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Serious lack of practice nurses in leadership roles finds QNI

Just 1.6% of practice nurses are nurse partners in a GP practice according to research from the Queen's Nursing Institute (QNI)

Just 1.6% of practice nurses are nurse partners in a GP practice according to research from the Queen’s Nursing Institute (QNI).

The charity surveyed 3405 nurses about their roles as a practice nurse and launched the results in a report titled General Practice Nursing in the 21st Century: A Time of Opportunity.

Speaking at the launch, Candace Imison, head of policy at the Nuffield Trust, was struck by the lack of nurse partners, nurse-led practices or nurses on CCG boards demonstrated in the report. ‘This report is a massive opportunity for nursing. I am struck by how few nurses are independent prescribers and this is where nurses have the edge over other workforces.'

Many of the nurses at the launch agreed that the report had not revealed any new issues and that many of the findings were problems that had plagued the practice nursing workforce for years. However, many agreed that the survey could be the stepping stone to improving conditions for practice nurses when taken alongside previous RCN research and Health Education England’s District nursing and practice nursing service: Education and career framework.

One of the biggest issues included the lack of robust terms and conditions between practices. As GPs are private employers, there is no set standards for practice nurses/team terms and conditions/salary. ‘There is no “clout” from the CCG/ government to ensure we are adequately reimbursed in salary/holidays/training needs – to the extent the rest of the nurses are in the NHS,’ said one respondent.

Around 65% of respondents stated that their salary didn’t reflect their role. One nurse commented that: ‘I am a clinical lead nurse. I mentor junior nurses and advise on all aspects of the role to colleagues. I am paid the equivalent £15/hr gross, which I do not feel reflects the degree of responsibility, stress organisational and department management and organisational skills that my role entails. I earned more in the private sector in a nursing home without my degree and masters level qualifications.’

Another huge concern highlighted in the report was that 33.4% of the respondents were due to retire by 2020. This finding confirms the trend identified in an earlier RCGP survey that a large proportion of experienced practice nurses are nearing retirement.

Due to this it was discussed that more needs to be done to encourage student nurses into general practice. However, only 25% of respondents stated that they provide pre-registration placements for student nurses. The QNI commented that: ‘It is disappointing and concerning that such a limited number of practices offer the opportunity for placement learning to nursing students.’

One respondent commented that ‘I feel a placement in general practice should be a mandatory part of a student nurses training. It would be inconceivable that a student nurse wouldn’t go on a medical ward prior to qualifying so why is it OK that they don’t do a placement in general practice?’

Crystal Oldman, the chief executive of the QNI, said: ‘We hope that this report can lead to real action to improve things for practice nurses. It was so great to see so many people [at the launch] from policy, commissioning, organisations and nurses on the ground.’

The survey covered a number of other topics such as revalidation, professional development, reasons for choosing practice nursing and multidisciplinary working.

In response to the findings the QNI have published an online resource: Transition to general practice nursing,’ to support nurses who are new to the role. During the course of 2016 the QNI will also work with the Queen’s Nursing Institute in Scotland to develop voluntary standards for education and practice, to enhance the existing NMC standards for practice nursing.