Nurse-led surgeries could be the solution to the GP shortage, say nurses who have established one of the first set-ups of its kind in the UK.
The Cuckoo Lane Practice in Ealing is owned and run by nurses and was recently rated “outstanding” by the Care Quality Commission, making it one of only 3% of surgeries inspected so far to get the top rating.
Nurses who work there say it could provide a model for future primary care services and help alleviate widespread shortages of GPs.
The practice, which provides services to around 4,000 people in North West London, is owned by two nurse practitioners – Julie Belton and Carol Sears – who run it under an Alternative Provider Medical Services contract.
“This is a proven model that could absolutely be delivered elsewhere and I do think it is a solution to GP shortages”
It is staffed by three part-time salaried GPs, five nurse practitioners, four nurses, a healthcare assistant and a range of non-clinical staff.
Started in 2005, Cuckoo Lane is understood to be one of the first nurse-led general practices set up in the UK and the only one still operating at the moment.
Ms Belton said this kind of set-up could “absolutely” be a solution to the current GP crisis, with nurses a “massive untapped resource”.
“This is a proven model that could absolutely be delivered elsewhere and I do think it is a solution to GP shortages,” she told Nursing Times.
However, she cautioned that to be successful it needed the “right kind of leadership and organisational culture”.
“You have to have the right skillset to drive these things forward, so it is about identifying people and preparing them for leadership roles,” she said.
“We need to invest in individual nurses with potential, so when practices come up, and GPs retire, bids by appropriate nursing structures are accepted,” she said. “There is a massive untapped resource out there.”
The Cuckoo Lane model has attracted interest from NHS England, but Ms Belton was keen to stress it should in no way should be seen as a cheaper option to more traditional GP practices.
She said nurses had ways of working, values and skills – including communication skills and the ability to engage with patients – that meant they were well-suited to running primary care services.
“It’s a model that could be replicated in the future, which may well address the shortage of GPs in five or 10 years time”
She added that she would like to see a national programme of investment, including in training, to help kick-start more nurse-led general practices.
In the meantime, Ms Belton revealed that she was interested in the possibility of expanding her practice in the future, as well as supporting others to develop their own.
Helen Ward, principal lecturer in non-medical prescribing at London South Bank University, works at the practice one day a week as an advanced nurse practitioner.
“I think it’s a model that could be replicated in the future, which may well address the shortage of GPs in five or 10 years time,” she told Nursing Times.
“Saying that, it has been extremely hard work for those involved in setting it up,” she said. “It has taken them a long time to get to where they are and there have been a lot of hurdles along the way.”
Ms Ward agreed that moves to establish more general practices along the same lines would require experienced nurses with the right skills.
“It’s finding the right nurses to be brave enough to take that model forward really,” she said. “You need to have sound leadership and management skills, insight into how a business is run and knowledge of how local commissioning works.
“It is not just an advanced clinical role by any means,” she noted. “It is about getting the right nurses in the right place and perhaps having more of a political agenda to support it.”