A nursing associate has been working to raise the profile and improve understanding of the role within primary care across Lincolnshire Integrated Care Board (ICB).
Samantha Simpson, who is based at Abbey Medical Practice and also works for the local primary care training hub, told Nursing in Practice that a lot of patients and some practice staff still do not know what a nursing associate does.
Ms Simpson said clear guidance would prevent nursing associates from ‘overstepping boundaries’ in practice, acknowledging that ‘grey areas’ around the role do exist.
‘Being a nursing associate in primary care is still not understood as well, but in the Lincolnshire ICB, we’re definitely pushing for our nursing associates,’ she said.
Ms Simpson started working at her local GP practice 16 years ago, first as a receptionist before retraining as a healthcare assistant.
After a decade in the role, she retrained again, this time as a nursing associate – making her what is believed to be the first nursing associate in Lincolnshire to train solely through primary care.
She has also spent the last two years working as a nursing associate ambassador at Lincolnshire Training Hub, supporting and training nursing associates across the county.
The hub works in partnership with the Lincolnshire ICB to provide training courses and information to support nurses, nursing associates, doctors, allied health professionals and other members of the primary healthcare team.
Ms Simpson said the role of a nurse or nursing associate in primary care was not always understood.
‘Many still have it drummed into them that you can only be a nurse or a nursing associate if you work in a hospital which is far from the case, there are so many skills that you can learn in general practice,’ she explained.
In her nursing associate role, she has completed additional cytology and immunisation training, alongside diplomas in diabetes and asthma care.
Ms Simpson said she currently has no plans to ‘upskill’ to a registered nursing position, stressing that she loves her job because of the challenges and clinical training opportunities it brings.
Since 2021, she has helped teach 48 students on the nursing associate programme across Lincolnshire, purely through general practice.
‘A lot of people have the perception that general practice is a boring environment, that it’s something to do when you want to retire and slow down,’ she explained.
‘Nursing is changing so much, the nurses are doing more of what the GPs used to do, so actually everything is changing quite quickly in the world of general practice.’
Despite the passion and pride Ms Simpson has in her role, she added that a lot of patients, and some practice staff, still don’t know what a nursing associate is.
Ms Simpson is working to raise the profile of the role as part of her ambassador role, where she helps explain what a nursing associate is and what nursing associates can bring to general practice.
She recalled times when GPs who were against hiring nursing associates now welcomed the role after hearing her explain what the position actually involved.
‘Some people do see nursing associates as a glorified healthcare assistant, but they’re not the same thing at all and the role is ever-changing,’ she said.
Ms Simpson added that more information was needed around the role from nursing bodies – noting that ‘grey areas’ do exist, and clear guidance would prevent nursing associates from ‘overstepping boundaries’ in practice.
‘It’s becoming less grey as the role progresses, but it’s still quite within its infancy and that role is changing and progressing over time as the demand for it changes,’ she told Nursing in Practice.
Earlier this year, the Queen’s Nursing Institute issued a position statement calling for guidance on the ‘scope and limits’ of nursing associates amid reports of those in post running independent clinics in general practice.
Meanwhile, the Royal College of Nursing has warned general practice nurses (GPNs) are increasingly being substituted with nursing associates following the introduction of the Additional Roles Reimbursement Scheme (ARRS).
When nursing associates were introduced in England in 2019, the Nursing and Midwifery Council set out six platforms for nursing associates and seven for registered nurses, which aim to highlight the differences between the roles. This includes that nursing associates contribute to integrated care, while registered nurses coordinate care
For Terry Vine, deputy director of nursing and quality within Lincolnshire ICB, Ms Simpson’s teaching around nursing associates has been an invaluable asset for the area.
‘She’s absolutely amazing,’ he told Nursing in Practice.
Mr Vine has been promoting nursing leadership in Lincolnshire since running the area’s then Clinical Commissiong Group (CCG) in 2017.
In the same year, he began a Post Graduate Diploma in Health Care Leadership at South Bank University, as part of NHS Improvement’s Aspiring Nurse Director Programme.
For his first assignment, Mr Vine had to write about a leadership challenge at work and chose general practice nursing.
‘I had recognised that within Lincolnshire this group of nurses were working across over 90 practices with no collective voice and no clear leadership,’ he said.
‘NHS England had issued their 10-point plan for GPNs around the same time I was working on my assignment. This plan recognised many of the same issues I had identified locally and offered a national framework for improvement,’ he recalled.
Mr Vine then decided to establish a Lincolnshire-wide GPN Reference Group, with the support of four CCG executive nurses. The group attracted a range of attendees, including nurses working in practice, Health Education England, Lincolnshire Training Hub, the local medical committee and relevant higher education institutions.
Since then, he has continued working to provide leadership for nurses and nursing associates working in general practice in Lincolnshire.
‘I can’t underestimate the importance of having a good training hub with really good leadership within the training hub. Our work would not have progressed anything like it has without our leaders,’ said Mr Vine.
‘In Lincolnshire we’ve made sure we’ve got strong system leadership roles available to people working in general practice. These leadership schemes aren’t just for people working in big acute trusts, they are for everyone, and a lot of people don’t realise that that there is that system offer in place.
‘General practice nursing teaches you to be a good leader because you’re working in an isolated practice and you have to fight for everything, you have to fight for your terms and conditions, and you have to fight to be heard as a nurse who is in general practice.
‘I think anyone can be a system leader or a leader for their profession.’
