A NEW style of nurse has arrived in Huddersfield.
Nurse practitioner is a name unfamiliar to many people, but it is one that is expected to become much more common in Huddersfield in the future.
The role is well established in North America and the NHS became interested because of the shortage of qualified doctors in this country.
Huddersfield alone is lacking about eight GPs at present.
Nurse practitioners work in hospitals and GPs' surgeries, where they see their own patients, make a diagnosis and write prescriptions.
Anne-Marie Russell has worked as a nurse practitioner at the Lockwood Surgery for just over a year.
She qualified as a registered nurse in 1987 and worked in hospitals in the Middle East, before returning to Britain and studying to become a midwife and health visitor.
She started training as a nurse practitioner in the Fieldhead Surgery, Golcar, in 2001.
"Nurse practitioners were possibly seen as a threat to GPs but at the end of the day there are not the GPs out there," she said. "We have to look to working together."
Anne-Marie, the mother of a 10-year-old son, is working towards a nurse practitioner (primary care) MSc at Huddersfield University.
The three-year part-time degree course is open to registered nurses who have a minimum of three years' practical experience.
"As a nurse practitioner I enjoy the patient contact and the intellectual challenge - although that can be quite draining - but I feel I learn something new every day," she said. "It is a very challenging place to be."
Working independently in the community in her previous two roles inspired Anne-Marie to train as a nurse practitioner.
She said: "I had done some bank work with NHS Direct and I saw that there was a gap to develop nursing skills and the nursing role in primary care.
"Having worked as a midwife and health visitor I was used to working on my own."
The role of nurse practitioner presents the individual with scope for personal development and greater responsibility.
"As a conventional nurse the patient had a diagnosis, so you knew what you were treating and what care was planned.
"Now you are taking responsibility for that patient and ensuring that they are appropriately investigated and treated.
"It is great to be able to provide a complete package of care and develop a relationship with the patient, but it is a huge responsibility."
She allocates 15 minutes with a patient compared with 10 per GP.
She says she is lucky to work with a very supportive team of GPs.
Anne-Marie does not have quite the free rein a GP does and can prescribe only a limited number of drugs for a limited number of minor illnesses and ailments.
"What I tend to do is plan the treatment and advise the GP and they agree and sign the prescription," she said.
Anne-Marie believes that over the next decade most GP practices will have at least one nurse practitioner on the staff.
"The majority of patients will be seen by nurse practitioners in the first instance," she predicted.
"GPs will be doing less general work and more specialised work or sessions in hospitals."