Universities and community education providers must work together to support newly qualified nurses, say Carmel Blackie and Julia Billington
A robust general practice setting that can meet the needs of the population is essential to the NHS’s reform agenda. At present, general practice is experiencing increased workload, winter pressures, social care failures and a general lack of funding. Falling numbers of GPs and practice nurses are exacerbating this and staff report extreme pressure.
A study carried out in 2016 by Mind, the mental health charity, found that nine out of 10 staff in general practice teams were adversely affected by pressure of work and increasing demands. One in five reported this having an adverse effect on their mental health, one in six said they take medication as a result, two in five use alcohol at home to limit stress and one in 10 report suicidal thoughts. This situation can’t continue.
In 2016, Reform, a right-wing think tank, proposed that nurses in general practice settings could safely take on 50% of the workload of medical colleagues. This would free up doctors to take on more severe cases, would relieve pressure within stressed teams and save the NHS an estimated £700m. The government has committed to increase spending in general practice, with a large proportion to be spent on increasing staff numbers.
Ensuring sustainability is critical and nurses are the key to achieving this. Partnership working between clinical providers and the university sector to ensure a supply of appropriately skilled nurses is essential.
There is a potential crisis within nurse staffing in general practice. It is difficult to recruit and many practice nurses are approaching retirement age. To remedy this, it is vital that newly qualified nurses are recruited into general practice, with a supportive career structure and an environment in which knowledge and skills are consolidated and developed. As part of this, student nurses must experience general practice as undergraduates.
The time has come for new and innovative partnerships to be brokered between universities and community education provider networks (CEPNs). As a university and CEPN, collaborators and colleagues are working closely in Kingston to develop general practice training environments for student nurses with creative approaches to practice learning, mentorship training and development. This includes partnering with other providers such as community nurses and nursing homes.
General practice requires nurses who are able to bring curiosity and critical thinking to their clinical competence. The structure of general practice allows nurses to change their career emphasis over time to accommodate life demands and create a work–life balance that may not be so easy to achieve in other areas of practice. Flexibility and diversity of provision within a team allows for people to work longer; this enables sustainability and for skills to be transferred and developed.
The rise of clinical commissioning groups with nurse members puts levels of strategic control of professional development into the hands of the profession. Vibrant and dynamic partnerships between practice settings and universities can be the catalyst to spark growth, reshaping sustainable and modern integrated primary healthcare and community provision.
Carmel Blackie is associate professor of primary health care and community nursing, Kingston University London and St George’s, University of London; Julia Billington is primary care nurse, Kingston Clinical Commissioning Group and clinical lead nurse, Kingston Community Education Provider Network.
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