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Next step in primary care workforce planning: involve nurses

Planning the community healthcare professional workforce in Scotland must be more joined up across all professions, said Rachel Cackett, policy advisor for RCN Scotland

Planning the community healthcare professional workforce in Scotland must be more joined up across all professions, said Rachel Cackett, policy advisor for RCN Scotland.

Speaking at the Next Steps for Primary Care conference held in Scotland at the end of January, Ms Cackett said there were already models of nurses working as senior decision makers, taking lead roles in primary care. She listed a number of good examples such as out-of-hours services in Grampian, island-based care in Cumbrae, acute services in the community in Lanarkshire and and specialist COPD services in Midlothian.

However, Ms Cackett said that 'patchworks of innovation are not going to transform community care and make the future of primary care sustainable'.

Hiring more A&E consultants was also not the answer, she said. 'We need investment in community and we need fully joined up commissioning of services that direct resources across all professions.'

'Look at how consultations in general practice have already changed, with nurses delivering a third of those consultations in 2012/13. That's a 31 per cent rise in 10 years; or look at nurse prescribing, which was evaluated to show that patient care was quicker and easier and was welcomed not only by the public, but also by medical colleagues,' she added.

She was among a number of speakers gathered in Scotland including GPs and policy advisors to discuss the future of primary care in Scotland.

Although the conference was largely focused towards GPs and general practice, practice and community nurses were described as a key resource in primary care.

Dr Ken Lawton, a GP in the Great Western Medical Practice, Aberdeen, said that in the future he sees there being an increase in nurse practitioners and minor injuries nurses with a greater role in developing primary care services.

He also said in a question and answer session that there needed to be a systematic approach to the training of advanced nurse practitioners, by 'identifying where they can augment the service'.

David Thomson, the deputy director of primary care with the Scottish government said that GPs and practice nurses dealt with 25 million interactions 'which just showed the balance and importance of primary care'.