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Use advanced nurse practitioners to fill gap in GP workforce

Advanced practice nurses, not physicians associates, should be used to plug the gap in the primary care workforce, Crystal Oldman writes.

In February 2015, the Migration Advisory Committee decided not to place nursing roles on the shortage list for recruitment overseas. This might be surprising when it is reported that many providers in the UK are relying on overseas nurses to fill vacancies.

Nursing has always relied on a supply of overseas nurses in the UK, and they bring a richness of experience and diversity to the workforce and the communities they serve. Generations of nurses from overseas have joined our community nursing teams since the 1960s and they have been essential to the delivery of NHS services.

In the UK, we also have a shortage of GPs and we are seeking to attract them back from the countries to which they emigrated. One of the ways in which this GP shortfall is being addressed is the recruitment of physician associates.

These healthcare practitioners have had two years of clinical training following a degree in a related subject, such as biomedical science. They work under the direction of a registered medical practitioner, in a hospital or a GP surgery. Physician associates are employed at band 7 – a level that would take nurses many years of education, development and experience to reach and is reflective of an advanced nurse practitioner (ANP) in primary care.

Physician associates cannot prescribe and are unregulated – although there are intentions to resolve the issue of professional regulation in the UK. They also appear to be without the well-defined career pathway that nurses and doctors enjoy.

Developing and employing more ANPs in primary care would directly address the shortage of GPs. ANPs are educated to undertake all the areas specified in physician associate training, such as taking medical histories; performing examinations; diagnosing illnesses; analysing test results; developing management plans. Moreover, ANPs can prescribe and are registered practitioners.

An opportunity is being missed for communities to be supported by skilled, experienced and knowledgeable nursing specialists within our nursing workforce.

The QNI will actively support the development of more ANPs in 2015 as a critical element of the primary care workforce.

We will also be seeking your views on this in our forthcoming survey of nurses working in general practice.

Crystal Oldman, chief executive,
Queen's Nursing Institute