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News focus: A new dawn for practice nursing?

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Recruitment and retention is key Recruitment and retention of general practice nurses is a key challenge for a primary-care -focussed NHS

No one working in primary care will be a stranger to the pressures on practice nursing. With an ageing workforce, recruitment and retention are crucial to the future of nurses in general practice. This priority is more vital than ever, as the NHS is increasingly becoming reliant on primary care.

However, a new plan developed by NHS England could be about to realise this ambition. The ten-point action plan for General Practice Nursing, Developing confidence, capability and capacity, outlines a series of actions which aim to ‘meet general practice workforce challenges by attracting new recruits, supporting existing GPNs and encouraging return to practice.’

‘It’s time to raise the profile of primary care. This framework for action recognises the tremendous contribution and challenges faced by general practice nurses and their teams, and highlights their pivotal role in delivering care closer to home,’ said Kathryn Yates, the RCN lead for primary care.

The plan aims to address an impending shortage of practice nurses, as many are approaching retirement age. ‘With large numbers of the workforce set to retire in the next few years, we can ill afford to delay implementing the recommendations on making general practice an attractive career for nurses,’ added Ms Cummings. It’s essential we increase access and showcase general practice to pre-registration nurses as a first destination career; ensure general practice opportunities are available on return to practice programmes and develop consistent career pathways for health care support workers.

In 2014, the HSCIC GPN Workforce and Development Census showed there was an increase of 1.6% in GPNs since 2012. Although the numbers have risen slightly, the functions GPNs undertake have also broadened to embrace expertise in LTC, preventative services, sexual health and advanced clinical skills, with positive outcomes for patients. ‘As the NHS transforms the way that we deliver care, treating more patients in the community, the importance of our general practice workforce will only increase,’ said Professor Jane Cummings, Chief Nursing Officer for England.

The plan is backed by a £15 million investment and will be used to target and prioritise where improvements are needed, most significantly in the area of recruitment and retention. It sets out key milestones (see box) which will allow progress to be measured across General Practice Nursing for the first time. According to the plan,
‘A growing and ageing population with multiple complex health conditions has led to increased pressure on the general practice workforce.’

The intention of the plan is to deliver more convenient access to care, more personalised care in the community and a stronger focus on prevention and population health driving better outcomes and experience for patients.

Actions include measures to:

Increase uptake and promote nursing in general practice – by raising the profile of nursing in General Practice through the ‘Image of Nursing’ programme, offering clinical placements for undergraduates and supporting additional routes into general practice nursing.

Support for existing GPNs – all nurses new to general practice will have access to an induction programme, training and mentoring and an expansion in leadership and career opportunities.

Encouraging GPNs to return to practice – The national return to practice programme will now include GPNs. Regional GPN Boards will provide a platform to share best practice.

‘It is clear, then, that we face very considerable challenges recruiting and retaining a workforce that is fit for the future. We must develop health and care services that have the resilience to cope with the changing landscape, demographic pressures and rising demand. We cannot and should not rely on traditional solutions – we must think differently,’ said Ms Cummings.

‘To ensure success it is essential that GPNs and healthcare support workers are engaged and involved in the plan’s implementation. Opportunities to foster leadership, clinical advancement and research opportunities are welcome,’ added Ms Yates.‘ However funding for primary care must also be matched and metrics to measure outcomes must not inhibit GPNs from carrying out their work.

The first stage of the plan is arguably its most important, as success will be contingent on it: Celebrate and raise the profile of general practice nursing and promote general practice as a first destination career. In order to do this, NHS England as committed to designing a national multi-media campaign promoting general practice nursing across healthcare organisations, schools, further education colleges, higher education institutions (HEIs) and the general public as part of the ‘Image of Nursing’ programme.

Additionally, the organisation will develop and maintain an up-to-date online toolkit (a library of guidance/ tools and support) to support the recruitment and retention of nurses to general practices.

‘Nurses working in general practice may not have always received the recognition they deserve in the past but they are central to our plan to improve care for patients and ensure the NHS is fit for the future,’ said Ms Cummings.

‘That is why I am determined to ensure that there is a proper career development programme for those who choose this vital path and make it an attractive first choice for newly-qualified nurses as well as helping experienced staff take advantage of the flexibility it offers to re-enter the workforce.’

So, after several years of being the rarely spoken about service vital to the NHS, practice nursing might finally be about to receive the recognition it requires to survive as a service.

‘Working collaboratively across general practices, GPNs and HCSW are well placed and indeed deliver high quality services, meeting the needs of their practice populations every day. We need to prioritise general practice and make it the ‘place to be’,’ concluded Ms Yates.

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