It was the 70th anniversary of the NHS on 5 July 2018 and many NHS organisations celebrated with their staff. In the weeks leading up to the celebrations, I was conscious of all the nurses working outside the NHS who did not get the opportunity to share the festivities.
According to the Nursing and Midwifery Council, around half of all registered nurses work in roles outside the NHS. These includes local authorities, social care, residential care homes, charities, social enterprises, community interest companies, private organisations, universities and, perhaps surprisingly, general practice. While delivering NHS contracts for primary care services, GP practices and all the staff working within them are not part of an NHS service.
One of the challenges of attracting newly qualified nurses to a career in general practice is that most do not offer the same terms as the NHS – the ‘Agenda for Change’ structure for salaries and benefits such as pensions and annual leave. When a newly qualified nurse has to choose whether to accept a role in the NHS or in general practice, these terms will form a very relevant part of the decision making. While there is an shortage of 35 000 registered nurses in England, there are many jobs to choose from.
When speaking at a recent conference in London for nurses in general practice, the delegates made it clear that there is an urgent need to address the issue of parity with their NHS colleagues in relation to the conditions of employment. This is currently a very hot topic following the announcement of a total 6% salary rise over the next 3 years for individuals in the NHS.
It is good news then that the NHS England 10-point plan for general practice nurses (GPNs) addresses some issues which may help to improve recruitment and retention. For example, point 10 states: ‘Work with commissioners, NHS Employers and professional bodies in supporting primary care to be a good place of employment for GPNs and HCSWs, e.g. to develop a model employment contract for GPNs.’
When the Queen’s Nursing Institute published a major survey of GPNs 2 years ago, a large number of respondents identified contractual terms and conditions of employment as a barrier to attracting and retaining registered nurses in general practice.
Our general practitioner (GP) colleagues are often in competition with each other for registered nurses and many employ other clinicians when they cannot fill a vacancy. My GP colleagues advise me, however, that registered nurses are their first priority for building the skill mix in their teams – so a contract which is commensurate with nursing colleagues in the NHS will be a cause for celebration in
Crystal Oldman CBE, Chief Executive of the Queen’s Nursing Institute