Nursing staff should be at the heart of any transformation in primary care and more must be done to encourage nursing leadership in the sector, the Royal College of Nursing (RCN) has told MPs.
Heather Randle, RCN professional lead for education and primary care, addressed the Health and Social Care Select Committee last week (14 June), where she told MPs that more needed to be done to encourage nurses to sign up to partnerships.
‘It’s not always appropriate for the GP to oversee care,’ she said. ‘As we are autonomous practitioners, we can manage the care of patients and escalate or refer on if needed. We need to think about the leadership skills of nurses as well as their medical colleagues, and that is often forgotten.’
Ms Randle said support was needed to help change attitudes, as many still considered seeing a nurse a poor alternative to seeing a GP. A report published earlier this year warned that raising the profile and value of the ‘misunderstood’ practice nurse role had become ‘urgent’ amid workforce challenges and the demand on primary care, with their knowledge and expertise ‘underestimated’.
Health and social care secretary Sajid Javid announced last week plans to change the primary care model, which he said was ‘not working’.
However, the RCN said any planned changes would be futile unless more was done to recruit and retain staff. MPs were told that practice nurses were working more hours than they were commissioned for, a situation exacerbated by the Covid-19 pandemic.
‘We’ve heard nurses say they haven’t seen a pay rise in 10 years,’ said Ms Randle. ‘Nurses are leaving the profession or doing additional jobs and working extra hours because they just can’t make ends meet.’
As general practices are external to the NHS, although they are NHS services, staff are not on Agenda for Change (AfC) pay scales and moving into the sector may mean negotiating individual employment terms and conditions.
The RCN has called for a pay rise at 5% above inflation for NHS staff on AfC contracts in 2022/23, in a split from other healthcare unions.
A group of 13 healthcare unions has also called on the Government to implement an ‘inflation-busting pay rise’ and an ‘urgent’ retention package for NHS staff and nurses.
Ms Randle added: ‘We’ve got evidence that shows that people are leaving the profession, and one of the biggest problems is that people aren’t coming into it.
‘We don’t see career pathways into general practice and often nurses feel they need to go into hospital work before considering general practice. We need to see action to incentivise nurses into this profession.’
Eight in 10 (83%) nurses have said the staffing levels on their last shift were not sufficient to meet patient needs, according to a recent RCN survey. The latest NMC data showed that more than 25,000 registered nurses left the register last year alone, an increase of 13% on the previous year.