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Lack of support for nurse entrepreneurs may hold back practice innovation

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Lack of support for nurse entrepreneurs within the nursing profession itself may be holding back the development of innovative practice, evidence suggests

The first large nurse-led social enterprise scheme was set up in 2006 as Central Surrey Health, and one of the first nurse-led general practices was set up under the scheme in 2005 in west London.

But latest research by Nursing Times suggests very little has happened since then, with only around three large nurse-led schemes having been set up and a further five either planned or likely to come into existence over the next two years.

There is also a handful of examples of smaller schemes such as the Cuckoo Lane surgery, the first nurse-led general practice set up in London in 2005, and the UK’s first ‘doula’ social enterprise company, which was launched in October 2008 by two nurses in Coventry.

But the Department of Health, which is pushing nurse-led social enterprise schemes as one of the strands of the NHS Next Stage Review, has no records on their current number and neither does the Social Enterprise Coalition network.

Rosemary Cook, director of the Queen’s Nursing Institute told Nursing Times that pioneering and innovative pockets of nursing and nursing practice were still in the minority.

Nurses need better support from colleagues and peers to allow them to innovate and become more entrepreneurial rather than being afraid of being ‘shot at’ by their colleagues, she said.

‘In the middle of spectrum we find nurses are not very supportive and that nurses who are innovating are often accused of thinking that they are better than everyone else. The experience of many of those who put themselves above the parapet is that they get shot at by their colleagues,’ she warned.

Ms Cook said that along with increasing support for innovation from within the nursing profession it was also important that nurses were taught how develop their new ideas and practices in a business environment and that the local NHS environment was made more supportive.

‘Nurses can definitely be unsupportive to other nurses as well as other NHS staff within the workplace. There should be a better tolerance of what is different,’ she added.

Catherine Baraniak founding partner and senior nurse of the Meadowfields practice in Derbyshire in 1998 – one of the first nurse-led general practices to be developed under the GP personal medical services contract – agreed.

‘We had a lot of difficulties setting up this practice 10 years ago because it was a complete departure for nurses to become self-employed or employ their own GPs and some areas were very hostile to this,’ she admitted.

Ms Baraniak said that in some cases the criticism was so extreme that some staff at the practice had received death threats.

‘At times it did feel like we were walking through treacle… when I was setting up the practice I was surprised that some nurses seemed to be so blinkered,’ she said.

‘I think that to support innovation the hierarchy within the nursing profession could support and identify nurses who are more entrepreneurial and innovative because at present they often fall at the first hurdle,’ she added.

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