Equipping Advanced Practitioners with the skills, insight, and confidence to lead in modern primary care The Advanced Practitioner in Primary Care is a timely resource that provides current and aspiring Advanced Practitioners (APs) with a practical roadmap for delivering high-quality, patient-centred care in complex and fast-paced primary care environments. Built on the four pillars of advanced practice-clinical practice, leadership, education, and research-this text supports practitioners in bridging the gap between academic theory and clinical application. Written by experienced clinicians…mehr
Equipping Advanced Practitioners with the skills, insight, and confidence to lead in modern primary care The Advanced Practitioner in Primary Care is a timely resource that provides current and aspiring Advanced Practitioners (APs) with a practical roadmap for delivering high-quality, patient-centred care in complex and fast-paced primary care environments. Built on the four pillars of advanced practice-clinical practice, leadership, education, and research-this text supports practitioners in bridging the gap between academic theory and clinical application. Written by experienced clinicians and educators, this book is framed by national and international guidelines-applicable to adult, paediatric, and mental health contexts-and reinforced by real-world case studies that contextualise concepts and build confidence in managing diverse clinical scenarios. Providing the structured support and evidence-informed guidance necessary for confident, competent, and reflective practice, The Advanced Practitioner in Primary Care: * Covers complex consultation skills, clinical reasoning, systems-based clinical assessments, and decision-making with evidence-informed guidance * Addresses the management of uncertainty and diverse patient presentations, including frailty and paediatrics * Offers practical insights on getting the most from supervision and professional development pathways * Includes a dedicated chapter on prescribing and medication management tailored for APs * Discusses the evolving scope of the AP role in the context of local, national, and international policy The Advanced Practitioner in Primary Care is essential reading for trainee and established APs working in primary care, as well as for nurses, paramedics, pharmacists, physiotherapists, and other professionals transitioning into general practice. It is also ideal for postgraduate programmes in advanced clinical practice and a valuable resource for educators and primary care teams supporting AP development.
Josey Coaten is a lecturer and Programme Director for the MSc Advanced Clinical Practice at the University of Hull. An experienced registered nurse and Advanced Clinical Practitioner, she is also a non-medical independent prescriber. Josey brings extensive experience from primary care, having held roles from practice nurse to Senior ACP. She holds a postgraduate certificate in academic practice and is a Fellow of AdvancedHE. Sarah Pay has experience as a lecturer in the MSc Advanced Clinical Practice programme at the University of Hull and currently works as an ACP and clinical educator at Haxby Group. With a background in adult nursing, she has worked extensively in primary care as both a practice nurse and a Senior ACP. She is a non-medical prescriber and holds a postgraduate certificate in academic practice, as well as being a Fellow of AdvancedHE.
Inhaltsangabe
Unit 1 - The ACP Role in Primary Care
Chapter 1 Scope of Practice and the ACP role in primary care Josey Coaten Aim Learning outcomes Introduction Chapter 2 How to get the most from supervision in practice Sarah Pay Aim Learning Outcomes Introduction What is supervision? Competence and Capability Frameworks and Standards Tailored Supervision Planning Supervision in Primary care Overcoming barriers to supervision Demonstrating capability Self- Awareness Reflective Points References Chapter 3 Patient Centred Care Josey Coaten Aim Learning outcomes Introduction
Chapter 4 Clinical Uncertainty Sarah Pay Aim Learning Outcomes Introduction Types of Uncertainty Managing uncertainty Information gathering The value of time as a tool Safety Netting Ethical Considerations and shared decision making Back to Basics Communicating uncertainty Uncertainty and Burnout Reflective point References
Chapter 6 Research Pillar in Primary Care Sarah Pay Aims Learning Outcomes Introduction The importance of the research pillar for ACPs Challenges of embedding research into primary care ACP roles Evidence Based Practice Research Opportunities and the National Institute for Health can Care Research (NIHR) Clinical Academic Roles Quality Improvement Audit Reflective Points References Chapter 7 Education and Teaching Josey Coaten Aims Learning Outcomes Introduction
Unit 3 - Consultation skills
Chapter 8 Consultation Models Sarah Pay Aims Learning Outcomes Introduction Consultation Models Introduction Overview of Models Using a model in practice The short or 15 minute consultation and agenda setting Remote Consultations Conclusion Reflective points References
Chapter 10 History Taking Sarah Pay Aims Learning outcomes Introduction Applying Structure to history taking Care study Preparation (Housekeeping) Introduction and Rapport Building Presenting Complaint Ideas, Concerns and expectations History of Presenting complaint Past Medical History Vaccination History Medication History Allergies Family History Social History Occupation Travel Sexual history Systematic enquiry Closing the encounter Difficult Consultations Collateral History Taking Communication considerations in history taking Managing time Digital tools in history taking Care study reflection References
