of leaders, perception of fair workload, education on roles/skill sets and development of these, shared professional understanding, interdisciplinary working, ED collaboration, clinical guidelines and social interactions.
Conclusions: A strong interprofessional team has evolved within the GP-led UCCs over time, breaking down traditional professional divides. Future implementation of UCC models should pro-actively incorporate the eight facilitating factors identified from the outset, to enable effective teams to develop more quickly.
NHS England has published Extending the role of community pharmacy in urgent care. This guidance provides practical tips and case studies for System Resilience Groups and local commissioners showing how to extend the role of community pharmacy to relieve pressure on urgent care and how to make best use of the tools such as the Directory of Services, NHS Choices and the Summary Care Record to support this.
NHS England has published Commissioning standards: integrated urgent care. This document outlines the standards which commissioners should adhere to in order to commission a functionally integrated 24/7 urgent care access, treatment and clinical advice service. It aims to bring urgent care access, treatment and clinical advice into much closer alignment through a consistent and integrated NHS 111 service model