Our healthcare roles

About care navigators in primary care

Care navigators work in practice reception teams and are specially trained to know about the care and services available to you at your surgery and in your area. While the name of this role may differ in your practice, they’ll listen and talk to you in confidence about your health problem, to understand your needs, so they can book an appointment with the right healthcare professional or service.

What can care navigators help with?

• Help patients get the right care from the right healthcare professional as soon as possible
• Know whether self-referral is available for certain services at your practice or in your area
• Make appointments for new kinds of care or new services you may not be aware of
• Access the appropriate healthcare professional

About physiotherapists in general practice

Musculoskeletal (MSK) health issues such as back, muscle and joint pains are the most common cause of repeat GP appointments and account for around 1 in 5 of all GP appointments. Most of these issues can be dealt with effectively by a physiotherapist without any need to see a GP.

Research shows physiotherapists are the most expert professional group regarding musculoskeletal issues with the exception of orthopaedic consultants. They have the same high safety record as GPs and some are trained to administer steroid injections, order diagnostic tests including scans, and also prescribe medication. 

What can physiotherapists help with?

• diagnosing and treating muscular and joint conditions
• advising on how to manage your condition
• referrals on to specialist services

How are GPs benefitting?

Physiotherapists help GPs to manage their workload more effectively through re-allocating appointments for patients with musculoskeletal problems and reducing the number of referrals into secondary care. This includes reduced demand on waiting times for orthopaedics, pain services, rheumatology, community physiotherapy and Clinical Musculoskeletal Assessment and Treatment services. 

What are the benefits for patients?

• quicker access to expert MSK assessment, diagnosis, treatment and advice
• help to prevent short-term problems becoming long-term conditions
• improve the patient experience
• a shorter pathway means patients have fewer appointments to attend
• simpler logistics means patients are less likely to miss appointments, or to suffer administrative errors
• patients can gain lifestyle and physical activity advice from experts
• longer appointment times so patients feel listened to, cared for and reassured

How can patients book to see or access advice from a physiotherapist?

Patients with back and joint pain, including conditions such as arthritis can see a physiotherapist by speaking to the GP practice care navigators/reception team, or by being referred by their GP.

About social prescribing link workers

Patients visit their GPs for a range of different reasons and sometimes these issues can be caused by non-medical matters such as loneliness, anxiety, unemployment, illness or debt.

Social prescribing link workers work in partnership with GP surgeries and can help people to access appropriate support in the community, to help them make positive changes to their personal wellbeing

What can social prescribing link workers help with?

• getting people to focus on their own priorities and the things that affect their wellbeing
• supporting people to take more control of their health
• introducing people to groups and activities in their community

How can social prescribing link workers help patients?

Social prescribing link workers can offer support and signposting for a variety of non-clinical interventions such as:

• people struggling to adapt or cope with chronic conditions that can’t be addressed by clinical consultation
• mental health and emotional wellbeing
• relationship difficulties
• domestic abuse
• loneliness and isolation
• low self esteem
• poor housing
• financial issues, including benefits
• carers
• bereavement
• health goals e.g. weight management, healthy eating, stop smoking, physical activity

How are GP practices benefiting?

Social prescribing enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services to support their health and wellbeing. Often people’s social situation can lead to depression and other health problems, which takes them to the GP for medical help. Helping people to address their personal problems and feel empowered to take back control often results in a reduction of medicines and less need for a GP’s help.

How can patients book to see or access advice from a social prescribing link worker?

Social prescribing is open to patients aged 18+ who present to their GP with issues that have a non-clinical underlying cause. Patients may have a social need, ongoing health conditions, regularly attend their GP surgery or are at risk of unplanned admission.

Social prescribing link workers meet patients referred by their GP at their practice, before referring and signposting to appropriate services. Patients are treated holistically with the point of referral determined by individual need – this could include information to support health, finance or social isolation.

Nursing Associates bridge the gap between Healthcare Support Workers and Registered Nurses, to deliver hands-on, person-centred care as part of the nursing team. They are members of the nursing team, who have gained a Nursing Associate Foundation Degree awarded by a Nursing and Midwifery Council (NMC) approved provider, typically involving two years of higher-level study.

What can a Nurse Associate help with?

Although a healthcare assistant is not able to prescribe medication they can carry out a variety of tasks within general practice, these can include:

• Blood pressure checks
• New patient medicals
• Learning Disability and NHS healthchecks
• Vaccinations, like B12, flu and COVID
• Health promotion i.e. obesity clinics, smoking cessation clinics, and body mass (BMI) calculations
• Electrocardiogram (ECG) readings
• Spirometry
• Phlebotomy
• Removal of sutures
• Applying simple dressings 

About healthcare assistants

Healthcare assistants can assist with a range of minor clinical duties, like taking blood samples, blood pressure checks, new patient checks, health promotion etc, under the guidance of the wider healthcare professional team. They work alongside the team and support with observing, monitoring and recording patients’ conditions, to provide joined-up care. 