Chapter 11 Introduction to clinical examination in primary care Sarah Pay Aims Learning Outcomes Introduction Equipment Home Visits The acutely unwell patient Red Flags Chaperone Structured examination principles Preparation/Housekeeping Environment End of bed/chair Inspection Hands Face and Mouth Palpation Percussion Auscultation Lymph Node Assessment History considerations Inspection Palpation Red flag signs for lymphadenopathy Typical features of lymph nodes and associated pathology Decision making, referrals or admissions Case Study - Lymphadenopathy Closer Look- Lymphoma References
Chapter 12 The Respiratory System Sarah Pay Aims Learning Outcomes Introduction History taking for the respiratory presentation Preparation Initiating the consultation Taking a respiratory history Common Presenting Symptoms Chest pain Cough Sputum Breathlessness Wheeze Stridor Haemoptysis Fever/Night sweats and Rigors Weight Changes Sleepiness Red Flags Clinical Examination of the respiratory system Environment End of the bed assessment Hands and arms Face, eyes and mouth Neck Inspection Palpation Percussion Auscultation Posterior Legs Common Presenting complaints in primary care Other investigations in primary care Pulse Oximetry Sputum Cultures Spirometry ECG Peak Flow Fractional exhaled nitric oxide Chest X-ray Blood tests Rapid point of care testing for C-Reactive Protein Pertussis testing Risk tools Case Study - Community Acquired Pneumonia References Chapter 13 The Cardiovascular System Josey Coaten Aims Learning outcomes Introduction
Chapter 17 Ear, Nose and Throat Josey Coaten Aims Learning Outcomes Introduction
Chapter 18 Dermatology Sarah Pay Aims Learning Outcomes Introduction Taking a dermatological history Common presenting symptoms Itching Rash Lesions Pain Psychosocial factors Examination of skin Inspection Description Palpation Systematic Review Examination of moles Dermoscopy and photography Red flags Case study References
Chapter 19 Paediatrics in Primary care Sarah Pay Aims Learning Outcomes Introduction Initiating the consultation with a child and history taking First Impressions Introductions and Rapport building Golden minute and establishing ICE Taking a history Examination Airway Breathing Compromised respiratory system Respiratory distress Respiratory Rate Oxygen saturation Chest Auscultation Circulation Colour Heart Rate Capillary Refill time Blood Pressure Disability ENT Examination Temperature Tummy Blood Glucose Examination Tips Identifying serious illness in children Vital signs Traffic light system/PEWS/Sepsis The Febrile Child Management and parental/carer advice The unexplained fever Growth and Feeding Safety netting Professional and Legal Issues in Paediatrics Consent Gillick Competence Fraser Guidelines Safeguarding Prescribing for children Closer look - Kawasaki Disease Case Study - Bronchiolitis Common differential in primary care - feverish illness Useful resources References
Chapter 20 Mental Health in Primary Care Sarah Pay Aims Learning Outcomes Introduction History taking in Mental Health consultations Mental Status Examination (MSE) Determining risk Ethnicity Frailty Maternal Mental Health Learning Disability Gender History taking framework for mental health Legislation and mental health The Mental Health Act 1983 The Mental Capacity Act 2005 Management of common low risk presentations in primary care Social Prescribing Generalised anxiety disorders Depression Bi-Polar Disorder Mental health of the practitioner Useful information Case study - depression References
Chapter 22 The advanced Practitioner as a Prescriber Sarah Pay Aims Learning Outcomes Introduction NMP Professional Considerations The NMP and Scope of practice in primary care Continuing professional development as a prescriber Remote Prescribing Repeat Prescribing Medication Reviews Re-authorisation of repeat medications Medication Review Structured Medication Review (SMR) Medicine Reconciliation Polypharmacy Medicines Optimisation Medicined optimisation for older people Antimicrobial stewardship Delayed prescriptions Communication regarding antibiotic prescribing Supporting other NMP's Reflection Activity References
Chapter 23 Completing the consultation/developing as an ACP and beyond Josey Coaten Aims Learning Outcomes Introduction
Chapter 1 Scope of Practice and the ACP role in primary care Josey Coaten Aim Learning outcomes Introduction Chapter 2 How to get the most from supervision in practice Sarah Pay Aim Learning Outcomes Introduction What is supervision? Competence and Capability Frameworks and Standards Tailored Supervision Planning Supervision in Primary care Overcoming barriers to supervision Demonstrating capability Self- Awareness Reflective Points References Chapter 3 Patient Centred Care Josey Coaten Aim Learning outcomes Introduction
Chapter 4 Clinical Uncertainty Sarah Pay Aim Learning Outcomes Introduction Types of Uncertainty Managing uncertainty Information gathering The value of time as a tool Safety Netting Ethical Considerations and shared decision making Back to Basics Communicating uncertainty Uncertainty and Burnout Reflective point References
