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Exclusive: Fear nurses sidelined from race for GP network director roles


The chief executive of the Queen’s Nursing Institute has called on the NHS to take action to elevate more nurses into leadership roles in primary care, amid fears they are being blocked from top tables.

QNI leader Dr Crystal Oldman wants to help nurses develop the skills required to take up clinical director jobs of the new primary care networks (PCNs) that are being formed.

“The frustration for me is they are overlooked”

Crystal Oldman 

As part of the new general practice contract, surgeries in England are required to develop partnerships with neighbouring practices to serve a population of between 30,000 to 50,000.

These networks will also involve other key health and social care organisations in that geographical area to provide integrated services to their communities.

Every PCN must have a named clinical director who will be appointed by the member practices.

Dr Oldman told Nursing Times that she was expecting just a “handful” of these posts to be occupied by nurses as it currently stood.

She said she had been left shocked by reports from a nurse practitioner, with more than 20 years’ experience, who was denied access to a key meeting about the development of the PCN in their area.

The nurse told Dr Oldman that they had requested to attend but were turned away at the door and informed that no nurses were invited.

“What does it look like for nurses if in some PCNs there are nurses who are deliberately and intentionally being excluded, as if they have nothing to offer,” said Dr Oldman.

“I just could not believe that that was happening…really experienced, highly qualified, highly skilled nurses are not getting a seat at the table on the primary care networks,” she said.

She added: “How can nurses ever have the time to put their case forward to a PCN that they could be a clinical director if they are not even around the table to discuss how the PCN is going to be led and managed?”

While acknowledging that this may have been an isolated case, Dr Oldman described the experience of the nurse she spoke to as “really disappointing”.

PCN handbook, produced by the British Medical Association, has stated: “It is expected that the clinical director will be selected from the GPs of the practices within the network, but any appropriate clinically qualified individual may be appointed.

“The clinical director must know and understand the practices of the network, in order to provide the appropriate leadership required to establish and develop a successful network,” the handbook added.

“The majority are going to be GPs who will slide into those position”

Crystal Oldman 

Dr Oldman said she feared GPs who may not have the leadership skills required would “slide into” the clinical director roles, while suitable nurses would be not be considered.

“The majority are going to be GPs who will slide into those positions, not necessarily with the leadership managements skills that are required,” she told Nursing Times.

“I’m not saying all the nurses have it, but the nurses are pretty good at this stuff and the frustration for me is they are overlooked,” she said.

To try and change this, Dr Oldman has put in a request for the QNI to run a clinical director development programme to support nurses into these roles.

She said she put forward the idea to chiefs from NHS England during the QNI All Queen’s Nurse Meeting at the end of March and they promised to consider it.

“They committed in front of 300 Queen’s nurses and said, yes, they would go away and look at it,” she told Nursing Times. “They warmly welcomed the idea, because they both recognised that nurses were in a great position to step up and become clinical directors of PCNs.”

Nursing Times has requested a response from NHS England but it has so far failed to respond.


Readers' comments (2)

  • Dr Oldham is right. Nurses with the right background & experience should not be excluded from the whole process, associated with competing for these types of leadership & management Primary Care executive roles.

    For that matter, other suitably qualified & experienced health care professionals, with a clinical practice & management background, should also be able to compete; though nurses, in my opinion, are amongst those most eminently suitable..(whilst I would say that, the career clinical activity experience, people- management skills & resource allocation abilities that keen senior nurses must learn about and deliver on, make them ideally suited to Clinical leadership.

    It's the old story I'm afraid, medics often decide, between them; and in a 'conceit' with high level politicos; to protect the status quo, in primary care..and will argue the old fudge about medico-legal responsibility, as a an insurmountable issue.

    Let's face it many ( but of course not all) Medical Practitioners, perhaps beause of their background, training; and, often personality; don't like theoretically reporting to someone, at the best of times; but they'll stomach another Registered Medical Practitioner, on the grounds that, only those from their sorority & fraternity, can likely, fully intellectually grasp the breadth, depth, and nuances of Primary Health Care & Wellbeing, LMCs, and clinical & social care commissioning & delivery; so to create & sustain, effectively, the necessarry sophisticated-enough relations with Academic Institutions; Policy Makers, money folk, those " on the ground" and wotnot.
    The first thing many then do, on appointment, is negotiate funding for someone to carry out what they've been hired for so that; although, of course, they know what's needed; he (& less often, she), can get on with the 'more important' stuff; and of course their clinic work & resesrch.

    This is when they will condider hiring, e.g. a Senior & able Registered Nurse or O.T....and sometimes..not!


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  • This is an example of why we should not listen to what people say, but watch what they do. In this case, weasel words about respect for nursing have been completely negated by the actions outlined in this article.

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