Practice nurse and health visitor management of acute minor illness in a general practice

Objective. To evaluate practice nurse (PN) and health visitor (HV) manageme nt of patients with acute minor illnesses, monitor the effect on general pr actitioner (GP) workload, and describe the range of conditions seen by nurs es. Design. Patients requesting 'urgent' appointments (within 24 hours) were of fered consultations with a PN or HV trained in the management of acute mino r illness. Comparative data were collected before and after the establishme nt of the acute minor illness service. Setting. A general practice in Nottingham, England. Main outcome measures. Patient satisfaction, consultation rate, prescriptio ns, investigations, referrals and urgent re-consultations for the same cond ition 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 o f 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 profess ional for prescription rates W=0.76), re-consultations (P=0.14), or referra ls to secondary care (P=0.07). General practitioners were more likely to in itiate further investigations than the PNs or HV (P < 0.001). Conclusion. With suitable training, PNs and HVs can successfully manage pat ients with a range of conditions. General practitioner workload can be redu ced while maintaining high patient satisfaction levels.