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'The role of the practice nurse has changed a lot'

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GP practices are getting their own version of Productive Ward, thanks to Liz Wilson’s team Practice perfect.

The opportunity to make a difference attracted practice nurse Liz Wilson to a secondment at the NHS Institute of Innovation and Improvement.

“I love being a practice nurse – it’s the best job in the world,” she says. “Although I wasn’t looking to leave my job at Bartley Green Medical Practice in Birmingham, when I came across an advertisement for a practice nurse adviser to the Productive General Practice programme for two days a week I jumped at it.”

Productive General Practice (PGP) follows the Productive Ward programme.

“GP practices are businesses and the role of the practice nurse has changed a lot over the years,” Ms Wilson says. “While doing injections and dressings is an important part of our job, many nurses are managing patients in nurse-led clinics and becoming more involved in the business side and we have some great ideas for improving services.”

Ms Wilson has been a nurse for 23 years, starting in accident and emergency, followed by work as a clinical tutor in Namibia with VSO. For the past decade, she has been a practice nurse. She has also set up a business offering independent respiratory nursing services, and works alongside respiratory commissioners.

She will have completed work on the PGP this spring. “I work with two seconded GPs and a practice manager. We draw on our experience in general practice to guide the NHS Institute team as to whether ideas are realistic in primary care.

“Every surgery has its own problems and aspirations. It’s fascinating, going into other practices that are testing the programme. You have to put aside your own opinions. The NHS Institute supports practices to find their own solutions to improving patient services, which isn’t always the way you’d do it yourself.”

Some ideas are around non-clinical aspects such as the reception area and office systems. “Reception and admin staff have great ideas about how to improve surgeries and the PGP programme encourages all team members to become involved. Ideas that grow and lead to change are more likely to stick, as staff have a sense of idea ownership.”

Successful projects have included reducing the time taken to get medical reports from 21 to 12 days. “The surgery involved did that by using a process mapping tool. Reducing the number of process steps saved a significant amount of time.”

Another surgery reduced time spent looking for repeat prescriptions.

Other projects looked at skill mix – ensuring there were enough nurses with the right skills. “It sounds obvious but NHS Institute tools helped practices collect information then present it in a skills mix matrix – a visual way to see what skills you have or have not got and identify areas for training.”

Most important for Ms Wilson was freeing up practice nurses’ time. “One surgery found its nurses were performing a lot of blood tests. The NHS Institute helped identify how they could increase the number of blood tests performed by phlebotomists to give practice nurses more time to spend with patients with more complicated nursing needs.

“Practice nurses have the opportunity to build relationships with patients. This relationship encourages patients to share important information with us that they may not want to bother the doctors with. I am proud to be an important part of the primary care team.”

For more on PGP, email, call 02476 475945 or visit

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