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General practice nursing plan to avert workforce crisis is fabulous, says lead nurse

Doncaster’s scheme to attract and keep practice nurses is part of a growing trend across the country
Picture shows a practice nurse with a female patient.  Doncaster’s scheme to attract and keep practice nurses is part of a growing trend across the country.

Doncasters scheme to attract and keep practice nurses is part of a growing trend across the country

  • Nurses are being connected with each other through initiatives such as primary care networks
  • Initiatives are supported by ten-point action plan for general practice nursing
  • Aim is to head off crisis, with one in three practice nurses due to retire in five to ten years

A scheme to help recruit and retain practice nurses in the Yorkshire town of Doncaster has been welcomed by NHS Englands lead nurse as part of a fabulous programme of work across the country.

It is part of a strategy to cope with a looming workforce crisis, with one in three general practice

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Doncaster’s scheme to attract and keep practice nurses is part of a growing trend across the country

  • Nurses are being connected with each other through initiatives such as primary care networks
  • Initiatives are supported by ten-point action plan for general practice nursing
  • Aim is to head off crisis, with one in three practice nurses due to retire in five to ten years
Picture shows a practice nurse with a female patient.  Doncaster’s scheme to attract and keep practice nurses is part of a growing trend across the country.
Nurse prescriber Shelley Casson with a patient at Frances Street Medical Centre
in Doncaster Picture: NHS Doncaster Clinical Commissioning Group

A scheme to help recruit and retain practice nurses in the Yorkshire town of Doncaster has been welcomed by NHS England’s lead nurse as part of a ‘fabulous’ programme of work across the country.

It is part of a strategy to cope with a looming workforce crisis, with one in three general practice nurses (GPNs) set to retire within the next five to ten years.

23,800

general practice nurses in England

Recruitment and retention of GPNs was highlighted by NHS England in a ten-point action plan for general practice nursing in 2017. This has been used as a blueprint by Doncaster clinical commissioning group (CCG) to draw up its new general practice nursing plan.

NHS England/Improvement’s primary care nursing lead Karen Storey says Doncaster is an example of ‘a much bigger programme of work across the country’ supported by the policy plan.

Primary care networks connect nurses to each other

The Doncaster plan follows the launch of GPN strategies in Devon, Leeds, Wolverhampton and London during 2018-19.


Watch: Doncaster General Practice Nursing Development Strategy 2020


‘This has never happened before,’ says Ms Storey, explaining that it has been more common for general practices and GPNs to work in isolation.

‘They want the public to understand what an autonomous, highly skilled job being a practice nurse is’

Zara Head, lead nurse for primary care quality in NHS Doncaster CCG

Picture of NHS Doncaster CCG lead nurse for primary care quality Zara Head. Doncaster’s scheme to attract and keep practice nurses is part of a growing trend across the country.
Zara Head

Now, through initiatives such as the launch of primary care networks (PCNs), in which groups of practices come together to cover populations of between 30-50,000 people, nurses are being connected with each other, she says.

Ms Storey says: ‘People have started working together more and are thinking about how to best recruit, retain and develop their workforces.

‘It is absolutely fabulous. In three years we have seen a great change happening across general practice nursing – it is amazing in some areas.’

Recruitment and retention

NHS Doncaster CCG lead nurse for primary care quality Zara Head says the new strategy has been written with GPNs in the area over the past year.

Ms Head says: ‘I have spoken to nurses across Doncaster and discussed what they needed. This is not our strategy – it is their wishes, needs and aspirations.

‘They want to feel valued, they want the public to understand what an autonomous, highly skilled job being a practice nurse is.’

Following this work, areas identified as requiring solutions cover training and development, leadership, communication and support, says Ms Head. An important area being looked at is in GPN recruitment and retention, she says.

Black Country and West Birmingham general practice nurse strategy

General practice nursing strategies are starting to spring up around England, as early adopters develop workforce plans.

One such strategy was launched by the Black Country and West Birmingham Sustainability Transformation Partnership in late 2019, after being approved by all local clinical commissioning groups.

The strategy outlines a forward view for general practice nursing in the area, which supports national initiatives such as the NHS Long Term Plan and the ten-point action plan for general practice nursing.

It includes documents to support the induction of new staff, preceptorship, competencies, skills and education and clinical supervision.

NHS Doncaster CCG chief nurse Andrew Russell explains: ‘We know a significant proportion of our GPN workforce is nearing retirement age.

‘This is one of the reasons why we have put clear steps in place to ensure we have enough nurses for the future and can point out the endless opportunities a career in primary care nursing can bring.’

55%

of general practice nurse workforce is over 50

The Doncaster area has more than 200 GPNs across 39 general practices, but the same ageing demographic seen across the country’s wider workforce is at play here, with an average age of 50.

Dispelling myths will be part of the process

As a result, the strategy proposes to:

  • Increase placements for nursing students.
  • Establish induction and preceptorship programmes.
  • Improve access to and support for return-to-practice programmes.
  • Extend leadership and educator roles.
  • Increase access to clinical academic careers and advanced clinical practice programmes.
  • Develop career pathways for healthcare support workers, apprentices and nursing associates.

Ms Head says the plans have the support of GPs across Doncaster, and that dispelling myths will be part of the process. ‘There is a myth that nurses can’t work in general practice until they have been on a ward for two years. This is not true.

‘It is about people realising that primary care is a first career.’

One third-year nursing student who is quoted in the strategy says: ‘I didn’t think I could work in general practice without years of experience in a hospital.’

10%

of GPN workforce is under 35

In fact, says Ms Head, general practices in the area are already supporting four newly qualified nurses who have come straight from graduation, with ‘a suite of support and education’ for the next 12 months, and more are planned.

An action plan to support the strategy’s aims is also in development.

Ms Head says there is ‘a lot of work that needs to be done to change perceptions of nursing’ for the public, as well as work to remind nurses why they love their jobs.

‘The opportunities and rewards in primary care are endless, and this is evident in the strategy’

Crystal Oldman, chief executive of the Queen’s Nursing Institute

Queen’s Nursing Institute chief executive Crystal Oldman is delighted by the strategy. ‘It articulates the skills, knowledge and competence required throughout a varied and rewarding career in general practice and supports a clear career pathway from being newly qualified, then working as an advanced nurse practitioner, a commissioner of services and eventually as a clinical director of a PCN.

‘The opportunities and rewards in primary care are endless, and this is evident in the strategy. I wish Doncaster well in the implementation and look forward to hearing about their success in recruitment and retention in their nursing teams.’

Ten-point plan for general practice nursing

Aims of the general practice nursing ten-point plan for England, launched in 2017:

  • Celebrate and raise the profile of general practice nursing and promote it as a first destination career
  • Extend leadership and educator roles
  • Increase the number of pre-registration placements in general practice
  • Establish inductions and preceptorships
  • Improve access to return-to-practice programmes
  • Embed and deliver a radical upgrade in prevention
  • Support access to educational programmes to deliver national priorities as set out in the Five Year Forward View
  • Increase access to clinical academic careers and advanced clinical practice programmes
  • Develop healthcare support worker (HCSW), apprenticeship and nursing associate career pathways
  • Improve retention

The general practice nursing ten-point plan was backed by £15 million in investment from government.


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