A Day In The Life...

Jan Flynn, Frailty Nurse Practitioner

Jan, and Liz Crabtree (Frailty Nurse), may well be familiar faces since they are often out and about in the community providing support to those who are frail and their families.

Following a career in general nursing, Jan's initial experience of working in General Practice was in Wiltshire when for the first time her job focus was helping people who were becoming frail to remain independent in their own homes and where possible, avoid an admission to hospital.

Having relocated to Warwickshire in 2017, Jan joined Shipston Medical Centre (SMC) also as a Frailty Nurse but, knowing that frailty services across the UK are very variable, I wanted to properly understand what the SMC team offers and how that compares with other areas.

Jan explained that the service has developed a great deal since she first joined the Practice as part of a three-year pilot funded by the League of Friends to assess the value of Frailty Team support for the Shipston community. With that value well and truly demonstrated, the service continues today as a result of ongoing investment by the Practice Partners.

Nowadays, GPs or families are able to refer individuals who are becoming frail to the Frailty Team. Jan and Liz also provide a drop-in service on the third Thursday of the month (10am to 12pm) at the Community Warm Hub which takes place at the Scout Hut, New Road, Shipston.

Between them, Jan and Liz are able to provide the full cycle of clinical assessment, treatment, follow up and review, according to need. Enabling that, Jan described how she has developed her skills and knowledge over the last few years, leading to the achievement of prescribing and advanced nurse practitioner qualifications.

As a PPG we regularly hear how much those who are frail appreciate the opportunity to have a continuing point of contact with the Practice; someone who gets to know them and their family members and can recognise and act when there is a need for a specific intervention. Supporting people to remain independent in their own homes, avoiding the need to be admitted to hospital, freeing up GP time, signposting to other services such as the social prescriber, and just giving people peace of mind are all seen as very worthwhile benefits.

Well ahead of any contractual requirement, the SMC Frailty Team have also for a long time provided clinical support to residents in Low Furlong and more recently, Shipston Lodge. Again, that has proved to be an invaluable service meaning that with frequent ward rounds at both, Jan and Liz are able to be proactive in advising staff (or families) who have health concerns about any of the residents.

Jan described the range of their activities during an average day starting at 8am. Included are; checking of blood test results, visits to patients either in their own homes or at one of the care homes, phone calls, referrals to and liaison with relevant hospital personnel, teaching (student nurses and doctors), communication with other staff and patients' families. The working day ends at 6pm with all patient related notes updated and actions completed.

So – what did I learn is different about the SMC frailty service?

The fact that between them, Jan and Liz take responsibility for the full cycle of care for the moderately and severely frail patients identified within our community. Also, unlike other areas, they continue to provide a clinical point of contact and appropriate follow up for those patients according to their level of need, something which I mentioned before is highly valued.

Coming to the end of our discussion, I asked Jan to comment on what she likes best about her job. Without hesitation, she described her satisfaction in helping patients to resolve a clinical or other problem – the 'opportunity to have a positive impact on someone's life'.