Advanced nurse practitioner model: Enhancing care for adults with intellectual disabilities

Reference: May-June 2026 | Issue 3 | Vol 19 | Page 57

Adults with intellectual disabilities (ID) experience a broad range of physical and mental health challenges that can significantly affect their quality of life and life expectancy. Compared with the general population, this group is disproportionately affected by chronic conditions such as obesity, epilepsy, diabetes, and cardiovascular disease, as well as mental health comorbidities.

The intersection of complex health needs and communication barriers often leads to delayed diagnoses, fragmented care, and frequent hospitalisations. These repeated admissions place additional strain on families, healthcare professionals, and the wider health system.

In Ireland, evidence highlights ongoing disparities in access to healthcare for adults with ID. Factors such as diagnostic overshadowing, limited specialist knowledge among frontline staff, and systemic barriers to care exacerbate inequities and contribute to preventable morbidity and mortality.^1,2

Addressing these issues requires innovative, person-centred solutions that promote continuity of care and empower staff to deliver high-quality, evidence-based interventions.

The advanced nurse practitioner (ANP) model represents a transformative approach to improving health outcomes for adults with ID. Within Corlann West, the introduction of an ANP in chronic disease and condition management has created a bridge between community support services and acute healthcare.

The ANP model embodies the principles of Sláintecare by prioritising integrated, community-based, person-centred care that is both accessible and sustainable.³

This article explores the implementation and impact of the ANP role within Corlann West, focusing on the ways in which it has improved healthcare access, enhanced staff competence, reduced unnecessary hospitalisations, and increased satisfaction among service users and families.

Transformative role of the ANP

The establishment of the ANP role within Corlann West represents a shift from reactive to proactive healthcare provision. Traditionally, adults with ID often accessed care only after a condition had deteriorated, frequently resulting in emergency department attendance or hospital admission. The ANP model addresses this by embedding advanced clinical expertise directly within the community – enabling earlier assessment, intervention, and follow-up.

The ANP in chronic disease and condition management for adults with ID functions autonomously within a collaborative multidisciplinary framework. The role integrates advanced clinical decision-making, leadership, research, and education – each aligned with the four domains of ANP practice established by the Nursing and Midwifery Board of Ireland. By operating at this advanced level, the ANP ensures continuity of care, promotes early intervention, and supports both service users and staff in managing complex health conditions.

Building trust and person-centred relationships

A cornerstone of the ANP model is its emphasis on person-centred care. Adults with ID often experience anxiety in clinical environments, particularly where communication and sensory needs are not adequately understood.

The ANP approach mitigates these challenges by fostering familiarity, trust, and inclusion. Consultations take place within comfortable, familiar community settings, ensuring that service users feel safe and supported.

Feedback gathered from individuals and families within Corlann West indicates increased confidence in accessing healthcare and greater understanding of chronic disease management. Families have reported reduced anxiety during health appointments and a stronger sense of partnership in the care process.

These findings reflect international evidence demonstrating that nurse-led, person-centred interventions improve both health literacy and patient satisfaction.¹

Empowering frontline staff through education

A key aspect of the ANP role is the development and delivery of targeted education programmes for frontline staff. Many healthcare support workers and nurses within ID services have limited exposure to chronic disease and condition management.

To address this, the ANP has implemented structured training sessions focusing on evidence-based assessment, monitoring, and management of conditions such as diabetes, epilepsy, constipation, and enhancing basic clinical skills training.

During 2024, 26 formal training sessions were delivered to 322 staff members across Corlann West, alongside additional workshops for Centres of Nursing and Midwifery Education. Building on this foundation, 2025 saw a significant expansion in both reach and impact, with 46 training sessions delivered to 611 staff.

This increase reflects a growing demand for clinical education, as well as the scalability and effectiveness of the ANP-led training model. Collectively, these initiatives have enhanced staff competence and confidence, equipping them to identify early signs of deterioration, apply clinical guidelines, and escalate appropriately.

Empowerment through education has a ripple effect: As frontline staff grow in knowledge and capability, service users receive more responsive, informed, and consistent care. Moreover, fostering professional development contributes to staff retention and morale, which are critical challenges in the healthcare sector.

