A general practice nurse in Newcastle has been offering a ‘one stop health shop’ at a local foodbank-turned welfare hub as part of her ongoing efforts to address health inequalities.
Rebecca Shearer, lead nurse and advanced nurse practitioner at West Road Medical Centre, told Nursing in Practice about the difference she was trying to make to patients’ lives and outcomes within her deprived area of Newcastle.
Since January she has been supporting the public at her local welfare hub with ‘the basics’ such as blood pressure checks, asthma and inhaler education and signposting to community pharmacies.
With the current pressures on primary care ‘the worst they have been’, Ms Shearer said working at the hub had given her ‘the beauty of doing what practice nurses don’t have time to do’.
While collecting data on how many GP appointments are saved by the hub, which is supported by a range of professionals including specialist nurses, health visitors and safeguarding staff, Ms Shearer is also focused on the barriers people have in accessing GP practices.
‘We have to accept the vulnerabilities of some of our patients,’ said Ms Shearer, who noted examples of patients with mental health illnesses or sleeping issues that were unable to be on the phone first thing in the morning to try and get an appointment.
Ms Shearer said she was yet to come across a practice that has got their access to appointments right and recognised there was not necessarily an ‘easy answer’.
‘But I think what we all know is that we’ve got to start addressing the whole needs of a person, so we can’t address the health if they live in a cold house, we can’t address their health if they can’t afford to eat properly and health is not a focus if there’s domestic violence issues at home,’ she explained.
Ms Shearer’s work at the hub came as part of an innovation project, funded by the Queen’s Nursing Institute, that she spearheaded to help tackle health inequalities.
As part of the same funding, Ms Shearer launched an initiative last spring to help patients who have a chronic disease better understand their results – such as from their weight and blood pressure checks – ahead of their annual reviews at the practice.
Around a fifth of the local population do not have English as their first language and many have poor literacy skills.
This meant a three-paged results letter handed to some patients ahead of their annual reviews was not always the best way to help them understand their condition or engage in care planning, she explained.
Her idea was to provide patients with their results in a format they understand, using a traffic lights system that used more pictures.
The plan was for patients’ results to be presented in red if they were bad, amber if they were in the middle and green if they were good – but IT barriers meant this was not possible.
Instead, she created a chart which gives patients a numerical result that they would compare to the traffic light colours to see how their results were.
Ms Shearer was disappointed she had not been able to achieve the simplistic approach she had aimed for, but she said she had searched ‘all over the place’ to find an IT system that would work without any luck.
Despite this, she said the new system was working much better for a lot of patients, especially the younger generation.
‘The idea is that if the patients understand the results, then we can improve outcomes,’ she told Nursing in Practice.
When asked what drives her to make these changes and improvements, Ms Shearer said: ‘I went into nursing to make a difference.
‘Every day I am still trying to do better and trying to make a difference to patients’ lives and outcomes.
‘It’s about any small improvement, no matter how small or how big.’
