– I wouldn’t be where I am now if it hadn’t been for that team. This is what Morten Ludvigsen says about the follow-up he has received through the primary care team at Brumunddal medical center. Over five years, the medical center has gained good experience with a separate offer for patients who need complex healthcare services. The question is whether these experiences can bring the health sector closer to a solution to the GP crisis. NURSE CONSULTATION: Nurse Tom Dalby Moe surveys the patients’ challenges and wishes for further treatment. Together with the patient himself, he gives a summary to the GP. Photo: Arne Sørenes / news Close follow-up Morten Ludvigsen has had several health challenges in recent years. Among other things, he needs help to deal with stress and “thinking”. – There have been times when I have been here up to twice a week for a conversation. Brumunddal medical center in Ringsaker municipality is one of a total of 17 GP offices in the country that is involved in a pilot project with primary care teams. Follow-up in primary care teams is especially for people who need closer contact with the health service. The team consists of a GP, nurse, psychologist and health secretary. – I feel that I am better heard and that I get good follow-up when the nurse and doctor talk to each other while I am in the room, says Ludvigsen. Primary healthcare teams in the municipalities Photo: Arne Sørenes / news On 1 April 2018, an experiment started with primary healthcare teams in GP offices. The purpose of the project is to offer better GP services to those patients who need it most. Patients who can benefit from a primary care team include patients with chronic diseases, mental health problems and drug addiction, frail elderly people, and people with developmental disabilities and functional impairments The project includes a total of 17 GP offices with a total of 112 GPs in the municipalities of Rana, Austevoll, Stad (Eid) , Kinn (Flora), Hå, Ringsaker, Seljord, Kristiansand and Oslo (the districts of Alna, Nordstrand and Sagene). The GP offices in the project have received resources for new nurses in the teams and two of the GP offices have received resources for a psychologist in the primary care team. The trial is being evaluated through a collaboration between the University of Oslo at the Department of Health and Society, the National Center for District Medicine (University of Tromsø) and Oslo Economics. Source: Directorate of Health The picture is from Brumunddal medical center in Ringsaker municipality, where the Norwegian Association of Psychologists, the Association of General Practitioners and the Norwegian Association of Nurses were recently on a study visit. More healthcare for the money The nurses have more time than the doctor to talk to the patients. Then they can get to know the individual well and get an overview of the challenges. Nurse at Brumunddal medical centre, Tom Dalby Moe, believes their work contributes to the doctors being able to make good professional judgements. The nurses also have time to work more preventively. – I think that as nurses and GPs we achieve very good teamwork. We have focused on what the various professional professions can contribute. BUILDING RELATIONSHIPS WITH THE PATIENTS: – Here we get time and confidence to be nurses and to provide good nursing care, says Tom Dalby Moe. Photo: Arne Sørenes / news Moe is supported by Navnit Singh Rattan. He works as a GP in his ninth year at the medical centre. Rattan believes that teamwork gives him a better overview and that he gets to use his time in the best possible way. – Instead of taking in the patients that the nurses follow up, I can take in new patients. Then we get increased available capacity. WORK SMARTER: Doctor Navnit Singh Rattan believes they work more efficiently and smarter now that they have established primary care teams. He believes that the tasks he, as a doctor, does not need to take responsibility for are better distributed now. Photo: Arne Sørenes / news Wants to learn from the experiences in Brumunddal Nils Kristian Klev is head of the Association of General Practitioners. He estimates that 235,000 people in Norway are without a GP. Klev says the workload for doctors is too high and that many young doctors feel they work a lot alone. More teamwork can be the way to go, he says. Back in 2015, then Minister of Health Bent Høie announced a completely new organization of the health service in Norway. Now the Association of Psychologists, the Association of General Practitioners and the Norwegian Nurses’ Association have been on a study visit to Brumunddal Medical Center. Klev has followed developments in the medical centre, and believes they have managed to think anew. – With extra resources, they have managed to organize the work which I believe both increases well-being and also benefits the patients. NEED TO RELIEF THE REGISTRY PHYSICIAN SYSTEM: According to Nils Kristian Klev, more doctors are needed who can share on the patient lists, and a better distribution of the tasks that others can also do. – For many it is important to see the doctor, but there are also other professional groups that have an important role. Photo: Arne Sørenes / news Kirsten Brubakk, deputy chairperson of the Norwegian Nurses’ Association, believes that medical centers must make room for different professional professions in the future. – Coming to a center that has clarified roles in relation to their responsibilities, and where the nurses’ time is prioritized to be present for the patients – that is the unique thing we have heard about today. Important to take on board The medical offices participating in the experiment with primary care teams have a great deal of freedom in how they organize their team. This has also given different experiences. The evaluation report from 2022 strengthens the perception that primary care teams are a good arrangement for patients. – The evaluation reflects the experiences we hear from the pilot offices, writes Liv Heidi Brattås Remo in an email to news. She is a department director in the Directorate of Health. It is crucial that the doctor’s office involves the nurse and health secretary in a good way in the work, according to the report. – The patients highlight conversation and information from nurses as important in the follow-up, writes Remo. The trial with primary care teams ends on 31 March 2023. – The experiences are important to take into account when the services are to be developed in the future to meet the GP crisis, concludes the department director. Task sharing may be the answer Yesterday, the Health Personnel Commission’s report was published. It is about how the challenges with staffing in the health sector are to be solved. The commission is proposing major changes to which tasks the various professional groups in the health services must carry out. – The Health Personnel Commission has given us a description of reality which we together must take seriously, stated Minister of Health and Care Ingvild Kjerkol (Ap) when she received the report. The Health Personnel Commission Consists of 16 members and is led by Gunnar Bovim. Was established in December 2021. Representatives from employees, employers, the specialist health service, the municipal health and care services and the education sector are involved in the work. 2 FEBRUARY 2023: Minister of Health and Care, Ingvild Kjerkol (Ap) and Minister of Research and Higher Education Ola Borten Moe (Sp) receive the report from the Health Personnel Commission’s head Gunnar Bovim. Photo: Javad Parsa / NTB
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