General practice nurses need a bigger voice in the leadership of the NHS at all levels of organisation, says leading primary care nurse Sara Baldwin.
Ms Baldwin, Queen’s Nurse and nurse manager at the Central Park Surgery in Leyland, is a member of the Primary Care Nursing Shared Professional Decision Making Council (SDMC) established by England’s chief nurse Ruth May in 2020.
Speaking to Nursing in Practice, Ms Baldwin said that decision-making at the level of the integrated care boards (ICB) and above was being limited by the lack of a strong voice for nurses at higher levels of the organisation.
‘It’s very difficult for there to be a full conversation if not everyone is at the table,’ said Ms Baldwin. ‘It’s improving, but actually there’s still not enough nurses at the higher levels; they have to be part of the conversation.’
While ICBs do usually employ a chief nursing officer, Ms Baldwin warned ‘across the country we are still fighting’ to be heard at the highest levels.
This is particularly important for nurses working in general practice, said Ms Baldwin, because practice nurses have a unique therapeutic relationship with their patients that allows for greater insight into the drivers of disease and demand at the practice level.
‘There’s no point in organisations making changes for the sake of changing – you need evidence. We [general practice nurses] deal with patients from birth to death, and in primary care we’re looking at patients from a completely holistic perspective.’
‘Nurses need an opinion,’ Ms Baldwin added. ‘We are patient advocates, but we need to share our patient advocacy in the most appropriate place.’
While the impact of groups such as the SDMC, and more nurses taking leadership training programmes such as those offered by the Florence Nightingale Foundation, is growing the voice of nurses at a higher level, one area where the voice of general practice nurses is heard less loudly is on pay.
Nurses employed by the NHS on Agenda For Change contracts have been collectively fighting for a better pay deal through industrial action over recent months.
However, nurses working in general practice negotiate their contracts directly with their practice. Although some have agreement for their salary to follow the Agenda for Change pay scale, the majority do not. Yet, it is hoped that an improved pay deal for Agenda for Change could give general practice nurses more bargaining power in their contracts.
Ms Baldwin said that the strike action lead by the Royal College of Nursing has put some additional strain on general practice, as more patients have been seeking out advice from general practice when they have been unsure they would receive adequate care at the hospital.
Heather Randle, RCN UK professional lead for primary care, said: ‘It is not acceptable that nurses in general practice do not receive equal pay terms and conditions to their NHS colleagues. For example, nurses in general practice are paid only statutory sick pay and maternity pay, and most have less paid holidays and no study leave, along with less pay.’
She said that not only does she understand her colleagues motivations for striking, but remains optimistic that their action may trickle down into the practice.
‘We’re really hoping that as a result this will have an effect [on general practice]. If they get a better deal we stand a better chance ourselves.’