Dual roles proposed to boost practice nurse numbers

Dual roles and better student placements could help address practice nurse shortage, says nurse clinical leader.
Practice nurse with patient

Dual roles and better student placements could help tackle practice nurse shortage, says a nurse clinical leader.

A student observes the work of a practice nurse  Photo: Alamy

South London practice nurse Mia Skelly said almost a third of practice nurses will retire in the next four years, and that as care moves into the community, the future workforce must follow it.

She told Nursing Standard: ‘Pre-registration student nurses are not getting regular placement opportunities in these areas.’

The next generation

Ms Skelly, who has just completed a fellowship in clinical leadership at Health Education England (HEE), added: ‘We need to capture those years of knowledge and pass it on to the next generation of general practice nurses.’

During a recent podcast interview, Ms Skelly told general practice think tank Ockham Healthcare that there was scope for nurses to play a bigger role in community care.

‘I think there will be – and are – nurses who would be interested in a dual role as a district nurse and general practice nurse,’ Ms Skelly suggested. ‘That’s not going to be for everybody but there is an opportunity there.’

Ms Skelly herself has held a dual role part-time as a general practice nurse and with the Community Education Provider Network in Wandsworth, London.

She added that some practice nurses undertake aspects of nursing that were historically district nursing roles, because of a corresponding shortage of district nurses.

‘I think care homes need to be taken into the conversation as well.

‘If we could see the future as these three areas in the community talking to each other, ultimately patients are going to win.’

Opportunities for students

She said exposing nursing students to district nursing, general practice and care home placements and mentorship opportunities would solve some placement problems.

‘If a student could follow one nurse from district nursing to practice to care homes, that is a good idea for a placement model.’

Queens Nursing Institute (QNI) chief executive Crystal Oldman said the biggest challenge for one person acting as district and general practice nurse would lie in being clinically credible and safe in both roles.

Dr Oldman said: ‘Think baby immunisations and childhood illnesses through to end of life for adults at home, and everything else in between, like sexual health, cervical smears, complex wound care, long-term conditions, visiting patients in care homes. This would be a very special nurse.’

Unpopular idea

A 2015 QNI report  detailed the ‘overwhelmingly negative’ views of nurses asked about general practice nurses doing the work of district nurses and vice versa. They suggested co-location in a GP surgery might work best.

Dr Oldman added that new ways of working in primary care might support a one-team approach, if not a dual role.

HEE said information about dual roles would be available in a general practice nursing strategy that is shortly to be published.

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