General practice nurses are facing ‘significant challenges’ and often feel ‘invisible’, MPs have heard as part of a health and social care committee (HSC) report published today on the future of general practice.
Heather Randle, RCN professional lead for education, said GPNs are ‘stressed and anxious about what is going on in general practice and the care that needs to be done that is being left undone as part of that’, in her evidence to the HSC – formerly headed by new Chancellor Jeremy Hunt – for the report.
She also said: ‘We have evidence that shows that people are leaving the profession… One of the things that our nurses say quite strongly is that they have felt invisible… They are struggling the same as our general practice colleagues.’
In light of the report, MPs have accused the Government and NHS of failing to heed evidence stressing the importance of continuity of care, hastening the decline of the ‘uniquely important’ relationship between patient and clinicians in general practice.
They called for NHS England to introduce a ‘national measure of continuity of care’ to be reported quarterly by all GP practices by 2024.
The trade-off between access and continuity of care has ‘shifted too far to access at the expense of continuity’, the report authors concluded.
They wrote: ‘Seeing your GP should not be like phoning a call centre or booking an Uber driver who you will never see again: relationship-based care is essential for patient safety and patient experience.’
Ms Randle told the report: ‘One of the skills of the nurse is being able to work in a team, and to lead teams. It is not always appropriate for the GP to be the person in charge of the care of a patient.
‘If they have chronic diseases, or if it is something related to their personal health, a nurse could be the person in charge of their care and could be the person who looks at it holistically. We are autonomous practitioners. We can manage the care of patients and escalate as we need to, or refer on.’
In her evidence to the report, Ms Randle also highlighted GPNs face significant challenges that are exacerbated by the fact that ‘terms and conditions as well as employment practices vary significantly between practices’.
The report also noted that it was problematic that general practice nurses do not generally have pay parity with their colleagues in secondary care, who are hired on Agenda for Change contracts.
However, the report largely focused on the GP workforce, which it concluded was demoralised, with GPs facing burnout from working in a ‘systemically toxic environment’, with unsustainable workloads, managing intensely complex cases at speed with fear over reprisals.
Responding to the report, Wes Streeting MP, shadow health and social care secretary, said: ‘Patients are finding it impossible to get a GP appointment in the manner they want one. Seeing the same doctor for each appointment means better care for patients, but under the Tories this is becoming rarer and rarer.
‘The Conservatives have cut 4,700 GPs in the last decade and closed hundreds of practices since the last election alone.’