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Promoting the role of the nursing workforce in primary care

As Director of Nursing, my role is to manage and develop the nursing team across the six surgeries within our PCN, which serves approximately 40,000 people.

To further my own professional development, I’m currently undertaking a fellowship supported by NHS Birmingham and Solihull Clinical Commissioning Group (CCG), and I’m using it as an opportunity to identify other directors of nursing within PCNs across the country. My aim is to build a network that can help showcase the importance of nursing in primary care, support career progression for general practice nurses, and help shape the nursing profession within PCNs.

Recognising nurses as an integral part of PCNs

While our role is relatively low profile, the nursing workforce is integral to primary care and my colleagues are a vital part of the team that delivers on the network contract directed enhanced service (DES) for PCNs.

It’s a trend we’re bucking in GPS, with our nursing team taking a full role in developing improved patient care across the network. For example, our nurses can carry out medication reviews when completing the patients’ long term condition review; these are often completed by pharmacists elsewhere. They also offer specialist support for the local frailty teams in caring for patients with leg ulcers and other wellbeing issues. We also train our health care assistants (HCAs) to support in areas such as ongoing monitoring of blood pressure, blood tests, ECGs and other essential parts of the medication reviews for patients with learning disabilities, long term conditions and frail elderly patients.

Our nursing team supports the GPs with the drive for early cancer diagnosis. We are currently looking at weekend clinics to improve access to cervical screening and encouraging men to attend for their NHS health checks to look for any early signs of cancer.

As a nursing team we can also lead on exciting innovations to improve patient care. This year, we delivered our very first drive-through flu clinic. We were supported by our contacts at Solihull College – whose car park we used – and the Round Table, who kindly provided us with the gazebos we needed. We were delighted that even in the challenging circumstances of the coronavirus pandemic we were able to safely deliver around 2,000 vaccinations, and the feedback from patients has been brilliant. I was delighted with the tenacity and dedication shown by the team to get the clinic off the ground with such successful results.

Expanding the nursing team

With the right development opportunities, the nursing team can expand its services even further by introducing new and exciting roles.

The GPS Healthcare nursing team includes apprentice HCAs, experienced HCAs, nurses, practice nurses, nurse practitioners and advanced nurse practitioners – we work as one group, with no divisions.

To support this, when I became Director of Nursing five years ago, after six local GP practices merged to create GPS Healthcare,  it was agreed with the practice managers that we would have an HCA as part of the team at every surgery.

We also support apprentices and student nurses whenever we can, and one of our two apprentice HCAs is already interested in going on to train as a nurse. In addition, one of our qualified HCAs intends to train as a nurse associate in the future with our support.

We have developed our own career framework to encourage and support these dedicated members of staff across the nursing team and we are always looking to the future so we can meet the growing demand for health care.

Planning for future health and care needs

We link closely with our local universities to offer nursing associate and student nurse placements.  We have recruited four newly qualified nurses who have become excellent practice nurses and will have the opportunity to become advanced nurse practitioners if they wish to develop.

We took part in nursing careers events at Birmingham University in February and September 2020, where we talked to students to explain the breadth of experience and job satisfaction they could achieve as a practice nurse in primary care. Student nurses tend to focus on secondary care, and don’t often realise that a rewarding career could await them in general practice, where they can provide cradle to grave care and specialise in areas such as diabetes or asthma.

I was amazed – but sadly not surprised – during the February event to see that only one other primary care provider was represented among around 30 stands. It’s crucial that, as a sector, we bring young people into primary care early and allow them to blossom.

Building the director of nursing network

If you’re working in a similar role to mine and would be interested in joining a network of peers that works to further the influence and development of the nursing profession within primary care, please do drop me a line at juliecarrick@nhs.net.

Julie was successful in becoming the Director of Nursing for GPS Healthcare in 2015, when six individual general practices across Solihull merged to become one. She started her journey in primary care back in 2007, when she was employed to provide care for patients who had diabetes.

Julie attended Birmingham City University to complete the Return to Nursing course, as she had been a midwife for 20 years previously, and could not become a practice nurse without obtaining a nursing qualification. Since qualifying as a nurse, Julie has not looked back and had enjoyed every moment of her journey so far.