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Investment for Scottish practice and district nurse training

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The Scottish government is to invest £6.9m over three years for training and educating practice nurses and district nurses to “help support a sustainable 24/7 community nursing workforce”.

The investment, announced alongside a new workforce plan, will mean improved nursing care provided closer to home will be made available, according to ministers in Scotland.

“The investment in nurse training will mean that more patients are treated in the community”

Shona Robison

It will ensure that the existing nurse workforce has the skills to “even better meet the needs” of people requiring care in their own homes, GP practices or in other community settings, they said.

The new Primary Care Workforce Plan sets out pledges to “significantly expand and strengthen primary care across Scotland and prepare against the challenges of Brexit in NHS Scotland”.

The plan is focussed on “developing, building and expanding” multi-disciplinary teams, made up of professionals each contributing their unique skills to managing care and improving outcomes.

The government said it would also work alongside partners, including the Royal College of Nursing, to “understand the requirements for sustaining and expanding” the community workforce.

“We are committed to undertaking this work at pace and will be in a position by September 2018 to better understand the requirements and investment necessary to grow the workforce,” it said.

“Integration authorities and NHS boards retain responsibility for planning and funding district nurse vacancies and projected retirals from existing budgets, noted the government’s report.

It also highlighted that chief nursing officer for Scotland Fiona McQueen was already leading work to maximise the contribution of the nursing, midwifery and allied health professionals workforce.

In addition, following the introduction of the new GP contract, the report outlined plans to support the recently announced target of recruiting an extra 800 doctors over the next 10 years in Scotland.

There will also be an annual investment of £35m by 2022 for an extra 800 mental health workers in “key locations”, such as emergency departments, GP practices, police stations and prisons.

“We welcome the recognition that district nurses, advanced nurse practitioners and practice nurses are essential”

Theresa Fyffe

Meanwhile, the document set out latest figures on nursing workforce numbers in primary and community care settings.

It said around 60,000 full-time nursing and midwifery staff were employed within NHS Scotland, of which 12,000 worked in community settings, representing almost 3,000 more than in 2007.

“The increase in nurses working in the community reflects our strategic goal of moving care out of hospital settings to home or a homely setting wherever possible,” stated the workforce plan.

It quoted a previous report suggesting there were around 2,300 general practice nurses, with around 1,540 whole-time equivalents. This was 160 and 125 more, respectively, since 2009. Around a quarter of them were nurse practitioners or advanced nurse practitioners.

“We have seen a rise of 5% (from 520 to 544) in the number of nurse practitioners/advanced nurse practitioners between 2013 and 2017, a positive indication of the enhanced role nurses are playing in general practice across Scotland,” said the plan.


Shona Robison

Shona Robison

However, it noted that in December, there were around 3,400 WTE staff working in district nursing in Scotland, representing a “slight fall” of 50 since December 2015.

In contrast, there had been an increase of around 270 health visitors over the same period, bringing the total to almost 1,450 WTEs.

Meanwhile, there were approximately 4,600 nurses working in care homes – with the vast majority in private care homes – and around 787 healthcare assistants working in the sector.

Scottish health secretary Shona Robison said: “A strong and professional workforce is at the centre of the success of Scotland’s health and social system.

“The investment in nurse training will mean that more patients are treated in the community and ensure the sustainability of a multi-disciplinary team approach,” she said.

“I am proud that we are the first nation in the UK to publish a plan that not only puts community care at its heart, but also helps prepare us for the expected challenges Brexit may bring for our workforce,” she added.

Theresa Fyffe

Theresa Fyffe

Theresa Fyffe

The Royal College of Nursing said it was “pleased” that ministers had listened to its concerns and that the plan reflected the need for a new approach to developing multi-professional primary care teams.

RCN Scotland director Theresa Fyffe said: “We welcome the recognition that district nurses, advanced nurse practitioners and practice nurses are essential in providing safe, high quality care in our communities and to the overall success of primary care services.

“The commitment to investing £6.9m over three years for the education and training of general practice nurses and district nurses is a move in the right direction,” said Ms Fyffe.

“We will continue to work with the Scottish government to support the development of plans for further investment to grow the community nursing workforce, and district nurses in particular, to meet the needs of patients and shift the balance of care from hospitals and into our communities,” she said.

She added: “We look forward to seeing the detail of the government’s commitment to this by September.”

“NHS staff working in primary care have waited a year for this plan”

Alex Cole-Hamilton

Scottish Liberal Democrat health spokesman Alex Cole-Hamilton said: “NHS staff working in primary care have waited a year for this plan. Many will question whether it was worth the wait.

“It is sorely lacking in new ideas and detail. For example, we are no closer to knowing how ministers will secure the new mental health staff we need into GP practices and A&E,” he said.

“The measure of this plan is whether it will end the scandal of year long waits for mental health treatment, the GP crisis and the staffing shortage that is leaving hundreds of critical clinical posts empty for months on end,” he added. 

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