National funding for retention and education schemes for general practice nurses (GPNs) in England is to be withdrawn at the end of March.
It is understood that funding for GPN fellowships and associated programmes will no longer come centrally from NHS England (NHSE) and will instead be at the discretion of integrated care boards (ICBs) as to whether these schemes continue.
The move has been met with outrage by nurse leaders who fear such schemes will be put at risk and that the situation could ultimately have a negative impact on the GPN workforce.
In its latest Primary Care Bulletin this month, NHSE said that national retention schemes for general practice, including fellowships for GPNs, will close at the end of March.
Nurses and GPs who join these schemes before 31 March 2024 will however be able to complete their two-year programme.
Chief executive of the Queen’s Nursing Institute (QNI) Dr Crystal Oldman said the announcement was ‘unexpected and with short notice’.
‘I understand that the funding will no longer be available centrally via NHSE, and any continuance of similar GPN education be at the discretion of the local ICBs,’ she added.
These changes ‘could potentially lead to unwarranted variation in the availability and funding of GPN education’, warned Dr Oldman.
It could also see recruitment and retention ‘decline back to the pre-GPN fellowship era’, prior to 2020 when they were launched, she added.
However, Dr Oldman added: ‘There is a plethora of evidence of the benefits of the GPN fellowship in recruiting and retaining registered nurses in general practice, which should make continuing the funding via an ICB irresistible to the commissioners.’
Practice nurse Magenta Franklin, who works in Hythe, is currently halfway through a GPN fellowship programme and said she would ‘be completely lost without it’.
Ms Franklin, who went into primary care as a newly registered nurse in November 2022, said the scheme, which supports her with different clinical competencies and skills, was ‘imperative’.
She told Nursing in Practice that having the offer of the fellowship was a ‘strong drive’ for choosing a career in primary care and that without it, she might not have.
Ms Franklin therefore felt that primary care was at risk of losing ‘a lot’ of GPNs if the fellowships were to be stopped altogether.
As previously reported, the training pathway for nurses new to general practice aimed to become a ‘gold standard’ national programme that would standardise training and move away from a ‘pick and mix’ of education that many GPNs currently face.
Strategic nurse lead Rachel Viggars, who is one of those behind the Staffordshire programme, told Nursing in Practice that the national GPN fellowship scheme had provided ‘significant funding’ for the delivery of the GPN school.
‘Whilst the fellowship will continue for those already on the programme till its completion, this decision will very likely have a negative impact on the recruitment of participating practices and PCNs [primary care networks], but also on the quality and quantity of what we can deliver in terms of the school itself,’ said Ms Viggars.
She explained that although the ‘fellowship monies are not the sole contributor to the programme’, the situation ‘has caused a risk for the sustainability of the programme in its current design’.
‘Effective workforce planning needs to be over multiple years, we are trying to get general practice to look ahead and plan for the future but quick changes in funding like this destabilises everything we strive to achieve,’ added Ms Viggars.
‘We will need to wait to see what comes next, and whether that comes quickly. We need strong primary care nurse leadership to help steer the direction of much needed funding to protect and value the GPN essential contribution to care delivery for patients and the wider primary care workforce.’
This GPN school is currently being evaluated by the QNI, and Ms Viggars said it was ‘already finding significant benefits and value in our programme which is seen as a blueprint for regional and national implementation’.
‘We will continue alongside support from the QNI to campaign and work towards the ultimate development of a GPN deanery for the benefit of all primary care,’ she added.
Professor of healthcare and workforce modelling Professor Alison Leary is among the team evaluating the Staffordshire scheme.
Commenting on the funding changes, she told Nursing in Practice: ‘An educated proficient workforce is essential for patient safety, and we know that continuing professional development is also essential to retain highly skilled people.
‘It seems short sighted to disinvest in a key workforce when there is so much demand in primary care.’
Posting on social media site X, NHSE primary care nursing lead Louise Brady said continuous professional development and education and training ‘makes a tangible difference in recruitment and retention of this integral [GPN] workforce’.
‘Decisions to secure funding going forward will now sit with ICB chief nurses and provision will vary from region to region,’ she wrote.
Ms Brady highlighted the GPN school in Staffordshire as an ‘excellent example of what can be achieved and accomplished’.
‘A consistent and national offer would have enabled and ensured long term success and sustainability, however the decisions are now the jurisdiction of ICBs,’ she added.
Nursing in Practice has contacted NHSE for further information.
Within its Primary Care Bulletin last week, it stated: ‘NHS England will continue to invest in GP retention in 2024/25. More information and guidance will follow in early 2024.’
