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Professor Jane Cummings: ‘If you are thinking of retiring, please reconsider’

The practice nurse workforce has been given a plan to improve the numbers of nurses choosing primary care as a career option, as well as programs to encourage those who have left to return. Nursing In Practice’s features editor, Alice Harrold, speaks with CNO for England, Professor Jane Cummings, about how the plan will be implemented and whether it will be enough to turn around the decline in GPN numbers.

Why has the 10-point plan only been released now? 

The general practice 10 point plan was produced to support the Five Year Forward View and the General Practice Forward View published in 2016. The 10 point plan describes the nursing element. Its development is informed by general practice nurses, the Queens Nursing Institute and ipsos Mori research.

The plan sets out the important work needed to deliver more convenient access to care, more personalised care in the community and a stronger focus on prevention and population health driving better outcomes and experience for patients. The key actions aim to meet general practice workforce challenges by attracting new recruits, supporting existing GPNs and encouraging return to practice.

What will the plan mean practically for primary care nurses?

Practically, it will mean that we are strengthening the opportunities for GPN with defined career pathways and more opportunities to advance their careers.

Many of the actions include support for existing GPNs, but going forward we expect all nurses new to general practice to have access to an induction programme, training and mentoring and an expansion in leadership and career opportunities.

The newly setup regional boards will be responsible for implementation and delivering action across the country. The regional boards will report to me via Paul Vaughan, our Director of Nursing – Transformation, who is leading this work for me.

From this I hope to see more new GPNs as well as experienced staff take advantage of the flexibility it offers to re-enter the workforce.

 Too little, too late? Has the  10-point plan to general  practice nursing arrived in time  to reverse the decline in GPN  numbers – Alice Harrold investigates.

What will it change for student nurses and trainee nursing associates?

By offering additional routes, we expect general practice will open up to student nurses and nursing associates. More work experience and placements offered will increase exposure and encourage more students to choose this as a first destination career.

With more nursing students there will be more opportunities created for general practice staff to develop their mentoring skills and showcase what a great place general practice is for nursing staff to work.

Will the effects of the plan take place before one third of the workforce retires in 2020?*

Work is already underway with our regional boards established and our key milestones, which set out what we hope to achieve and when. We will start to see some of the effects before 2020.

The development of Return to Practice programmes will attract nurses who have left the nursing register to return and take up a career in general practice nursing.

We need to see new recruits coming in, encourage existing staff to stay in the profession and see more nurses return to practice and I remain positive that we will see progress across the board.

The image of nursing programme will undoubtedly play an important role in this.

There are some fantastic examples of good practice up and down the country and we must continue to share and adopt this if we are to see improvement on the ground.

Where will the money come from to fund the plan and how will it be distributed? Will it be ringfenced?

The plan is backed by a £15m investment, allocated when the General Practice Forward View was published in May 2016. Funding will be aligned to the 10 actions and spent over the next four years.

We are working to define elements that will attract funding this year. Some key areas will include establishing Education Facilitator posts in each CCG area, additional training programmes in each of the four regions and work in collaboration with Public Health Education to increase digital accessibility as well as the resources available to strengthen prevention and self-care, benefiting the people we care for.

The four regional GPN delivery boards will work with myself and the national team to decide on how best to spend this money to achieve our outcomes. It’s likely that these will vary from region to region. While there will be investment in some national initiatives, such as the return to practice programme, there will also be local initiatives to address specific needs in each of the four regions as determined by the regional GPN delivery boards.

Why is the demand from nurses to lift their pay cap not included in the plan?

The primary aim of the plan is to recognise and develop the roles that general practice nurses have, which transform care and help deliver the plan to make the NHS fit for the future.

For the vast majority of GPNs, they are employed by individual employers and negotiate their pay locally.

All nurses have a vital role in delivering care to our population and do a magnificent job, it is important that this work is recognised.

Has the scrap the cap summer of action had any influence of the plan or its timing?

I have wanted a plan that recognises and supports general practice nurses for some time. They are key to both the nursing and general practice family. First pledged in the Forward View – I then announced that we were working on a 10-point action plan at my CNO Summit in March this year. 

We planned on publishing it early this year, the general election delayed this slightly.

How might the RCN’s plan of full industrial action if the cap is not lifted impact the plan?

There are only a small number of practices in England who are managed directly by NHS Trusts. Staff working in those practices will be subject to the same terms and conditions as those working in the NHS and if they are RCN members, they may choose to take part in industrial action. This should not have a widespread impact on the delivery across England but will be taken into consideration by our regional boards.

We know that the General Practice Nursing workforce have been asking for this plan and it provides direct action in relation to what nurses working in this field have said is important to them to support and strengthen their leadership across primary care nursing. 

It builds on our conversations and research with nurses that was commissioned by NHS England in 2016 and further research from the Queens Nursing Institute. It also aligns with the Health Education England GPN workforce plan published in May this year. 

What is your message to our readers (primary care and community nurses)?

This is an exciting time for all nurses working in primary and community care. It is clear there are considerable challenges recruiting and retaining a workforce that is fit for the future and this action plan is a fantastic opportunity for primary care and community nurses to directly lead changes to improve the provision of and delivery of care, closer to home.

We need to develop health services that have the resilience to cope with the changing landscape, demographic pressures and rising demand. We need to think differently and not rely on traditional solutions. This is an opportunity for you all so I would wholeheartedly encourage you all to support the work that will take place over the next few years to support and strengthen the primary care and community nursing workforce.

What is your message to any practice nurses planning to retire early this year?

We value the skills and expertise of all our GPNs. If you are thinking of retiring, please consider looking for alternatives, reducing your hours, offering mentorships. The GPN places a strong focus on providing a number of options for existing GPNs to improve retention and career development.

The plan will also focus on supporting, strengthening and developing the GPN role and working with GP practices to explore flexibility within roles to improve retention and career development.

I would also encourage you all to support our next generation of GPNs to become future leaders as your experience and knowledge is second-to-none.

Most importantly I would like to thank you for all your hard work as I know the people you care for would too!


*The Queen’s Nursing Institute. General Practice Nursing in the 21st Century