In November 2007 I was asked to research options for a combined recruitment and training programme for practice nurses and healthcare assistants working in Tower Hamlets PCT - a small but densely populated area of inner east London. A very poor result in a survey of access to GP care prompted this research. Despite the PCT performing well in many other areas, it needed to make radical changes to the infrastructure to improve access.
One of the planned changes was to increase the number of clinical staff working with GPs. Teams were struggling to recruit and retain nurses with the skills needed to deal with the complex health and mental health issues experienced by the ethnically diverse population.
Training gap identified
Through my research and interviews with senior practice nurses in the area, it was revealed that the nurses were extremely busy and many were stressed due to staff shortages. This resulted in a reluctance to train new staff due to the time commitment involved and the drop in patient access this would cause, so the problem was getting worse and something urgently needed to be done to reverse this vicious cycle. And so the Open Doors initiative was created.
Funding for the project was obtained from money the PCT received to increase access for patients.
The Open Doors programme