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Large general practice groups 'improving nurse training'

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Nurses and healthcare assistants working for new large-scale general practice organisations are benefitting from extra training and peer support which is leading to improved retention rates, a new report has suggested.

Research by the Nuffield Trust think tank found practices were pooling resources and working together to train and develop staff including those employees that have traditionally had little training.

It found high levels of staff satisfaction among practice nurses, advanced nurse practitioners and healthcare assistants in a snapshot sample of large-scale GP organisations.

”Staff particularly valued education and training opportunities and peer support arrangements across practice boundaries”

Nuffield Trust report on large-scale general practice

However, the report found little evidence to suggest such bodies were doing better than average when it came to quality of care and patients outcomes, or expanding to manage services such as district nursing or specialist care - suggestions outlined in NHS England’s future plan for the future, the Five Year Forward View.

National surveys carried out with the Royal College of General Practitioners show about 75% of English general practices now work in collaboration with others, said the report.

Survey data also showed around a quarter of GP practices working in collaboration had invested in staff training within the first two years of forming.

In-depth case studies of four large-scale GP organisations revealed they were providing innovative training opportunities for nursing staff and support that led to improved recruitment and retention.

”Several nurses said they were more inclined to plan for a career at [general practice group] Harness because of the support they were offered”

Nuffield Trust report on large-scale general practice

“Staff particularly valued education and training opportunities and peer support arrangements across practice boundaries, which provided rapid access to clinical advice, offered support with day-to-day operational problems and reduced professional isolation,” said the Is Bigger Better? report.

For example, the Harness Healthcare group of more than 20 practices has set up monthly “peer-to-peer forums” for nurses and healthcare assistants, which include education sessions, the chance to discuss cases and find out about developments in the organisation.

Many nurses reported these sessions improved their confidence as professionals, decreased isolation, and also improved the care they delivered, said the report.

“Several nurses said they were more inclined to plan for a career at Harness because of the support they were offered,” it added.

Nurses at the Harness group also had opportunities to develop areas of clinical special interest with some training modules available through the organisation’s intranet and through face-to-face mentoring.

Nurses and advanced nurse practitioners at another group of 16 surgeries – called Modality Partnership - met weekly to review case studies and take part in discussions as part of their continuing professional development.

A nurse training programme was being developed but this had teething problems, the researchers found. “We heard that the nurse facilitator often had to use the allotted planning sessions to cover the illness or absence of other nurses, and high expectations and delivery delays led to the facilitator taking a period of sick leave,” said the report.

At the AT Medics group of about 20 practices healthcare assistants had the chance to gain new skills including carrying out health checks under the supervision of GPs.

”Most English GPs are now joining large organisations and this research shows that can help keep practices going after years of financial pressure and rising workload”

Rebecca Rosen

An analysis of staff satisfaction scores across three of the case study sites found nurses were mostly positive about a range of areas including the amount of variety in their job and opportunity to use their abilities.

“Survey findings that staff feel more positive than their counterparts across England, suggest that the arrangements we saw to train and develop staff and provide peer support were valued,” said the report authors.

There was also evidence training and support meant staff “were more likely to stay with the organisation and that recruitment was easier as a result” said the report.

It concluded large-scale GP groups were helping general practice survive in the face of intense financial pressure and shortages of doctors and nurses – with one third of practice nurses due to retire by 2020.

However, Nuffield Trust research fellow and GP Rebecca Rosen said it was important NHS leaders did not “let expectations of these new organisations run away from the reality” when it came to taking on new services and managing change across the health service.

“Most English GPs are now joining large organisations and this research shows how that can help keep practices going after years of financial pressure and rising workload,” she said.

“What they need now is time and support to develop good relationships with other parts of the NHS, and to make investments needed to realise long-term benefits,” she added.

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Readers' comments (1)

  • michael stone

    'Nurses and healthcare assistants working for new large-scale general practice organisations are benefitting from extra training and peer support ... However, the report found little evidence to suggest such bodies were doing better than average when it came to quality of care and patients outcomes'.

    Worth pondering - shouldn't extra training lead to better outcomes for patients ?

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