What can a healthcare assistant help with?

Although a healthcare assistant is not able to prescribe medication they can carry out a variety of tasks within general practice, these can include:

• Blood pressure checks
• New patient medicals
• Health promotion i.e. obesity clinics, smoking cessation clinics, and body mass (BMI) calculations
• Electrocardiogram (ECG) readings
• Spirometry
• Phlebotomy
• Removal of sutures
• Applying simple dressings 

How are GPs benefitting?

Healthcare assistants play a valuable role in freeing up practice nurses and GPs time to treat more complex patient needs. This helps to reduce patient waiting times, and improve access to appointments. Healthcare assistants also directly contribute to health promotion and disease prevention.

How can patients book to see or access advice from a healthcare assistant?

Patients can be booked in to see a healthcare assistant by the team in their clinic. Patients will see a healthcare assistant in the same way they would usually see their GP or practice nurse, in a private room in the surgery.

About mental health therapists and practitioners

Looking after our mental health is important for everyone. If you, or someone you know requires support, it’s important to find the right kind of help early on, and your GP can help you to do this. Mental health professionals are now available at your local GP practice to help you get the support you need, when you need it.

If you, or someone you know is struggling with mental health issues, speak to someone at your local GP surgery who can arrange the right kind of support for you.

Mental health therapists and practitioners can help with:

• talking therapies to support patients on a wide range of topic and issues
• providing tools and techniques to help manage symptoms
• supporting people who are experiencing the psychological effects of managing long-term conditions, such as diabetes

How are GP practices benefiting?

Intervening at an earlier stage and addressing common mental health issues can drastically improve care. Closer team-working can help reduce the number of referrals to hospital or community care, therefore reducing demand on GP and hospital appointments.

How can patients book to see or access advice from a mental health therapists and practitioners?

Sessions are usually one-on-one, but can also be in couple or group settings, by phone or online. Referrals can be made directly via the local psychological therapies (IAPT) service, GP, clinical pharmacists, practice nurses and healthcare assistants.

About clinical pharmacists

Clinical pharmacists work as part of the general practice team to improve value and outcomes from medicines and consult with and treat patients directly.  This includes providing extra help to manage long-term conditions, advice for those on multiple medicines and better access to health checks.  The role is pivotal to improving the quality of care and ensuring patient safety.

What can clinical pharmacists help with?

• prescribing
• medication reviews
• queries about medications
• telephone reviews
• treatment of minor illnesses
• managing a patient’s condition holistically
• ensuring patients get the most out of their medication
• ensuring there is joined-up care for patients

How are GP practices benefiting?

Clinical pharmacists can prescribe certain medication and conduct medication reviews. They can answer questions about medication and support patients over the course of their treatment.

Having clinical pharmacists in GP practices means that GPs can focus their skills where they are most needed, for example on diagnosing and treating patients with more complex conditions.  This helps GPs to manage the demands on their time.

How does the role of the clinical pharmacist differ from that of a community pharmacist?

A clinical pharmacist’s role within a GP practice differs markedly from a pharmacist who is based in the community. One of the big changes is that pharmacists based in GP practices are able to prescribe medicine for patients. For example, when a person is diagnosed with a condition, such as diabetes or hypertension, the clinical pharmacist is able to manage their condition holistically to ensure they are getting the right advice. This includes making sure they start or stop treatment at the right time and ensure they are getting the most out of their medication, to manage their condition appropriately.

Clinical pharmacists support patients by advising them about minor illnesses and self-care. They are also responsible for giving people general advice on maintaining good health and preventing long-term disease, as well as ensuring patients are taking their medication correctly and as intended by the prescriber.

Clinical pharmacists work together with a range of other healthcare professionals, including pharmacists in the community or those in the hospital. A clinical pharmacist does not give a patient their medication, this would need to be collected from a community pharmacy in the usual way.

How can patients access advice and support from a clinical pharmacist?

Patients can be booked in to see a clinical pharmacist by the surgery in their clinic. They will see a clinical pharmacist in the same way they would using see their GP or practice nurse, e.g. in a private room. If a patient sees a clinical pharmacist, they will still be able to see a GP if they need to.

Examples of how clinical pharmacists can help patients:Long-term conditions 

Long-term conditions include things like asthma, type 2 diabetes, arthritis or high blood pressure.

If a patient has a long-term condition, the clinical pharmacist can offer expert advice on their medications. For example, making sure they are on the most appropriate medication and that it is working for the patient and they are getting the most out of their medications.

