A specialist dementia nurse has told of the difference she and her colleagues are making in primary care and why she believes the sector is the ‘best place’ for an Admiral Nurse to be located.
In an interview with Nursing in Practice, Admiral Nurse Liz Tomlinson described the ‘on hand’ support she and her team in Rotherham give to people living with dementia and how this is helping to save GP appointments and prevent hospital admissions.
Admiral Nurses are specialist dementia nurses who are supported and developed by the leading charity, Dementia UK. With plans to have 1,000 Admiral Nurses in post by 2030, there are currently more than 450 in post.
Ms Tomlinson leads a team of seven Admiral Nurses covering six primary care networks and 29 GP surgeries in the Rotherham area.
She said one of her ‘main challenges’ was knowing that not everyone can receive this specialist face-to-face support ‘because Admiral Nurses are not a statutory service that is provided by the NHS’.
‘I always say that I don’t want Admiral Nursing to be a postcode lottery,’ she said. ‘The better we’re getting at diagnosing [dementia] as well, the more people that are needing our support.’
Ms Tomlinson, who spends three days a week supporting families with dementia, is based in a GP surgery but carries out all her contacts at people’s homes, where they typically feel most comfortable.
She and her team support ‘the most complex families’ experiencing and living with dementia and offer help with managing risks, non-compliance with medications and family dynamics, as well as supporting carers and end-of-life issues, among others.
‘That specialist support is literally on hand. We work so hard to avoid hospital admissions and keep people in their preferred place of care and really look at understanding their wishes and take that time to understand who they are and where they’ve come from,’ explained Ms Tomlinson.
She added: ‘I think it’s really important in primary care because often – well probably 98% of the time – if somebody’s experiencing a problem, their first port of call is their GP.
‘And if we are there, then that cuts out that GP appointment, and where they are not going to get an hour and a half [of support], because we are just far too stretched as it is in primary care to be able to give that time.’
According to Ms Tomlinson, the team can see as many as 30 referrals a week to their services and typically have a caseload of between 50 and 60 people.
Admiral Nurses in primary care are usually ‘there from the beginning and all the way through’ a person’s experience with dementia, noted Ms Tomlinson, who previously worked in secondary care.
‘You’re often seen as [becoming] part of the family and part of the furniture of that person’s life,’ she added.
When asked if she felt more Admiral Nurses were needed across primary care settings, Ms Tomlinson said: ‘Yes, definitely, 100%.’
Admiral Nurses have the specialist training to guide people and families ‘through every stage of [their] journey’, she added.
‘So, I think primary care is a real good place to be supporting those families,’ she said.
‘Obviously it’s your first point of contact. It doesn’t take as long as it does to get to secondary care. It doesn’t take as long as it does to get to a memory clinic.’
Ms Tomlinson described how her team worked closely with memory clinics, mental health teams, consultants and GPs, adding: ‘We sort of bring it all together.’
‘So, I believe it’s the best place for an Admiral Nurse to sit if we’re looking at pre-diagnosis and post-diagnostic support,’ she told Nursing in Practice.