PART 3 – PLACEMENT 1 – 2024 SEPT – Managing Complex Patient Needs in Primary Care

NMC Reflective Account Form

Reflective account:

What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice?
During my GP placement (October 2024), I encountered patients with multiple comorbidities and complex care needs. Some patients required comprehensive assessments, multi-disciplinary team (MDT) involvement, and long-term management planning. Engaging with these cases helped me develop a broader understanding of holistic patient care, integrating clinical, psychological, and social aspects.

What did you learn from the CPD activity and/or feedback and/or event or experience in your practice?
I learned that managing complex patient needs requires a structured, patient-centred approach. Applying Miller’s Pyramid of Clinical Competence (1990), I developed confidence in synthesising patient histories, applying clinical reasoning, and recognising when to escalate care. Additionally, collaborating with other healthcare professionals, including practice nurses, pharmacists, and GPs, highlighted the importance of interdisciplinary teamwork in long-term patient management.

How did you change or improve your practice as a result?
Following this experience, I became more methodical in patient assessments, ensuring a comprehensive evaluation of physical, emotional, and social needs. I also improved my ability to prioritise care and communicate effectively with the MDT. Moving forward, I plan to develop my skills in chronic disease management, particularly in diabetes and cardiovascular health.

How is this relevant to the Code?

• Practise effectively: Managing patients holistically ensures comprehensive, high-quality care.
• Preserve safety: Recognising when to escalate complex cases improves patient outcomes and prevents complications.
• Promote professionalism and trust: Coordinating effectively with the MDT enhances collaboration and ensures seamless care delivery.

This reflection highlights the importance of structured clinical assessment, interdisciplinary collaboration, and long-term patient management in primary care.

SOURCES USED:

1. Leadership and Supervision in Nursing – A Reflective Analysis
   • Miller’s Pyramid of Clinical Competence (1990) and structured patient assessment.
   • Emphasis on the importance of interdisciplinary collaboration in primary care​.
   • Structured delegation and long-term management planning in complex patient care.
2. PART 3 – PLACEMENT 1 – 2024 SEPT – Reflection on Learning from Others
   • Reflection from GP Placement on learning from a Diabetic Nurse Specialist Team in an MDT setting.
   • Holistic patient-centred care and structured patient assessments.
3. PART 2 – PLACEMENT 1 – 2023 NOV – Episode of Care 1 (Part 2)
   • Reflection on Outpatients Department (HH) experience, emphasising risk assessments and care planning for complex patient needs​.