Carry on nurse – tackling the impending crisis in practice nurses

The problems with recruitment and retention in general practices are well known. Myself and colleagues have been on television, radio and in the paper getting this across to the public, I think with good effect.

The numbers of GPs retiring in the next five years is a worry but less recognised is a similar issue with our practice nurses. We have a significant number looking at retirement in the next five years and a shortage of replacements. This has been highlighted in the primary care ‘Forward View”.

We know that practice nurses and nurse practitioners are the cornerstone of modern general practice, running most of the chronic disease management, minor illness and health promotion clinics.

Increasing nurse training in primary care

I met recently with local nursing leaders – Amanda Gibson from the University of Suffolk and Amanda Lyes from the Community Education Providers Network to discuss this.

Locally, we have 100 nursing students who spend most of their time in hospital, only a handful come to experience general practice. It is not surprising therefore that trainee nurses do not understand the challenges and opportunities of working in primary care.

I know many have been put off by the payments of £15 per day to have trainee nurses in practice, and the requirements for mentoring qualifications, but I do think this is a real lost opportunity for showcasing our profession.

Identifying nursing workforce and training capacity

We know that there are many nursing mentors already out there with a 998 qualification which just needs a brief update to stay current.

I will be writing to practices and practice managers asking them to look at increasing the update of student nurses in general practice, because I feel we need to do it for the benefit of primary care.

We know that medical students who receive primary care training in general practice rather than a classroom are more likely to choose to enter the profession, and the same must surely be true for our nursing colleagues (ref BJGP 2017 Alberti, et al). There is a Foundation in Primary Care, for registered nurses at the end of their training or for nurses moving from other areas into primary care and this course is being run locally at the University of Suffolk. For further information please contact Amanda Gibson (A.Gibson3@UOS.AC.UK).

Improved perception of primary care nursing

The perception of a practice nurse among nursing students is not good. The old adage that practice nurses are for ‘nurses with bad backs’ is an outdated stereotype but a perception that we do need to change. The appointment of our Chief Nurse, Sheila Smythe and Director of Primary Care, Jules Styles, has enhanced the Federation’s nursing awareness.

Supporting and developing our current workforce

Suffolk GP Federation is running nurse development workshops, similar to the successful ones run for GP colleagues. We have also set up a nurse forum and nurse meetings for those working in GP+. We are keen to receive feedback or advice on how we can help. Please email Sheila Smyth (sheila.smythe@suffolkfed.org.uk)

Work is also being undertaken with higher apprenticeships which may be an opportunity for up skilling health care assistants (HCAs) within practice to higher qualifications.

New models of care

Working as a unit of small practices can be difficult. We tend to replace staff only when one leaves, which can leave us with an unbalanced age range of staff. This may be helped by working more collaboratively together with staff working across practices.

I am well aware of the pressure upon us all and, just as the Vocational Training Services (VTS) can be a source of recruitment into local general practice, I feel the same way about our nursing students.

It may be that groups of practices will be able to take blocks of students, which would certainly make it easier for educational colleagues to place their students in practices without having to have dozens of different arrangements.

Paul