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Practice nursing – saving the Cinderella service

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Heather Randle Heather Randle, Professional Lead for Primary Care, RCN

Much has been said about the incredible efforts of health and social care staff during the pandemic.

So it is very odd that one group who have played a key role in rolling out one of our main defence against COVID-19 –the vaccine programme – should feel largely invisible.They are nurses like me who work in general practice.

We have led on both infection control within our services and the largest vaccination programme in history. We have provided leadership and training to colleagues with limited knowledge of immunisation, and have supported patients having their COVID-19 jab.

We’ve ensured that the childhood immunisation programme has continued along with screening programmes, such as cervical cytology, and supported patients to manage their chronic diseases.

This has not been an easy task during the pandemic, especially when we were asking mothers to bring their children to the surgery to be immunised, an environment that many thought was unsafe.So we spent a lot of time ensuring our surgeries were COVID-19 safe and reassuring parents they were not putting themselves or their children at risk by visiting them.

We know our practice population, who the vulnerable patients are, such as the refugee and migrant communities, those who are homeless and vulnerably housed, traveller communities and people with learning difficulties, and have a relationship of trust with them.

Like many areas of health and social care, we’re seeing unprecedented demand in an already-stretched system.

Given this and the other circumstances we find ourselves working in, including acute workforce shortages and poor pay, it’s no surprise that many of my colleagues tell me they feel undervalued and invisible.

Pay is a key issue. Practice nurses are not paid on NHS terms and conditions and often have only statutory sick pay (including for COVID-19), statutory maternity pay, and no release or funding to access training, education and development.

We are autonomous practitioners who work as part of a practice team yet the ways of working and the GP contract do not recognise us for the specialist generalists we are.

Years of under-funding and poor pay, terms and conditions mean that a system that was already under strain is now in crisis with not enough skilled nurses and many additional roles resulting in dilution of the GPN role.

We are key to the reduction of referrals into secondary care and play a vital role in health promotion and prevention, but without enough of us unnecessary hospital admissions are inevitable.

The role of the nurse in general practice is essential to the provision of safe and effective care, yet given all of the above it’s obvious why we feel undervalued and ignored. Something must change.

What do you think? Leave a comment below or tweet your views to @IndyNurseMag

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