GP Service

A GP service is available to the residents of The Fern Dean providing medical and nursing care in conjunction with the nursing and healthcare staff.

Doctor Geraint Warlow MB BCh (Wales) BSc (Wales) PGDip (Warwick) MRCGP.

I have a keen interest in complex care and medicine for the elderly and have worked in several different London-based integrated care and nursing home projects and held an academic associate position in University College London before moving to Ireland in 2016. I graduated from Cardiff University with degrees in medicine and physiology in 2007 and became a member of the Royal College of General Practitioners in 2014 and more recently completed a diploma in diabetes from the University of Warwick.

I am the clinical lead for the GP service and have created a framework of care that allows us to deliver beyond what is mandated by the HSE. Nursing home residents are excluded from much of the progress made in traditional general practice – services like the HSE Chronic Disease Management programme, for example. We bridge that gap by bringing these services into the nursing home using regular reviews by both the GP and our practice nurse, Sarah Toland.

We take a balanced and tailored approach to care. What is right for one resident, may not be right for the next. We are here to listen to everyone – firstly the resident but also those around them to find the right path and anticipate and work through some of the challenges ahead.

Nurse Sarah Toland RN (TCD) RNP

Sarah qualified as a nurse in 2007 following her training in Trinity College and Tallaght Hospital. She has worked in general practice for 14 years. She provides chronic disease care including diabetes, asthma and COPD. Sarah coordinates the in-house bone health service and is a registered nurse prescriber. Given Sarah’s experience and qualifications, she is able to manage many conditions independently. She is very popular with the residents, families and staff.

Alexandra Donnelly

Alex has worked in primary care for over 20 years and has extensive knowledge of primary care. Alex coordinates the non-clinical side of the medical team.

We deliver

Timely access to medical review. Senior nursing staff can contact the GP service at any time Monday-to-Friday with urgent concerns. Our response time is usually less than 1 hour and often within a few minutes. When appropriate, we can start treatment remotely and conduct a clinical review later that day to prevent delay. Access to diagnostics and chronic disease management in-house. Our mobile clinic allows residents to have investigations in their own room, without the need to travel to a clinic:
  • ECG and single lead ECG
  • Ambulatory blood pressure monitoring
  • Ankle-brachial pressure index measurement
  • Cryotherapy
  • Ear syringing
  • Diabetes reviews
  • Diabetic foot checks
  • We can arrange x-rays in the residents’ rooms, in conjunction with Mobile Medical Diagnostics.
Nurse-led bone health service. We conduct a fracture risk screen for almost all residents. There are several very good treatments currently available to improve the strength of bones and reduce the risk of fracture. If practical, we often suggest referral for a DEXA scan to guide treatment. When this is not possible, we will work with families and the nurses to produce the most appropriate treatment plan. We aim to publish the results of this project. Family liaison. Come and meet us and talk about your concerns. We are here to help you and your family member. Family meetings are available by appointment – in person, on the phone or by video call. Having a loved one admitted to a nursing home can be a challenging time. We can support their journey, help you understand the medical challenges and work with you to do what is best. The change from accompanying your loved one to appointments to having the doctor visit them in the nursing home can leave a gap in communication which can be stressful. The nursing staff will keep you up to date after every GP visit, but should you need to have more detailed discussion then please book.

Research

A Novel Primary Care-Based, Practice Nurse-Led Bone Health Service for People in Long Term Care
Geraint Warlow, Sarah Toland

Publication in ‘Age and Ageing’ 2024

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