Nurses leaving general practice within a year over pay and lack of support

Concerns around pay, terms and conditions as well as workload pressures and a lack of support are driving nurses out of general practice within their first year, a conference has heard.

Sarah Hall, clinical standards manager at NHS Devon Integrated Care Board and a general practice nurse (GPN) of more than 20 years, was speaking at the Queen’s Institute of Community Nursing’s annual conference on Tuesday when she highlighted the importance of strong workplace support in retaining nurses in general practice.

She suggested this was especially important given a recent trend in nurses leaving the sector within their first year.

Ms Hall spearheaded the Legacy Nurse Mentorship initiative at Devon ICB – a mentoring programme launched in 2021 to help retain both experienced and new nurses within general practice.

The scheme sees the role of a ‘legacy mentor’ – an experienced GPN – partnered up with a new to general practice nurse to provide supportive mentorship through professional advice and guidance.

Ms Hall said the scheme had been ‘very successful’ and had seen a 100% retention rate in the initial years of the programme.

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‘I think it’s just such a valuable programme and it just recognises our most experienced nurses – their value – as well as supporting nurses new into general practice,’ she told the conference.

‘It has proved very popular and very successful over the time.’

However, she suggested retention issues were becoming more prominent within general practice nursing.

‘I would say now, more recently, that we have for the first time seen that we are losing nurses within their first year of coming to general practice – and we’re not alone in this,’ said Ms Hall.

‘Last year, 50% of the nurses on the programme left within their first year, and not all practices sign up to the programme.

‘I think financial constraints and workload pressures in primary care are very challenging at this time, and I think that now more than ever, we need these programmes to work.’

Nurses that are leaving are citing that ‘they are not supported in practice’, she added.

‘And then there’s always the elephant in the room, which is pay, terms and conditions, unfortunately for general practice nursing,’ she said.

‘So, we cannot just keep thinking this will work every time, we have to keep going back and reviewing and changing and looking to what we can do better to support nurses or any new nurses.

‘I think it’s not just in general practice. I think it’s a very challenging time to come into being a nurse.’

Later in her session, Ms Hall was pressed further on the issues effecting nurse retention in general practice.

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‘We’re seeing nurses saying that they’re not being supported and that, and that gets me really frustrated, because I know that general practice cannot afford to pay in line with Agenda for Change pay, terms and conditions. So, I think that that is, in itself, is another challenge.

‘But I think that what is it within general practice’s gift is to actually look after the nurses. You’ve got to support them, to train them and educate them and give them time.’

She described the complex work carried out by GPNs and the ‘huge among of responsibility and learning’ required.

‘They need time to embed their learning. They need that support. They need mentorship. In practice, it can be really isolating,’ said Ms Hall.

She highlighted that many GP practices are relatively small, with small teams and have gone without employing a new nurse for many years.

‘We’ve developed a programme to support them, but unfortunately, not all practices are signing up for it. We have to ask, why is that? What is it that general practice wants? What is it they expect? How can we help and support them?

‘But even [then] still we’re still finding, even though nurses have been on the programme, they’re still leaving, and it is a real challenge.’

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Ms Hall recently spoke with Nursing in Practice about nurse leadership and support as part of our How Nurses Count campaign.

Nursing in Practice’s General practice nurse pay: A salary survey of the profession 2025 report – produced with our sister title Management in Practice in April 2025 – found that GPN pay lags behind the earnings of their hospital counterparts who have the benefit of being on Agenda for Change contracts, and that this was a ‘major barrier for practices in their efforts to recruit greater number of the profession’.

The report, based on a survey of more than 550 general practice nursing staff, found that more than a quarter (28%) were considering leaving their jobs within the next 12 months. Dissatisfaction with pay and feeling undervalued were among the key reasons for this.