Interdisciplinary collaboration and system integration

The ANP role also strengthens interdisciplinary collaboration across healthcare systems. Adults with ID frequently interact with multiple professionals – including GPs, psychiatrists, physiotherapists, and social care staff – often resulting in fragmented care. The ANP acts as a central coordinator, facilitating communication and ensuring that care plans are shared, cohesive, and responsive to individual needs.

Partnerships have been developed between the ANP service, community healthcare networks, and acute hospital teams. This collaborative model aligns closely with the Sláintecare vision of integrated, community-based healthcare delivery.³ The ANP’s leadership in case management reduces duplication of effort and ensures that individuals receive the right care, in the right place, at the right time.

Findings

The evaluation of the ANP service across its initial two years provides compelling evidence of its impact across multiple domains.

IMPROVED ACCESS TO CARE
A total of 276 clinical interventions were conducted for 82 individuals in 2024. This expanded further in 2025, with 367 clinical interventions delivered to 123 individuals, demonstrating increased reach and service utilisation. These interventions included chronic disease assessments, medication reviews, health promotion sessions, and follow-up monitoring.

Prior to the ANP’s introduction, many of these interventions would have required external referrals or hospital visits. The ANP’s direct involvement has enabled more timely, person centred management within community settings, reducing unnecessary hospital attendance and improving overall access to care. These included chronic disease assessments, medication reviews, health promotion sessions, and follow-up monitoring.

Prior to the ANP’s introduction, many of these interventions would have required external referrals or hospital visits. The ANP’s direct involvement allowed for timely management within community settings, reducing unnecessary hospital attendance.

REDUCTION IN EXTERNAL HEALTHCARE UTILISATION
Quantitative analysis revealed a 30 per cent reduction in external healthcare usage, particularly in relation to GP consultations and unscheduled hospital visits. This reduction not only alleviates pressure on primary and secondary healthcare services but also enhances continuity of care for adults with ID.

Importantly, by managing non-urgent and chronic care needs within the community, the ANP model frees up valuable GP appointments for individuals requiring urgent or acute medical attention, contributing to more efficient use of healthcare resources and improved access for the wider population.

IMPROVED WAITING TIMES
The average waiting time for accessing care reduced to 9.7 days, compared to a previous average of over 14 days when relying solely on GP services. This improvement demonstrates the efficiency of the ANP model in responding to emerging health needs and preventing escalation of conditions.

ENHANCED SERVICE CAPACITY
The introduction of the ANP role resulted in an 85 per cent increase in service capacity, meaning more individuals could access timely, comprehensive care. This improvement reflects the scalability of the ANP model and its potential to address the growing demand for specialist ID healthcare services in Ireland.

STAFF TRAINING AND EMPOWERMENT
Staff training has had a measurable impact on both knowledge and confidence. Post-training evaluations showed a marked improvement in staff’s ability to manage chronic conditions and recognise signs of clinical deterioration. Anecdotal feedback highlighted greater clarity in care planning and improved communication across teams.

SERVICE USER EXPERIENCE
Feedback from individuals supported and their families revealed consistently positive experiences. Service users reported reduced anxiety during consultations, better understanding of their health conditions, and greater involvement in decision-making. Families expressed appreciation for the accessibility and empathy demonstrated by the ANP, describing the service as “reassuring”, “efficient”, and “person-centred”.

Conclusion

The introduction of the ANP model within Corlann West marks a significant advancement in healthcare delivery for adults with ID. The model demonstrates how expert nursing leadership, embedded within community services, can achieve tangible improvements in access, quality, and continuity of care.

By integrating clinical expertise, education, and leadership, the ANP role directly addresses systemic barriers that have historically hindered equitable healthcare for people with ID. The outcomes observed during the first year of implementation – including reduced hospital utilisation, improved waiting times, enhanced staff capacity, and increased user satisfaction – underscore the model’s effectiveness and sustainability.

Looking ahead, the continued evolution of the ANP service offers opportunities to expand interdisciplinary collaboration, enhance chronic disease prevention, and strengthen health promotion initiatives. Future developments may include establishing formal partnerships with general practice networks and acute hospital services, creating shared care pathways that extend beyond organisational boundaries.

The ANP model exemplifies the principles of Sláintecare – integrated, person-centred, and community-based care – and offers a blueprint for replication across Ireland’s ID services. Ultimately, it reflects a compassionate, evidence-driven approach that empowers individuals, supports families, and elevates the standard of nursing practice nationwide.