Almost eight in 10 general practice nurses (GPNs) have reported working unpaid overtime during a week period, a survey has suggested.
Those among the profession have described the admission as evidence that staffing within primary care ‘does not adequately reflect capacity demands’ and warned the situation was ‘exhausting, unfair and unsustainable’ for GPNs.
The finding comes within latest research by the Queen’s Nursing Institute’s (QNI’s) International Community Nursing Observatory (ICNO) which surveyed more than 500 GPNs on the impact of the Additional Roles Reimbursement Scheme (ARRS) in England.
Concerns were raised around GPNs being ‘expected’ to train and supervise ARRS colleagues, despite being paid less, and that in some cases having ARRS staff had actually increased their workloads.
In addition, the survey also revealed more than three-quarters (78%) of GPNs reporting that they had worked at least one hour of unpaid overtime – including working through breaks – over a week period in September 2023.
The results saw more than half of GPNs (51%) state that had carried out between one and three hours unpaid, while 16% had done four to six hours.
Some 5.5% also said they had done seven to 10 hours unpaid overtime over the last week, while 2% had done between 11 to 15 hours, and a further 2% reported working more than 15 additional hours unpaid.
Responding to the findings, advanced nurse practitioner and chair of the Royal College of Nursing’s Women’s Health Forum, Ruth Bailey, said unpaid overtime was ‘exhausting, unfair and unsustainable’ for the profession.
‘The prevalence of regular unpaid overtime carried out by GPN’s is further evidence that staffing in primary care does not adequately reflect capacity demands and the expertise of GPN’s is underestimated and undervalued,’ she told Nursing in Practice.
‘Unpaid overtime is simply exploitation and leads to burnout. We are haemorrhaging GPN’s and need radical change to retain the ones we have.’
Meanwhile, research fellow at the University of York and a registered nurse by background, Dr Helen Anderson, pointed to a recent study on which she led, that showed GPNs had felt ‘pressurised to work outside contracted hours from home’ – including by working on blood test results, write care plans and organise workload.
‘Nurses working in general practice are reporting increased workload both in terms of volume and complexity,’ she told Nursing in Practice.
‘This impacts on nurses’ wellbeing and can lead to stress and, in some cases, to burnout and nurses leaving general practice and nursing altogether.
‘Nurses experience moral distress when demand exceeds capacity, and they cannot deliver the care patients require.’
Lee Collins, a GPN in Cornwall, suggested nurses were ‘often not supported by some managers and blamed for “poor time management”’.
‘Often, as GPNs we just “get on with it” under the guise of helping our patients,’ he told Nursing in Practice.
‘If we’re running late in clinics, we often blame ourselves.’
He added: ‘The ARRS scheme has taken further advantage of the nurses’ good nature by insisting that we help support new members of the team; those who are not experienced enough to undertake the roles they have been employed for.’
While this additional pressure was taken by many nurses ‘in their stride’ in order to help their patients, for others it was ‘increasing levels of burnout in an already pressured working environment’.
The research published by the QNI this week, led by director of the ICNO Professor Alison Leary and Dr Geoff Punshon, comes amid concerns around an increasing use of ARRS-employed nursing associates substituting GPNs.