They may also help by offering advice on how a patient can make lifestyle change to help manage their condition and to help them stay well.

Dealing with side effects

If medication is making a patient feel unwell, the clinical pharmacist can help by changing the medication or changing the dosage they are taking. If the patient is on multiple medications, the clinical pharmacist can help to make sure they are all working well together.

Medication reviews

If a patient Is taking medication for a long time, they will need to have a medicine review at least once a year. This is to ensure the medication is still working properly. The clinical pharmacist can check all the patients’ medication and talk to them about how their medication is working for them. They can also perform health checks such as taking the patients’ blood pressure or making appointments for them to have other tests, like blood tests.

If a patient had recently been to hospital, their medication may have changed while they were there. The clinical pharmacist can help to explain any changes to the medication and to make sure they are working well for the patient.

About advanced nurse practitioners

Advanced nurse practitioners are registered nurses who have completed extra training and academic qualification to be able to clinically assess, diagnose, refer and treat patients who present with undiagnosed or undifferentiated problems.

Advanced nurse practitioners are highly-trained health professionals that can undertake complex reviews of patients, similar to GPs. They can assess symptoms and build a picture of a patient’s condition, treat minor health problems, infections, minor injuries and prescribe medication where necessary. They can also often manage more complicated problems, for instance, patients presenting with long-term health conditions, such as diabetes and COPD. 

What can advanced nurse practitioners help with?

• complex patient reviews/assessments
• diagnosing acute and chronic conditions
• treatment of minor illnesses
• prescribing and reviewing medication
• advising on prescribed medication
• evaluating treatment plans
• managing conditions holistically
• ensuring joined-up call for all patients

How are GP practices benefitting?

Advanced nurse practitioners have an important role to play in supporting and enhancing primary care service provision.  They have been shown to improve a patient’s satisfaction, alleviate pressure on GPs and provide high quality care where it is needed.

In the NHS Long Term Plan, NHS England explains that it aims to increase the number of additional healthcare professionals and develop multidisciplinary teams to give GPs more time to focus on complex cases. In addition to increasing the skill mix in primary care, healthcare teams can also realise the potential of the roles of the advanced nurse practitioners and other advanced clinical professionals.

How does the role of an advanced nurse practitioner differ from that of a practice nurse?

Advanced nurse practitioners usually come from a range of different clinical routes – this includes via primary care or even secondary care.  This means that the skills and training acquired will be varied and often, no two advanced nurse practitioners are the same.

Advanced nurse practitioners have a broad scope of practice, having undertaken advanced clinical training to be able to manage and assess patients more expertly (similar to a GP), as well as usually having more generalist skills (depending on the background). They will often have an area of special interest, such as undertaking assessments and planned reviews of patients with long term conditions, like diabetes.

If the individual was formerly a practice nurse, then they will be able to do a mixture of things such as blood tests, cervical screening or child immunisation in addition to advanced practice clinics. This will depend on the individual and the training that has been undertaken to be able to perform various roles, and it will also depend on the practice and their needs.

Advanced nurse practitioners are able to asses the history of a patients and interpret the results of different investigations in order to make a diagnosis, and plan and deliver care. They are often able to substitute for GPs, which can help to alleviate pressures within primary care teams.

Can advanced nurse practitioners prescribe medication?

All fully qualified advanced nurse practitioners can prescribe medication for any condition within their competence. If they can’t prescribe medication, then they are usually trainee advanced nurse practitioners.

They can see patients with undiagnosed, undifferentiated medical conditions and make treatment decisions, including referring patients for any necessary follow-up consultations or referrals – both in primary and secondary care.

Advanced nurse practitioners are able to utilise the wider multidisciplinary team if they are unsure about making a clinical judgement, for Instance, gaining advice from a GP if they require further expertise.

What can patients see advanced nurse practitioners for?

Patients can see advanced nurse practitioners for both minor and long-term conditions. This ranges from the treatment of common illnesses, such as infections or more complicated or chronic conditions, such as diabetes and COPD.

Common minor illnesses include problems such as sore throat, ear ache, cold and flu, cough, chest infection, thrush, athlete’s foot, wounds, emergency contraception, conjunctivitis, infections, diarrhoea and vomiting, headaches, joint pain, musculoskeletal problems (back, hip and shoulder pain) and minor injuries.

How can patients book to see or access advice from an advanced nurse practitioner?

Patients can book an appointment by contacting the surgery in the usual way. With an increasing number of GP practices working together to deliver services, there might also be an option to see an advanced nurse practitioner on the weekend. 

Patients will see an advanced nurse practitioner in the same way they would usually see their GP. e.g. in a private room. If a patient sees an advanced nurse practitioner and requires further clinical expertise, they will still be able to see a GP if they need to.