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Primary care nursing in 2015 and 2016

The NHS has once again had a big year. Seeta Bhardwa speaks to primary care nurses on the ground on their reflections and predictions for the next year

Jane Cummings, Chief Nursing Officer, England
We have faced, and continue to face, significant challenges and pressures. Last year saw a number of changes, including the introduction of revalidation from next April. I’m proud of what we have achieved. The work of nurses and midwives in primary and community care has never been more important.

Building on Compassion in Practice, I am leading work on a new vision and strategy co-developed with arms-length body nurses and midwives, nurses, midwives, care staff, the public, carers, organisations and academia. The new strategy is launching in the spring and is a great opportunity to harness our collective contribution.

Sharin Baldwin, health visiting clinical lead, London North West Healthcare NHS Trust
This year has been a momentous one for health visiting. The Implementation Plan ended and commissioning moved to the local authorities. The Plan raised the profile of the profession, attracting nurses and midwives into health visiting. With the new commissioning arrangements, health visitors can continue to lead the Healthy Child Programme working with early years and children’s centre colleagues to deliver comprehensive and cohesive services to children and families. These are exciting times and I am looking forward to seeing the new developments and opportunities that 2016 brings.

Sarah Sherwin, senior lecturer/ course leader school nursing SCPHN, University of Wolverhampton
School nursing has experienced an exciting 12 months. One of the major highlights was hosting the International School Nursing Conference in London in July, with delegates attending from all over the world. The conference was informative and inspiring. Most importantly pupils played a central role throughout by sharing their experiences. Other highlights of the year include the Sandwell school nurses team voted Team of the Year at the Nursing Times Awards representing lots of school nurses who are delivering innovative practice to meet the health needs of children and young people. An interesting development has been that a number of teams have gone back into traditional nurses’ uniform, in response to young people wanting school nurses to be visible. During the year the school nurse community has been embracing the use of Twitter using the @WeSchoolNurses handle to share information and connect with other school nurses across the country.

Alison Tait, practice nurse, co-chair Scottish Practice Nurse Association, Edinburgh
We’ve had a busy year in general practice nursing in Scotland with confirmation of the revalidation model, the introductions of new immunisations and Travax (travel health website) reaching its 30th birthday.

The review of the Scottish general practice contract is underway and while changes to primary care will raise opportunities and challenges for nurses it will strengthen the identity of practice nursing. Additionally Scottish government initiatives have started to make an impact on transforming the nursing role in Scotland.

As health and social care integration gathers momentum practice nurses need to continue to respond to meet the population needs with the appropriate knowledge and skills. To support us there is a national network of practice nurse education advisors. More so than ever the future of practice nursing in Scotland depends on attracting nurses to consider the role of GPN as a career. It is encouraging that the NHS Education Scotland practice nurse education programme is in its fourth year with 23 participants across Scotland. The future of practice nursing remains challenging but offers some exciting opportunities.

Richard Cotton, school charge nurse, Stoke-on-Trent
For a majority of NHS community services, 2015 has seen a continuation of tendering and re-commissioning.

The reorganisation of school nursing services in my area took place this year; the county school nurses work for an out-of-area NHS provider, while the city team remain under the existing Trust but with a changed service.

Previously the delivery of public health promotion, complex health needs and immunisations has been the role of every practitioner but the reorganisation saw this separate into three teams, commissioned independently. At ground level the priorities of school nursing continues to be obesity, mental health, and sexual health; yet all these require input and support from other agencies that are either overwhelmed (as in the case of CAMHS) or subject to repeated re-commissioning by providers (whether local authority or CCG) that are desperate to make savings.

The election result this year points to no likely improvement in terms of local authority funding for the coming year, and much of what we do will be scrutinised for cost effectiveness and outcomes. Children and young people want school nurses to be visible and confidential. If 2015 is a sign of what’s to come, that first demand is going to be much harder to meet.

@WeLDNurses, learning disability nurses, UK-wide
Three years ago we saw the launch of Strengthening the Commitment, a four nation review of learning disability nursing. This was a turning point for learning disabilities nursing. Something to hang our hats on and show what we already do and what we can do.

Following a three-year implementation period, it was time to look again. What was new, different, exciting? What had been achieved on the back of Strengthening the Commitment?

Turns out quite a lot. In June this year we saw the now five nation document (with the Republic of Ireland having joined the original four) Living the commitment launched at a celebration event in Derby. The event recognised the achievements of practitioners, but most importantly recognised that we still have much to do. The words that rang the truest were those spoken by people with learning disabilities and the families of those with learning disabilities.

They remind us of why we became nurses, they remind us of how far we have come but most of all they remind us that we still have far to go; but we are very much on our way.

Sharon Poll, senior practice nurse, Liverpool CCG
Networking events such as the Practice Nurse Vox Pop event can help raise the profile of practice nursing nationally. The education framework [for practice nurses and district nurses] has been great and we need to continue to promote the role of the practice nurse. We need to understand the role better, as it is so varied across the country. In 2016, we need to build on the new models of care from the Five Year Forward View. It should be an exciting year for practice nurses. We are a massively valuable resource, we have good relationships with our patients and wider colleagues and that needs to be taken more seriously.

Kay Kane, independent district nurse, Northern IrelandThe highlight of 2015 was the work by NHS England on the framework for commissioning community nursing. It sets out eight components to realise an effective way of delivering district nursing, based on outcomes rather than counting activities, and builds on the Five Year Forward View. The aim is to help commissioners and providers change the service for the future. There is an emphasis on caseload analysis, workload management, and technology solutions. When district nurses have access to data to help them critique their practice and create solutions the service will be more pertinent to the needs of local populations.