The Advanced Practitioner in Primary Care
Equipping Advanced Practitioners with the skills, insight, and confidence to lead in modern primary care

The Advanced Practitioner in Primary Care is a timely resource that provides current and aspiring Advanced Practitioners (APs) with a practical roadmap for delivering high-quality, patient-centred care in complex and fast-paced primary care environments. Built on the four pillars of advanced practice—clinical practice, leadership, education, and research—this text supports practitioners in bridging the gap between academic theory and clinical application.

Written by experienced clinicians and educators, this book is framed by national and international guidelines—applicable to adult, paediatric, and mental health contexts—and reinforced by real-world case studies that contextualise concepts and build confidence in managing diverse clinical scenarios.

Providing the structured support and evidence-informed guidance necessary for confident, competent, and reflective practice, The Advanced Practitioner in Primary Care:

  • Covers complex consultation skills, clinical reasoning, systems-based clinical assessments, and decision-making with evidence-informed guidance
  • Addresses the management of uncertainty and diverse patient presentations, including frailty and paediatrics
  • Offers practical insights on getting the most from supervision and professional development pathways
  • Includes a dedicated chapter on prescribing and medication management tailored for APs
  • Discusses the evolving scope of the AP role in the context of local, national, and international policy

The Advanced Practitioner in Primary Care is essential reading for trainee and established APs working in primary care, as well as for nurses, paramedics, pharmacists, physiotherapists, and other professionals transitioning into general practice. It is also ideal for postgraduate programmes in advanced clinical practice and a valuable resource for educators and primary care teams supporting AP development.

1148075620
The Advanced Practitioner in Primary Care
Equipping Advanced Practitioners with the skills, insight, and confidence to lead in modern primary care

The Advanced Practitioner in Primary Care is a timely resource that provides current and aspiring Advanced Practitioners (APs) with a practical roadmap for delivering high-quality, patient-centred care in complex and fast-paced primary care environments. Built on the four pillars of advanced practice—clinical practice, leadership, education, and research—this text supports practitioners in bridging the gap between academic theory and clinical application.

Written by experienced clinicians and educators, this book is framed by national and international guidelines—applicable to adult, paediatric, and mental health contexts—and reinforced by real-world case studies that contextualise concepts and build confidence in managing diverse clinical scenarios.

Providing the structured support and evidence-informed guidance necessary for confident, competent, and reflective practice, The Advanced Practitioner in Primary Care:

  • Covers complex consultation skills, clinical reasoning, systems-based clinical assessments, and decision-making with evidence-informed guidance
  • Addresses the management of uncertainty and diverse patient presentations, including frailty and paediatrics
  • Offers practical insights on getting the most from supervision and professional development pathways
  • Includes a dedicated chapter on prescribing and medication management tailored for APs
  • Discusses the evolving scope of the AP role in the context of local, national, and international policy

The Advanced Practitioner in Primary Care is essential reading for trainee and established APs working in primary care, as well as for nurses, paramedics, pharmacists, physiotherapists, and other professionals transitioning into general practice. It is also ideal for postgraduate programmes in advanced clinical practice and a valuable resource for educators and primary care teams supporting AP development.

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The Advanced Practitioner in Primary Care

The Advanced Practitioner in Primary Care

by Josey Coaten, Sarah Pay
The Advanced Practitioner in Primary Care

The Advanced Practitioner in Primary Care

by Josey Coaten, Sarah Pay

Paperback

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Overview

Equipping Advanced Practitioners with the skills, insight, and confidence to lead in modern primary care

The Advanced Practitioner in Primary Care is a timely resource that provides current and aspiring Advanced Practitioners (APs) with a practical roadmap for delivering high-quality, patient-centred care in complex and fast-paced primary care environments. Built on the four pillars of advanced practice—clinical practice, leadership, education, and research—this text supports practitioners in bridging the gap between academic theory and clinical application.

Written by experienced clinicians and educators, this book is framed by national and international guidelines—applicable to adult, paediatric, and mental health contexts—and reinforced by real-world case studies that contextualise concepts and build confidence in managing diverse clinical scenarios.

Providing the structured support and evidence-informed guidance necessary for confident, competent, and reflective practice, The Advanced Practitioner in Primary Care:

  • Covers complex consultation skills, clinical reasoning, systems-based clinical assessments, and decision-making with evidence-informed guidance
  • Addresses the management of uncertainty and diverse patient presentations, including frailty and paediatrics
  • Offers practical insights on getting the most from supervision and professional development pathways
  • Includes a dedicated chapter on prescribing and medication management tailored for APs
  • Discusses the evolving scope of the AP role in the context of local, national, and international policy

The Advanced Practitioner in Primary Care is essential reading for trainee and established APs working in primary care, as well as for nurses, paramedics, pharmacists, physiotherapists, and other professionals transitioning into general practice. It is also ideal for postgraduate programmes in advanced clinical practice and a valuable resource for educators and primary care teams supporting AP development.


