Let’s empower practice nurses to improve care

How many times have we read a report or piece of research that suggests nurses could be taking on more of the work currently performed by doctors? It is invariably accompanied by figures suggesting that the NHS would save squillions of pounds every year if only consultants and GPs let nurses take on more responsibilities. Not only that, but access to services would improve and outcomes would be unaffected or might even be enhanced.

Another such report was released last week. It came from think tank Reform and focuses on primary care, arguing that up to half of GP appointments could be conducted by other professionals such as nursing staff. In one scenario, the NHS would save £727 million a year.

However, this approach to role substitution is far from straightforward. The medical and nursing professions exist because they differ from each other; there is some overlap, but one does not lead seamlessly to the other.

Nonetheless, there is scope to develop practice nurses, nurse practitioners and others working in primary care to deliver a better service to patients and, in so doing, reduce reliance on GPs and save money. This would require significant additional recruitment and a retraining programme for nurses in secondary care to equip them with the necessary skills.

However, as the Royal College of General Practitioners (RCGP) has pointed out, surgeries cannot find enough nurses as it is, and a high proportion of those in post are due to retire within a few years. Recent research published in The Lancet shows that practice nurses are struggling with their workloads and undertaking more consultations that by necessity take longer.

RCGP nurse champion Jenny Aston is calling for a strategy to develop practice nursing, and NHS England has said such an initiative is in the offing. This offers hope that practice nurses can develop their careers to the benefit of us all.