APPENDIX 5
Memorandum by Ms Paula Hull (GP06)
I am an executive nurse for New Forest PCT and
lead for primary care nursing.
The general readiness of Primary Care Trusts
to undertake their responsibilities with regard to Out-of-hours
services
— The role of GP co-operatives.
— The role of NHS Direct.
— The potential impact on other NHS
services, including community hospitals, minor injury units, GP
clinics, and A&E services.
I think there is huge potential for community
hospitals to take part in this work. Our community wants to be
seen locally but there is limited availability of training for
the staff to upgrade their competencies to offer these services.
We need pragmatic approaches to developing practice based work
programmes that are validated by local universities. Flexible
training programmes that value experiential knowledge and enable
nurses to develop new skills in order to offer a comprehensive
service in the community, reducing the burden on the secondary
sector.
— Potential financial implications.
— Potential implications for quality
of out-of-hours services, including rapidity of response, provision
of backup and quality of patient care.
— Skill-mix within out-of-hours services.
The training issues remain relevant for skill
mix in primary care, particularly clinical supervision. Consolidation
of theoretical skills and transferring knowledge to practice requires
mentorship and time out to reflect on care. Nurses often have
only enough time to perform their own role, and are reluctant
to take on responsibility for training. Health care support workers
especially require considerable time and supervision, programmes
that work across practices sharing expertise and training must
be developed in order to support this. Some practices are hoping
to become training practices, to offer induction training to other
practices perhaps as an enhanced service, this should be developed.
— Arrangements for monitoring out-of-hours
services.
— Implications for urban and rural
populations.
Our rural area with 25% elderly will require
special thought to the needs of the population, we have considered
health buses and alternatives to primary care centres.
June 2004
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