Lucille Kelsall-Knight reflects on the shortfall in general practice nurses and why the provision of student placements in primary care should be a vital area of focus
The Nursing and Midwifery Council stipulates that pre-registration nursing programmes in the United Kingdom have standards that must be adhered to by Approved Education Institutions (AEIs).1 These standards incorporate the legal requirements, entry requirements, availability of recognition of prior learning, length of programme, requirements for supervision and assessment and information on the award for all pre-registration nursing education programmes.
Standard 3.4 details that students should be provided with no less than 2,300 practice learning hours, of which a maximum of 600 hours can be in simulated practice learning.1 The NMC details that all learning environments must have the capacity and resources needed to deliver safe and effective learning experiences for students, and that students must have suitable support and supervision when placed in a practice learning environment.2
Suitable support and supervision will vary in differing circumstances, and will be dependent upon many factors, but include the programme that the student is studying on, the outcomes the student is trying to achieve, the confidence and independence of the student, and the environment they are learning in. The placement must be safe and effective, in that it must be an inclusive learning environment with suitably trained people in place to supervise and support students.
When considering nurse education and training places, it is vital to consider the current numbers of nurses registered and the retention of staff. The Health Foundation detailed that the NHS in England, unless there is a change in policy, is facing a significant shortage of GPs and general practice nurses over the coming decade.3 They estimated that a shortfall of around 1,700 FTE in general practice nurse numbers in 2021/22 is projected to grow to around 6,400 FTE, approximately 1 in 4 posts, by 2030/31.
Furthermore, The Health Foundation projected that the number of FTE nurses in general practice is set to decline by around 0.6% a year (from 16,600 in 2021/22) over the 9 years to 2030/31.3 This information has been determined by recent trends and increases in nurse leaver rates. Moving forward the NHS Long Term Workforce Plan has detailed a need to increase adult nursing training places by 65–80 per cent by 2030/31, with training places increasing by 41 per cent to almost 28,000 over the next six years.4 In order to support these additional nurses, it is vital that nurses are also retained in healthcare.
Having considered the plans to increase nurse numbers and also retention of staff, a key point to contemplate would be ways to encourage nurses into practice nurse positions. One approach to this is to ensure that student nurses experience placements in the general practice setting.
The Royal College of Nursing highlighted that students with general practice experience are more likely to consider a career in primary care and that hosting students is known to improve retention of existing staff.5 In addition, being a placement provider who hosts students can have a positive impact on the whole team in the practice in terms of an increase in staff critical thinking. Students learning as part of the practice team can bring in diversity and a differing skills set; meanwhile a smaller practice can have a role in education and workforce development. From a financial perspective, the practice will receive an income from the placement tariff which is payable to them.
General practice placements can offer unique learning opportunities for student nurses as they will become involved in primary care, and develop skills in preventative care, chronic disease management and health promotion. General practice placements are an ideal environment to recognise the importance of building therapeutic relationships with patients, whilst providing continuity of care. All of these skills are key to pre-registration nursing curricula.
General practice placements in pre-registration nursing programmes could be the key that encourages newly qualified nurses into general practice, to expand and then retain the workforce.
Lucille Kelsall-Knight is a lecturer in children’s nursing at University of Birmingham School of Nursing
References
- Nursing and Midwifery Council (2023) Standards for pre-registration nursing programmes. Available at:
https://www.nmc.org.uk/globalassets/sitedocuments/standards/2023-pre-reg-standards/new-vi/standards-for-pre-registration-nursing-programmes.pdf
- Nursing and Midwifery Council (2019) What must be in place. Available at: https://www.nmc.org.uk/supporting-information-on-standards-for-student-supervision-and-assessment/learning-environments-and-experiences/designing-reviewing-safe-effective-learning-experiences/what-must-be-in-place/
- The Health Foundation (2022) REAL Centre Projections: General practice workforce in England: Summary of findings. Available at: https://www.health.org.uk/publications/reports/projections-general-practice-workforce-in-england
- NHS England. (June 2023). NHS Long Term Workforce Plan. www.england.nhs.uk/wp-content/uploads/2023/06/nhs-long-term-workforce-plan.pdf
- Royal College of Nursing (2023) Busting myths: general practice placements. Available at: https://www.rcn.org.uk/magazines/Career/2023/Sep/Busting-the-myths-on-general-practice-placements
