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New GP inspector warns of nurse shortage in primary care

More primary care nurses need to be trained “now”, according to the Care Quality Commission’s new chief inspector of general practice.

Speaking at the chief nursing officer for England’s summit last week, Professor Steve Field highlighted that nurses were “central” to all areas of primary care, especially long term conditions.

“My worry is that we don’t have enough nurses trained properly to work in general practice and primary care,” he said. “We need the nursing schools in universities to actually start to train nurses for general practice and primary care now.”

He said this was vital if the NHS was “serious about moving care out of hospital and into the community”.

He called on Health Education England to “get aligned” with the community agenda in order to “get more nurses out quickly” into primary care settings.

Professor Field also raised concerns about care standards in small practices. He said: “I’ve met some outstanding nurses in general practice – they tend to be in the larger practices because they are working more as teams.

“One of the things I’m really worried about is the isolation of small practice GPs and nurses,” he told delegates. “I think gone are the days when small practices could work in splendid isolation.”

He warned that nurses in small practices could be “disempowered” by GPs, meaning they sometimes did not act professionally or speak out about concerns.

Professor Field, who took up post in October, will oversee the CQC’s new inspection regime for GP surgeries in England. The regulator has been inspecting surgeries since April this year but is currently revamping the process in line with the one already underway in the acute sector.

He noted that problems in hospitals attracted headlines but care failings in primary care could “affect many hundreds of patients quietly”. For example, not monitoring fridge temperatures could affect the immune status of hundreds of children, he said.

In addition, he called for the “crazy divide” between general practice nursing and community nursing to be dropped, because it “does not serve the patients at all”.

Professor Sir Bruce Keogh, NHS England’s medical director, spoke in the same session.

He warned there are still “little bits” of similar bad practice to that seen at Mid Staffordshire Hospital Trust in all UK hospitals.

He said his review this year into trusts with high mortality rates had found a “bunch of hospitals that were caught in an imbalance of being regulated but a lack of help.”

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Readers' comments (2)

  • michael stone

    '“This is about training more and better primary care nurses and getting rid of this divide between general practice and community care,” he added.'

    About 'getting rid of divides'.

    I sent some questions to Steve a month or two ago, and in his reply he pointed out that while he is the Inspector for the behaviour of GPs within patients' own homes, the behaviour of District Nurses - who of course work in patients' homes - falls within the scope of Mike Richards (the CQC Inspector for hospitals).

    The CQC (David Behan) is in the process, of explaining to me why as GPs and DNs are both primary care, they shouldn't both be part of Steve's job (the reason appears to be 'because DNs are usually employed by hospitals now, and Mike does hospitals' - that doesn't look like sanity {in terms of making sure that GPs and DNs are 'on the same page' and behave coherently} to me.

    Unsuitable or offensive?

  • Yes we should have more nurses out in Primary Care Setting but to achieve this and patient receives a high standard of care for the nurse to have at least 2yrs hospital experience and then be encouraged to carry out different courses for the Primary Care Setting.
    As these courses are very expensive the only way most nurses can do this is get sponsored by NHS England or GP and this is not always available in the whole of the UK.

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