Product Details

ISBN-13: 9781394253739
Publisher: Wiley
Publication date: 03/09/2026
Series: Advanced Clinical Practice
Pages: 464
Product dimensions: 6.00(w) x 1.25(h) x 9.00(d)

About the Author

Josey Coaten is a lecturer and Programme Director for the MSc Advanced Clinical Practice at the University of Hull. An experienced registered nurse and Advanced Clinical Practitioner, she is also a non-medical independent prescriber. Josey brings extensive experience from primary care, having held roles from practice nurse to Senior ACP. She holds a postgraduate certificate in academic practice and is a Fellow of AdvancedHE.

Sarah Pay has experience as a lecturer in the MSc Advanced Clinical Practice programme at the University of Hull and currently works as an ACP and clinical educator at Haxby Group. With a background in adult nursing, she has worked extensively in primary care as both a practice nurse and a Senior ACP. She is a non-medical prescriber and holds a postgraduate certificate in academic practice, as well as being a Fellow of AdvancedHE.

Table of Contents

Unit 1 – The ACP Role in Primary Care

 

Chapter 1        Scope of Practice and the ACP role in primary care

Josey Coaten

Aim

Learning outcomes

Introduction   

Chapter 2        How to get the most from supervision in practice

Sarah Pay

Aim

Learning Outcomes

Introduction

What is supervision?

Competence and Capability

Frameworks and Standards

Tailored Supervision

Planning Supervision in Primary care

Overcoming barriers to supervision

Demonstrating capability

Self- Awareness

Reflective Points

References     

Chapter 3        Patient Centred Care

Josey Coaten

Aim

Learning outcomes

Introduction   

 

Chapter 4        Clinical Uncertainty

Sarah Pay

Aim

Learning Outcomes

Introduction

Types of Uncertainty

Managing uncertainty

     Information gathering

     The value of time as a tool

     Safety Netting

     Ethical Considerations and shared decision making

     Back to Basics

Communicating uncertainty

Uncertainty and Burnout

Reflective point

References

               

Unit 2 – Leadership

 

Chapter 5        Leadership

Josey Coaten

Aims

Learning outcomes

Introduction   

 

 

 

 

Chapter 6        Research Pillar in Primary Care

Sarah Pay

Aims

Learning Outcomes

Introduction

The importance of the research pillar for ACPs

Challenges of embedding research into primary care ACP roles

Evidence Based Practice

Research Opportunities and the National Institute for Health can Care Research (NIHR)

Clinical Academic Roles

Quality Improvement

Audit

Reflective Points

References     

Chapter 7        Education and Teaching

Josey Coaten

Aims

Learning Outcomes

Introduction   

 

Unit 3 – Consultation skills

 

Chapter 8        Consultation Models

Sarah Pay

Aims

Learning Outcomes

Introduction

Consultation Models Introduction

Overview of Models

Using a model in practice

The short or 15 minute consultation and agenda setting

Remote Consultations

Conclusion

Reflective points

References     

 

Chapter 9        Advanced Clinical Reasoning

Josey Coaten

Aims

Learning Outcomes

Introduction   

 

Unit 4 – Clinical Examination and Assessment

 

Chapter 10     History Taking

Sarah Pay

Aims

Learning outcomes

Introduction

Applying Structure to history taking

    Care study

    Preparation (Housekeeping)

    Introduction and Rapport Building

    Presenting Complaint

    Ideas, Concerns and expectations

    History of Presenting complaint

    Past Medical History

    Vaccination History

    Medication History

    Allergies

    Family History

    Social History

    Occupation

    Travel

    Sexual history

    Systematic enquiry

    Closing the encounter

Difficult Consultations

Collateral History Taking

Communication considerations in history taking

Managing time

Digital tools in history taking

Care study reflection

References     

 

Chapter 11     Introduction to clinical examination in primary care

Sarah Pay

Aims

Learning Outcomes

Introduction

Equipment

Home Visits

The acutely unwell patient

    Red Flags

Chaperone

Structured examination principles

     Preparation/Housekeeping

     Environment

     End of bed/chair

     Inspection

        Hands

        Face and Mouth

     Palpation

     Percussion

     Auscultation

Lymph Node Assessment

     History considerations

     Inspection

     Palpation

     Red flag signs for lymphadenopathy

     Typical features of lymph nodes and associated pathology

Decision making, referrals or admissions

Case Study – Lymphadenopathy

Closer Look- Lymphoma

References     

 

