Addressing problems with pay, terms and conditions is key to retaining nurses in primary care, according to a new survey of nursing staff.
The poll also added weight to well-rehearsed concerns about lack of clarity over nurse titles in the sector and their connection with education and training.
The survey was carried out with more than 500 nursing staff across Dorset, Hampshire, the Isle of Wight, Somerset, and Wiltshire who operate under the Wessex Local Medical Committees (LMCs). It was led by Helene Irvine, nurse advisor to the LMCs.
The nurses were asked what could be done to retain nurses in general practice and the top response was around pay, terms and conditions with 66% of the 455 who answered this question citing this.
The Agenda for Change pay scheme for nurses in the NHS does not apply to general practice.
One nurse told the survey that a universal pay structure for practices nurses would be a “positive move”.
In the report to accompany the survey results, Ms Irvine said tackling issues around pay, terms and conditions was vital in making general practice nursing attractive.
“There have been occasions where some professional groups have been employed on salaries far in excess of the current nurses working at an advanced level,” she said.
Meanwhile, Ms Irvine highlighted how nursing staff employed in practices under Wessex LMCs currently held 33 different titles.
The most common were advanced nurse practitioner, nurse practitioner, general practice nurse and health care assistant.
However, more obscure titles included minor illness nurse, frailty nurse, practice sister, proactive nurse, triage nurse and treatment room nurse.
Ms Irvine noted that the titles held by the nursing staff did not always correlate to levels of education or experience.
“A nurse employed in general practice may perform a different role in each practice,” Ms Irvine said in the report.
“There is ambiguity and confusion of roles, titles, competencies and link to academic achievement and this needs to be addressed,” she added.
For example, out of the 68 respondents who identified themselves as an advanced nurse practitioner (ANP), 31% said they had a master’s level qualification in health-related areas.
One said they had a district nurse qualification and one was trained as a midwife.
All of those who used the title of ANP indicated that they were a non-medical prescriber.
There have long been calls for the role of ANP to be regulated due to confusion over credentials needed and scope of practice.
In recent years Health Education England has taken action to try and improve consistency and provide clarification over advanced practice nursing.
In 2017, it published the first ever career framework and is currently developing plans for a national academy of advanced practice.
A third of those who responded to the poll said they were planning to retire in the next five years.
Ms Irvine said it was therefore important to continue work to raise the profile of general practice nursing and make it an attractive option to student nurses and people looking for a career change.
She also highlighted the need to entice more men into the profession. Of those who took part in the poll, 99% were female.
“If we are to attract more people into primary care including men, then we need to look at portfolio careers and the opportunity for using a variety of multi skills and knowledge in a flexible working environment,” said Ms Irvine. “This may cross boundaries and challenge the historical concept of nursing in primary care and the community.”
Despite the issues raised, 89% of polled nurses said they would recommend their practice as a place to work.
They told the survey that the ability to work as part of a team was one of the best things about general practice and Ms Irvine said it was important that this was not lost in the move towards primary care networks.
Other key benefits of working in primary care identified by nurses were the variety of the role, flexibility in terms of the working hours, and the job satisfaction.