Chapter 6 Research Pillar in Primary Care Sarah Pay Aims Learning Outcomes Introduction The importance of the research pillar for ACPs Challenges of embedding research into primary care ACP roles Evidence Based Practice Research Opportunities and the National Institute for Health can Care Research (NIHR) Clinical Academic Roles Quality Improvement Audit Reflective Points References Chapter 7 Education and Teaching Josey Coaten Aims Learning Outcomes Introduction
Unit 3 - Consultation skills
Chapter 8 Consultation Models Sarah Pay Aims Learning Outcomes Introduction Consultation Models Introduction Overview of Models Using a model in practice The short or 15 minute consultation and agenda setting Remote Consultations Conclusion Reflective points References
Chapter 10 History Taking Sarah Pay Aims Learning outcomes Introduction Applying Structure to history taking Care study Preparation (Housekeeping) Introduction and Rapport Building Presenting Complaint Ideas, Concerns and expectations History of Presenting complaint Past Medical History Vaccination History Medication History Allergies Family History Social History Occupation Travel Sexual history Systematic enquiry Closing the encounter Difficult Consultations Collateral History Taking Communication considerations in history taking Managing time Digital tools in history taking Care study reflection References
Chapter 11 Introduction to clinical examination in primary care Sarah Pay Aims Learning Outcomes Introduction Equipment Home Visits The acutely unwell patient Red Flags Chaperone Structured examination principles Preparation/Housekeeping Environment End of bed/chair Inspection Hands Face and Mouth Palpation Percussion Auscultation Lymph Node Assessment History considerations Inspection Palpation Red flag signs for lymphadenopathy Typical features of lymph nodes and associated pathology Decision making, referrals or admissions Case Study - Lymphadenopathy Closer Look- Lymphoma References
Chapter 12 The Respiratory System Sarah Pay Aims Learning Outcomes Introduction History taking for the respiratory presentation Preparation Initiating the consultation Taking a respiratory history Common Presenting Symptoms Chest pain Cough Sputum Breathlessness Wheeze Stridor Haemoptysis Fever/Night sweats and Rigors Weight Changes Sleepiness Red Flags Clinical Examination of the respiratory system Environment End of the bed assessment Hands and arms Face, eyes and mouth Neck Inspection Palpation Percussion Auscultation Posterior Legs Common Presenting complaints in primary care Other investigations in primary care Pulse Oximetry Sputum Cultures Spirometry ECG Peak Flow Fractional exhaled nitric oxide Chest X-ray Blood tests Rapid point of care testing for C-Reactive Protein Pertussis testing Risk tools Case Study - Community Acquired Pneumonia References Chapter 13 The Cardiovascular System Josey Coaten Aims Learning outcomes Introduction
Chapter 17 Ear, Nose and Throat Josey Coaten Aims Learning Outcomes Introduction
Chapter 18 Dermatology Sarah Pay Aims Learning Outcomes Introduction Taking a dermatological history Common presenting symptoms Itching Rash Lesions Pain Psychosocial factors Examination of skin Inspection Description Palpation Systematic Review Examination of moles Dermoscopy and photography Red flags Case study References
Chapter 19 Paediatrics in Primary care Sarah Pay Aims Learning Outcomes Introduction Initiating the consultation with a child and history taking First Impressions Introductions and Rapport building Golden minute and establishing ICE Taking a history Examination Airway Breathing Compromised respiratory system Respiratory distress Respiratory Rate Oxygen saturation Chest Auscultation Circulation Colour Heart Rate Capillary Refill time Blood Pressure Disability ENT Examination Temperature Tummy Blood Glucose Examination Tips Identifying serious illness in children Vital signs Traffic light system/PEWS/Sepsis The Febrile Child Management and parental/carer advice The unexplained fever Growth and Feeding Safety netting Professional and Legal Issues in Paediatrics Consent Gillick Competence Fraser Guidelines Safeguarding Prescribing for children Closer look - Kawasaki Disease Case Study - Bronchiolitis Common differential in primary care - feverish illness Useful resources References
Chapter 20 Mental Health in Primary Care Sarah Pay Aims Learning Outcomes Introduction History taking in Mental Health consultations Mental Status Examination (MSE) Determining risk Ethnicity Frailty Maternal Mental Health Learning Disability Gender History taking framework for mental health Legislation and mental health The Mental Health Act 1983 The Mental Capacity Act 2005 Management of common low risk presentations in primary care Social Prescribing Generalised anxiety disorders Depression Bi-Polar Disorder Mental health of the practitioner Useful information Case study - depression References
Chapter 22 The advanced Practitioner as a Prescriber Sarah Pay Aims Learning Outcomes Introduction NMP Professional Considerations The NMP and Scope of practice in primary care Continuing professional development as a prescriber Remote Prescribing Repeat Prescribing Medication Reviews Re-authorisation of repeat medications Medication Review Structured Medication Review (SMR) Medicine Reconciliation Polypharmacy Medicines Optimisation Medicined optimisation for older people Antimicrobial stewardship Delayed prescriptions Communication regarding antibiotic prescribing Supporting other NMP's Reflection Activity References
Chapter 23 Completing the consultation/developing as an ACP and beyond Josey Coaten Aims Learning Outcomes Introduction
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