Improved training and a nationwide return-to-practice scheme to encourage more nurses back into primary care are among key recommendations in a major new report on ways to expand and revitalise general practice nursing.
The general practice nursing workforce development plan, published on Wednesday by Health Education England, sets out a range of measures to expand numbers of general practice nurses and make the role “a top career destination”.
“This report offers some clear guidance and steps that can be taken”
It follows growing concerns in recent years that an increasing shortage of practice nurses, and an impending retirement bubble, is adding to the workforce crisis in general practice.
“For so long we have become used to reports, comments and analysis about workforce pressures in general practice but its only recently that attention has been drawn to the increasing pressures in the general practice nursing workforce,” said the HHE report.
It warned: “Unless we keep general practice nursing at the centre of our workforce reconfigurations we will simply not develop robust enough teams with the necessary skills to bridge the increasing gap between capacity and demand brought on by an ageing workforce, lack of new entrants and increasing workloads.”
- Practice nurse pressure spiralling, suggests survey
- NHS England pledges to invest in practice nursing
- Breakdown of primary care nurse workforce revealed
- New GP inspector warns of nurse shortage in primary care
Among 17 key recommendations in the plan is the need to boost the number of pre-registration placements in general practice and develop recruitment and support schemes to attract newly qualfied nurses.
The HEE report also said that every nurse considering coming back into the profession should be offered the chance to embark on a return-to-practice programme specific to general practice.
It calls for the establishment of a standardised nationwide programme that would include a general practice placement, mentorship and other support.
The plan – entitled Recognise, Rethink, Reform – was drawn up by a group of experts chaired by GP Dr Peter Lane.
“The highly-skilled general practice nursing workforce of today provides an essential, high standard of care to their local populations and are invaluable members of primary care teams,” said Dr Lane.
“This report offers some clear guidance and steps that can be taken to improve general practice nurse recruitment and retention, and encourage nurses to return to the profession,” he added.
“It is important to recognise… the need to make sure that we have the numbers we need for the future”
The report stated that much of the responsibility for tackling problems lay with individual GP practices, GP federations and new types of community providers.
Clinical commissioning groups and training hubs being developed by Health Education England, as part of efforts to support and develop general practice, would also have “a crucial part to play.”
In addition, Dr Lane called on those involved in developing England’s 44 regional sustainability and transformation plans – or STPs – to embrace the drive to boost the general practice nurse workforce.
As well as encouraging more nurses into general practice, the plan stressed the need to provide training and career development for those in the job to equip them for every level of their role.
In common with GPs, retention of practice nurses has become a real issue due in part to “a feeling of being undervalued” and lower job satisfaction.
Meanwile, increased pressure and responsibilities have prompted some nurses to request fewer hours, retire or leave the profession altogether, said the report.
It suggested the creation of new, flexible roles could encourage more nurses to stay, with a greater emphasis on “portfolio careers” that would allow nurses in primary care to combine education, research and management roles with clinical work.
“General practices and federations may be able to attract a wider workforce if they are able to offer flexible contracts and consider ways to attract nurses looking for full-time careers,” said the report.
Plan unveiled to try and attract more nurses to primary care
“There is the possibility of creating attractive, innovative posts that incorporate clinical and non-clinical roles,” it stated.
When it comes to luring nurses back into general pratice, the report flagged up the fact most return-to-pratice schemes currently available were “almost exclusively secondary care focused”.
It also highlighted a lack of mentors in general practice, especially “sign off” mentors able to confirm that nurses were able to return-to-practice.
“There are anecdotal cases of nurses with lapsed registrations returning to general practice as healthcare assistants, but having to leave in order to do their return-to-pratice training in a hospital because no suitable arrangements can be made,” noted the report.
It highlighted a new programme devised by the University of Sheffield that supports nurses to return-to-practice in primary care, with initial recruitment done jointly with GP providers and follow-up preceptorship support available.
A group led by the university has also developed an Nursing and Midwifery Council-approved mentorship programme that supports nurses to gain direct experience of mentorship in primary care, noted the report.
Alongside efforts to boost numbers of practice nurses, the report called for more work to increase the number of healthcare assistants in general practice and to ensure that training for HCAs in primary care was up to scratch.
Professor Lisa Bayliss-Pratt, HEE’s director of nursing and deputy director of education and quality, welcomed the report, adding that “the challenge now is to take things forward”.
“It is important to recognise the pivotal role that general practice nurses play in delivering care to patients up and down the country, and the need to make sure that we have the numbers we need for the future,” she said.
“There is already some great work happening locally, such as training hubs that enable nurses to develop their skills in specialist areas and progress their careers within general practice. We want to make sure that this type of best practice is shared,” she added.