Nurse Roxanne O'Reilly treats patients at a clinic in Boorowa in the NSW Riverina. (ABC Riverina: Jess Scully )

Nurses working at a medical centre in southern NSW are stepping onto the frontline of patient care to ease the burden on GPs.

The Nurse-Led Clinics initiative that was trialled at 18 practices across the Riverina last summer is being expanded.

Nurses involved focus on patients needing chronic disease management or routine health checks, rather than diagnosis.

For Roxanne O'Reilly, the program allows her to help her community.

Born in the Riverina town of Young, she still lives in the area and has worked as a nurse at a local medical clinic for the past four years.

"Even though it's tough and hard, it's a rewarding job where you're helping other people," she said.

"I've seen the struggle [of] how hard it is to get health care out here."

Ms O'Reilly is running a nurse-led clinic at the Boorowa Street Practice, as part of a pilot scheme run by the Murrumbidgee Primary Health Network.

Acute shortages​

The program's expansion coincides with a nationwide shake-up of the profession that will eventually see registered nurses allowed to prescribe medications.

It also comes at a time when many rural and regional areas are struggling to attract general practitioners (GPs).

The shortage has become so acute that many communities are offering incentives for GPs willing to relocate, and there are lingering concerns about patients presenting at hospital emergency departments due to long waiting lists for GP appointments.

Figures from the NSW Government's Bureau of Health Information show that in the first half of this year more than 11,000 patients went to emergency department's in the Murrumbidgee Local Health District seeking treatment for non-urgent medical issues.

Ms O'Reilly said the Hilltops region had a higher prevalence for diabetes than the national average — 17 per cent of adults compared to 11 per cent nationwide — so the clinic had a logical focus.

"Bringing in a foot-care clinic just dedicated to diabetics in this region reduce the chances of people losing limbs or heading to hospital" she said.

Ms O'Reilly said her role was to monitor and manage patients' chronic health conditions.

"I do a lot of wound care … injections, immunisations, chronic disease care plans," she said.

While any serious concerns would be relayed to the doctors at the clinic, Ms O'Reilly said taking on more routine duties allowed the GPs to see more patients.

"If they did [all those things] in one day, then they wouldn't see a patient for anything else," she said.

Follow-ups more likely​

Chairth Wickramaratne says the wait time to see a doctor in the practice is usually about two days.

He said the new system allowed him to spend more time with patients who had complex needs.

Dr Wickramaratne would like to see nurses' duties to be billable on the Medicare Benefits Schedule. (ABC Riverina: Jess Scully)

"Honestly, this program should have happened a long time ago," Dr Wickramaratne said.

"If I have to come monitor somebody while they're having an infusion [that takes] half an hour."

Dr Wickramaratne said patients now seemed more likely to come back for follow-up appointments as Ms O'Reilly worked as a connection between the patient and their doctor.

​

"They prefer to see the nurse than the GP" he said.

"Continuity of care is the most important part of the whole game."

But Dr Wickramaratne said under present funding models, most of what Ms O'Reilly did could not be billed under Medicare.

Murrumbidgee Primary Health Network project officer Elise Penton said the project would be expanded this year from 18 locations, including Tumut, Temora, Tumbarumba and Wagga Wagga, to 28 nurse-led clinics across the region.

She said the program was designed to ease the burden on GPs and the hospital system.

​

"This is just scratching the surface but … we'll start seeing better health outcomes for patients, particularly with chronic diseases," Ms Penton said.

An evaluation of last year's trial showed 94 per cent of GPs and practice managers agreed the model was sustainable, with 87 per cent reporting they were likely to continue using it.

By Jess Scully

 

[Benny's Light]

A great idea to help access better health care and reduce wait times.

 

[Gezzabel]

There’s a huge difference between the knowledge of a doctor and a nurse. I’m a nurse, and I would never want the responsibility to prescribe any medication, because that’s what doctors and pharmacists do best. This is a short cut, and mistakes will be made. Pharmacology taught in Nursing school, is totally inadequate, and it’s a big responsibility for nurses, when doctors are trained to prescribe medications. Nurses are not.

 

[Luckyus]

Think I'll stick with my GP.

 

[Gezzabel]

Sticking a bandaid on our doctor shortages, isn’t going to be resolved by nurses writing scripts. It’s not just a simple medication script, but it’s about the pharmacology involved when considering patients safety. Side effects are a big problem to deal with. Also, what would be the legal consequences, for a nurse who has prescribed medication unsuitable for a patient.

 

[Vet543]

HEAR! HEAR! Gezzabel.
I love nurses they have the best job caring for people, me included. I only need one medication that I have been taking for 22 years. It is no big deal BUT I feel that the Doctor should authorise the repeats for me .. and that can simply be an Approval without a consultation other than what the nurse can see and pass on to the doctor at my clinic.
Simply ascertain and pass the decision to the Doctor. He/She has access to my medical files, so, many people in the clinic are getting help with a Nurse for First Aid and such things as Dewaxing, Vaccinations and more issue that don't need a Doctor.
Back in 1968, we had a beautiful little girl in Townsville, The heat was horrible, the baby could not keep breast milk down and began deteriorate. Doctors remedies were failing and a chemist suggested talking to a retired nurse, who sent us to buy supplement food and cease breast feeding... quite a big issue BUT IT WORKED. She was the only person from the district that seem to know the complexities ... I Love that Nurse. She saved our girl.
The clinic doctor approved and the supplements worked great. So this issue was suggest by a highly knowledgeable Nurse and approved by a phone call to the doctor .. She did NOT write a script, simply helped to save our girl and have a doctor approve.. I call that "perfect care" without wasting a doctors care-time. I often wonder how many babies in Townsville that this nurse saved. She deserve a medal, if she is still alive today
Daddy's Girl is now 57 and working with the Police Force in Solomon Islands.

 

[Sherril54]

I have nothing against nurses at all and I think they do wonderful job under some very difficult cicumstances, but this is pushing it too far.! In Australia it takes about 10-15 years to become a registered G.P. To become a registered nurse it is approximatley 3 yrs. So there you are, I know who I`d prefer to see. As for nurses prescribing medications ?? Doctors can make mistakes with this, it is such a specialised area. I think this entire situation is risky and is the result of a shortfall of doctors in rural and regional areas. The Government realy needs to step up incentives for those who want to undertake medical studies and also those who graduate. There will be a greater influx of migrant Doctors arriving in Australia if this dosen`t improve and I know many people don`t like this, but it is a fact. I have previously said if Muslim Dr`s were not workimg at our local hospital the doors would close. By the way I have found Muslim Dr`s to be caring and very professional.