Understanding pressures in general practice. 2016. (accessed 21 June 2021)

Billay D, Myrick F, Yonge O. Preceptorship and the nurse practitioner student: navigating the liminal space. J Nurs Educ.. 2015; 54:(8)430-437

Birt L, Scott S, Cavers D, Campbell C, Walter F. Member checking: a tool to enhance trustworthiness or merely a nod to validation?. Qual Health Res.. 2016; 26:(13)1802-1811

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol.. 2006; 3:(2)77-101

Collins D. Assessing the effectiveness of advanced nurse practitioners undertaking home visits in an out of hours urgent primary care service in England. J Nurs Manag.. 2019; 27:(2)450-458

Goetz K, Kornitzky A, Mahnkopf J, Steinhäuser J. At the dawn of delegation? Experiences and attitudes of general practitioners in Germany—a questionnaire survey. BMC Fam Pract.. 2017; 18:(1)

Green J, Willis K, Hughes E Generating best evidence from qualitative research: the role of data analysis. Aust N Z J Public Health.. 2007; 31:(6)545-550

Hamric A. A definition of advanced nursing practice, 5th edn. In: Hamric A, Hanson C, Tracy MF, O'Grady E (eds). St Louis, MO: Elsevier Saunders; 2013

Harris M, Advocat J, Crabtree B Interprofessional teamwork innovations for primary health care practices and practitioners: evidence from a comparison of reform in three countries. J Multidiscip Healthc.. 2016; 9:(9)35-46

Kerr L, Macaskill A. The journey from nurse to advanced nurse practitioner: applying concepts of role transitioning. Br J Nurs.. 2020; 29:(10)561-565

King N, Horrocks C. Interviews in qualitative research.London: Sage; 2010

Main R, Dunn N, Kendall K. Crossing professional boundaries: barriers to the integration of nurse practitioners in primary care. Educ Prim Care.. 2007; 18:(4)480-487

MacDonald JA, Herbert R, Thibeault C. Advanced practice nursing: unification through a common identity. J Prof Nurs.. 2006; 22:(3)172-179

McKenna H, Pajnkihar M, Murphy F. Fundamentals of nursing models, theories and practice.Oxford: Wiley Blackwell; 2014

NHS England. Five year forward view. 2014. (accessed 21 June 2021)

Nursing and Midwifery Council. NMC Strategy 2020-2025. 2020. (accessed 21 June 2021)

Riessman CK. Narrative methods for the human sciences.London: Sage; 2008

Royal College of Nursing. Advance nurse practitioners: an RCN guide to the advanced nurse practitioner role, competencies and programme accreditation. 2008. (accessed 21 June 2021)

Royal College of Nursing. Standards for advanced level nursing practice. 2018. (accessed 21 June 2021)

Skill mix: how paramedics can help general practice. 2016. (accessed 21 June 2021)

Theile G, Kruschinski C, Buck M, Müller C, Hummers-Pradier E. Home visits—central to primary care, tradition or an obligation? A qualitative study. BMC Fam Pract.. 2011; 12

Tod A. Interviewing, 7th edn. In: Gerrish K, Lacey A (eds). Chichester: Wiley-Blackwell; 2015

van den Berg N, Heymann R, Meinke C, Baumeister SE, Flessa S, Hoffmann W. Effect of the delegation of GP-home visits on the development of the number of patients in an ambulatory healthcare centre in Germany. BMC Health Serv Res.. 2012; 12

Van der Biezen M, Adang E, Van Der Burgt R, Wensing M, Laurant M. The impact of substituting general practitioners with nurse practitioners on resource use, production and health-care costs during out-of-hours: a quasi-experimental study. BMC Fam Pract.. 2016; 17:(1)

In-hours acute home visits by advanced nurse practitioners in primary care: a qualitative study

08 July 2021
Volume 30 · Issue 13



The extension of roles within the primary care team is one approach recommended to address the shortage of GPs in the UK. A key aspect of care that advanced nurse practitioners (ANPs) can undertake is acute home visits.


To evaluate the perspectives of ANPs performing acute in-hours home visits in primary care.


Qualitative data were gathered in eight semi-structured interviews across a primary care locality, then analysed via a process of thematic analysis.


Three key themes were identified: providing holistic care; engaging with the home setting; and negotiating role ambiguity.


Practices wishing to involve ANPs in acute home visits should ensure clear definition and good understanding of the ANP role. Effective interprofessional relationships should be fostered with appropriate mentorship and clinical supervision to support ANPs in optimising their contribution to acute home visits.

Primary care advanced nurse practitioners (ANPs) are health professionals who can make autonomous decisions about patient diagnosis and screening, order tests and investigations, prescribe, refer to other services such as secondary care and work with other primary care professionals to provide patient care (Royal College of Nursing (RCN), 2018). ANPs are now working widely as ‘doctor substitutes’ in primary care, and this substitution is considered a promising model worldwide (Van der Biezen et al, 2016). It has been highlighted that general practice is in crisis due to a growing workload uncompensated by any increase in funding or workforce (Baird et al, 2016). General practice is delivering care under significant pressure, not just in the surgery setting, but also in patients' private homes and residential/nursing care facilities. As the general practice workload has increased with an emphasis on carrying out more care out of hospital (NHS England, 2014), the ANP role within general practice has been expanding from chronic disease management to cover more elements of acute care.

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content