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Don't let GPs get all the gold

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VOL: 97, ISSUE: 14, PAGE NO: 33


As April dawns, we will see the advent of another 122 primary care trusts in the English health service, heralding new ways of working for many community and primary care nurses.

As April dawns, we will see the advent of another 122 primary care trusts in the English health service, heralding new ways of working for many community and primary care nurses.

April will also bring an announcement on the general election D-Day. Election fever has already set in, with the opposition parties launching major health policy statements while Labour pulls out the customary pre-election goodies.

Some of these affect GPs and have significant implications for community and primary care nurses.

One is the move to involve ward sisters and practice and district nurses in signing sick notes, passport forms and driving licence applications (March 22, p5).

This will be welcome relief for busy GPs, but how will hard-pressed nurses cope? It is assumed that nurses can easily unburden GPs of their tedious paperwork, but they will need to see commensurate rewards - either in terms of pay or by other means.

Two other pre-election incentives caught my eye: the £5,000 'golden hello' to new GPs joining the NHS and the £10,000 'golden goodbye' for those who wait until they are 65 before retiring from the NHS.

It is clear that GP recruitment is at an all-time low and there are genuine fears that many GPs nearing retirement age will leave the NHS within the next decade.

But even more of a problem is looming in terms of nursing staff. In community health services alone, we will soon have a serious shortfall of nurses and health visitors. More than half of the community nursing workforce is in the 45-50 age group.

Nurses can retire at 55, and many are physically and mentally exhausted enough to do so. But can the NHS afford to let them go? What incentives exist to induce them to stay?

While waiting for preregistration nursing students to be trained, we need to offer incentives to older nurses to make the idea of staying on in the NHS attractive.

These don't need to be linked to cash rewards. Sabbaticals of three or four months could be one approach. Or nurses nearing retirement age could have their skills channelled towards supporting newly qualified nurses or take more sedentary roles, such as working for NHS Direct.

While GPs will welcome the government goodies, I wonder how much thought has been given to the enhancement of nurses' pension funds and other retention incentives?

Considering the current age profile of the population, 55 could be considered quite youthful. If we want to ensure sufficient numbers of skilled hands on deck for the NHS, then we will have to come up with realistic and sustainable incentives.

Nurses may be ageing, but there can be little substitute for a sound knowledge base coupled with experience.

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