Chapter 12     The Respiratory System

Sarah Pay

Aims

Learning Outcomes

Introduction

History taking for the respiratory presentation

     Preparation

     Initiating the consultation

     Taking a respiratory history

Common Presenting Symptoms

     Chest pain

     Cough

     Sputum

     Breathlessness

     Wheeze

     Stridor

     Haemoptysis

     Fever/Night sweats and Rigors

     Weight Changes

     Sleepiness

     Red Flags

Clinical Examination of the respiratory system

     Environment

     End of the bed assessment

     Hands and arms

     Face, eyes and mouth

     Neck

     Inspection

     Palpation

     Percussion

     Auscultation

     Posterior

     Legs

Common Presenting complaints in primary care

Other investigations in primary care

     Pulse Oximetry

     Sputum Cultures

     Spirometry

     ECG

     Peak Flow

     Fractional exhaled nitric oxide

     Chest X-ray

     Blood tests

     Rapid point of care testing for C-Reactive Protein

     Pertussis testing

Risk tools

Case Study – Community Acquired Pneumonia

References     

Chapter 13     The Cardiovascular System

Josey Coaten

Aims

Learning outcomes

Introduction

               

Chapter 14     Abdomen/Urology and Gynaecology

Josey Coaten

Aims

Learning outcomes

Introduction   

 

 

 

Chapter 15     Neurological Assessment

Josey Coaten

Aims

Learning Outcomes

Introduction   

Chapter 16     Musculoskeletal and Rheumatology

Sarah Pay

Aims

Learning Outcomes

Introduction   

 

Chapter 17     Ear, Nose and Throat

Josey Coaten

Aims

Learning Outcomes

Introduction   

 

Chapter 18     Dermatology

Sarah Pay

Aims

Learning Outcomes

Introduction

Taking a dermatological history

Common presenting symptoms

     Itching

     Rash

     Lesions

     Pain

     Psychosocial factors

Examination of skin

     Inspection

     Description

     Palpation

     Systematic Review

Examination of moles

Dermoscopy and photography

Red flags

Case study

References

               

Chapter 19     Paediatrics in Primary care

Sarah Pay

Aims

Learning Outcomes

Introduction

Initiating the consultation with a child and history taking

     First Impressions

     Introductions and Rapport building

     Golden minute and establishing ICE

     Taking a history

Examination

     Airway

     Breathing

          Compromised respiratory system

          Respiratory distress

          Respiratory Rate

          Oxygen saturation

          Chest Auscultation

     Circulation

           Colour

           Heart Rate

           Capillary Refill time

           Blood Pressure

     Disability

     ENT Examination

     Temperature

     Tummy

     Blood Glucose

     Examination Tips

Identifying serious illness in children

     Vital signs

     Traffic light system/PEWS/Sepsis

The Febrile Child

     Management and parental/carer advice

     The unexplained fever

Growth and Feeding

Safety netting

Professional and Legal Issues in Paediatrics

     Consent

     Gillick Competence

     Fraser Guidelines

Safeguarding

Prescribing for children

Closer look – Kawasaki Disease

Case Study – Bronchiolitis

Common differential in primary care – feverish illness

Useful resources

References   

               

Chapter 20     Mental Health in Primary Care

Sarah Pay

Aims

Learning Outcomes

Introduction

History taking in Mental Health consultations

     Mental Status Examination (MSE)

     Determining risk

          Ethnicity

          Frailty

          Maternal Mental Health

          Learning Disability

          Gender

     History taking framework for mental health

Legislation and mental health

     The Mental Health Act 1983

     The Mental Capacity Act 2005

Management of common low risk presentations in primary care

     Social Prescribing

     Generalised anxiety disorders

     Depression

     Bi-Polar Disorder

Mental health of the practitioner

Useful information

Case study – depression

References     

 

Chapter 21     Frailty

Josey Coaten

Aims

Learning outcomes

Introduction   

 

Chapter 22     The advanced Practitioner as a Prescriber

Sarah Pay

Aims

Learning Outcomes

Introduction

NMP Professional Considerations

The NMP and Scope of practice in primary care

     Continuing professional development as a prescriber

Remote Prescribing

Repeat Prescribing

Medication Reviews

     Re-authorisation of repeat medications

     Medication Review

     Structured Medication Review (SMR)

     Medicine Reconciliation

     Polypharmacy

Medicines Optimisation

     Medicined optimisation for older people

Antimicrobial stewardship

     Delayed prescriptions

     Communication regarding antibiotic prescribing

Supporting other NMP’s

Reflection Activity

References    

               

Chapter 23     Completing the consultation/developing as an ACP and beyond

Josey Coaten

Aims

Learning Outcomes

Introduction   

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