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Staking nursing’s claim on the future of primary care

Primary care
Nurses should stake a claim to define the future of primary care, writes Crystal Oldman

Last week, the two-day annual conference of the National Association of Primary care (NAPC) took place in Birmingham. Attended by GPs, nurses, allied health professionals and managers, the lively event demonstrated the best of multi-disciplinary working, with many discussions around the evolution of the Primary Care Home to the Primary Care Network (PCN).

I was struck by the similarity of the conversations I had with nurses working in general practice, who were delighted to be working in an autonomous role, serving a community they know well. And then the ‘but’ – they were feeling excluded by no having a seat at the table with the current discussions on the development of their local Primary Care Networks.

The QNI mantra ‘be at the table, or you will be on the menu’ seemed significant here. Not being invited to participate in discussions around the upcoming opportunities for developing services for the local community can lead to nurses feeling marginalised and unrecognised for their knowledge and expertise.

Over the last two years, the QNI has been working with Suzanne Gordon, international journalist and author, to develop resources for nurses to learn how to articulate their value. The QNI is creating a new resource which will support nurses in explaining their role and the impact they make on the lives of the individuals, carers, families and communities served.

This work is particularly poignant for nurses working in the community and primary care, where the services are delivered in a person’s home or behind the closed doors of a clinic. The public image of a nurse is generally one in a hospital, in a uniform and beside a patient in a bed: in the community the wide variety and scope of roles is far from this one-dimensional picture.

Nurses are working autonomously, assessing, diagnosing, prescribing, creating care plans, making referrals to the multi-disciplinary team, and providing care co-ordination and case management services. Nurses also focus on leading teams, teaching, quality enhancement and service improvement – bringing not only a comprehensive understanding of their community’s health needs, but also innovative ideas about how to address them.

Nurses are an asset in the PCNs and their knowledge, skills and commitment to their communities makes them valuable members of the leadership team. The opportunities which are now developing, from service improvements for groups of the population through to strategic clinical director posts, make this an exciting time for nurses in general practice.

It is unthinkable that nurses should be excluded from discussing the development of the PCN. The NAPC conference will have enthused more nurses to go back to practice with sharp elbows and a clear articulation of their own value, to make sure that they have a place at the table.