Nurse Practitioners’ Perceptions of their Role and Value in UK General Practice

This research explores the role and value of nurse practitioners to UK general practice from the perspective of nurses working in these advanced roles. Nursing has had a presence in general practice for decades, but it is only over the last twenty years that it has extended into a traditional medical domain of care and treatment. Research has understandably focused on the ability of nurses to substitute for doctors and there has been relatively little investigation of what nursing at an advanced level contributes. The study is located within a qualitative interpretive paradigm utilising a Social Constructionist (SC) approach which recognises that knowledge is not based solely on objective observations of the world, but is generated between individuals in the course of their everyday life. The theoretical perspective grounded in this epistemological paradigm is symbolic interactionism (SI). This emphasises the construction of the social world and meaning through the use of symbols, particularly language. Thematic Analysis (TA) is utilised deliberately as a research strategy guiding sampling, data generation, collection and analysis. A purposive sample of ten nurse practitioners was selected. Semi-structured interviews were conducted, digitally recorded, transcribed and the data analysed using Braun and Clarke’s model. Four broad themes were identified from the narratives; the enactment and development of the nurse practitioner role, its value to the organisation and function of general practice, the impact of nurse consultation upon the patient experience and finally, how the role has integrated into the primary health care team. The findings demonstrate that rather than one generic nurse practitioner role in general practice there are multiple constructs, driven at macro level by political necessity, negotiated at micro level by the needs of individual general practices and framed within a professional vacuum of non-regulation. This has not been fully explained before. The research provides a clear and original understanding of what nurse practitioners can contribute to general practice through the diversification of their roles, not as substitute but as part of a diverse, fluid team working collaboratively to address the needs of the general practice population.