Keynote:

Mentorship in GP – encouraging a new approach to advanced nursing practice within general practice

Core Messages:

The role of the Advanced Nurse Practitioner (ANP) was devised to address doctor shortages by increasing access to affordable, equitable healthcare. Development remains in the early stages in primary care, comprising of only 0.7% of the nursing workforce in Ireland.
GP ANPs scope of practice is broad, delivered to a wide cohort of patients with the ability to assess, diagnose, treat and refer patients to secondary care. A significant part of ANP training is receiving close one on one clinical supervision from a GP and as such, mentorship plays a huge role in this service development. Research has proven that ANPs are effective in delivering timely, holistic, quality care. This role is only possible through a close mentorship between GP and candidate ANPs (cANPS), a role I am grateful to carry out.

Objectives:
Educate my European GP colleagues on the evolving role of ANP in GP

Discuss how the role of mentorship between GP and cANPs is essential to shaping their education and utilisation

Inspire my GP colleagues to reflect on potential solutions for their own practices in terms of expansion of nursing roles and taking on a mentorship role in order for this to be facilitated

Explore ways we can promote interdisciplinary mentorship and utilise clinical supervision as a means of ensuring good governance.

My core message centres on maximising the value of the staff surrounding us in our GP practice. By discussing the role mentorship has played between the GPs in my practice with the nursing staff, this will allow for discussion around the potential scope of nursing roles within a modern and evolving general practice environment, mindful of the current challenges facing GP in Europe with the goal of providing high quality clinical care in a team environment.

Themes &structure.

Narrative structure – personal reflection on my own journey to independent clinical practice (completed GP training in June 2024) and how mentorship shaped me. I work principally as a practicing GP but I also teach and examine GP trainees in preparation for their final clinical examinations for the GP training programme in Ireland.

I would look at the Irish context before widening out to a European perspective on GP ANP. From my personal perspective, during GP training I was exposed only to nurses working in traditional roles. In beginning in my current role since completing my GP training 18 months ago, I have been amazed by the range of skills our nursing staff have been trained to provide. Our practice is fortunate to have two nurses - one training as an ANP and another has undertaken clinical prescribing training. I have acted, alongside my GP partner, in a mentorship role for both of these nurses as they have undergone further training, linked with the Royal College of Physicians in Ireland. This has been a formative experience for myself and I will reflect on this.

One key aspect of our mentorship is the presence of a psychologically safe environment, allowing for learners to feel empowered to take risks such as sharing an idea for improvement or asking questions whereby the learner admits to knowledge deficits. This has allowed us to foster a positive, open atmosphere allowing for high standards to exist with patients at the core of our endeavours. As a result, it has been a rewarding experience professionally & personally.

Themes include mentorship, one on one clinical supervision, planning and assessing the learning needs of the mentee, structural support and the evolution of GP practice. The goal is not to replace the GP but to enhance the support in place for patients in allowing them access to high quality, community focused, dignified care.

I’d expand on what the ANP role has meant for our practice - the cANP’s scope of practice has expanded through clinical exposure with supervision. The ANP role is distinguished by higher-level practice that includes knowledge sharing, clinical leadership, and the development of others. This was demonstrated by our cANP through dissemination of best-practice obesity management, auditing urinary tract infection management, and leading a benzodiazepine reduction initiative. The principal driver of influential change in practice has been multidisciplinary loop reflection. This deeper level of critical thinking allowed the team to overcome barriers to change via continuous, cyclical team reflection.
I would finish my talk by reflecting on the future for our own practice – our cANP has received a lecturing position. The cANP and myself have been selected to present our a cANP led benzodiazepine deprescribing initiative at the WONCA Europe 2026 conference this summer and hope to use this as an opportunity to showcase the range of collaborations possible between GPs and advanced nursing staff.

Why this perspective matters

In Ireland, there is understaffing across GP, resulting in increased demands on existing GPs. I would highlight the multiple benefits of upskilling nursing staff – improved staff morale, staff retention, improvement in the quality of care patients receive, keeping up to date in terms of clinical practice, improved patient access to high quality, appropriate clinical care and ultimately protecting against clinician burnout.

Across Europe there is variation in the teams that operate to support GPs. This example may provide inspiration to GPs across Europe and allow them to see themselves reflected in our example. ANP is an emerging field in general practice and quite likely is something that the majority of attendees may not be entirely familiar with. Having attended the Equip conference to do a poster presentation in 2024, I have retained links with GPs from across Europe and been inspired to push myself further in my clinical work as a result.
GP is a collaborative endeavour and there is great potential for the development of advanced nursing practice to assist in providing a high quality care to our communities across Europe. I hope that by illuminating this evolving area that this may lead to further collaboration and innovation amongst my European colleagues.