Clinical scope and workforce contribution of advanced nurse practitioners in general practice: a cross-sectional study.

Abstract

Aim: To examine the clinical activity and workforce contribution of Advanced Nurse Practitioners (ANPs) working in general practice.

Background: Primary care systems internationally are experiencing increasing demand due to ageing populations, rising multimorbidity and workforce shortages. Advanced nursing practice has expanded globally as a strategy to strengthen service capacity, improve access and maintain quality outcomes. Although there is substantial evidence regarding patient outcomes associated with advanced practice roles, there is comparatively limited empirical data describing the day-to-day clinical activity of ANPs in primary care settings.

Methods: This national cross-sectional descriptive study, conducted in Ireland and reported in accordance with the STROBE Statement, involved a 1-week activity capture of General Practice Advanced Nurse Practitioners (GP ANPs) and candidate ANPs (cANPs) working across general practice settings. Data collected included consultation type, prescribing activity, complexity of care and clinical outcomes. Data were analysed using descriptive statistics.

Results: Twenty GP ANPs/candidate ANPs recorded 1659 consultations, including 757 full episodes of care (45.6%). Practice spanned acute illness (adults and children), chronic disease management, women's health and preventive services. Medication optimisation activity included 503 medication reviews, 251 prescriptions issued and 59 medications deprescribed. About 15% of consultations were classified as complex and 14.8% involved multiple presenting complaints. Most consultations were independently managed.

Conclusion: GP ANPs demonstrate broad clinical capability and contribute substantially to general practice capacity. The findings highlight the value of a holistic nursing approach, which is well suited to chronic disease management, health promotion, patient education and the management of multimorbidity, supporting access to care and strengthening primary care workforce capacity.