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Winter work


Practice nurses have never stopped working face-to-face



NHS England sent a letter to practices on 13 May instructing them to offer patients face-to-face appointments if that is their preference. The letter has caused much dismay amongst general practice staff, many of whom are working through one of the busiest times in general practice – where demand is high and staffing is difficult, with isolation periods and illness par for the course of the pandemic.

Regardless of all of this, the show has gone on and feedback from patients during this time at my practice has been overwhelmingly positive. I appreciate this won’t be the case for all patients and that a range of access is required to meet demand, but my experience of meeting with nurses and nurse leaders nationally, through these difficult times, is that many nurses have barely altered their way of working and have continued to see face-to-face patients for a significant amount of their consultations. Many nurses even resumed services before it was directed because they felt it was impacting on patients in a negative way.

The direction from NHS England of ensuring GP practices must offer face-to-face appointments fails to acknowledge that primary care nurses have never ceased to see patients face-to-face. What’s more, GPNs have also managed to be innovative by embracing telephone and online consulting for improving follow-ups and continuity of care for long-term conditions. This year’s flu vaccine, for example, was delivered as effectively if not more so than previous years with doors very much open.  The huge success of the flu and Covid-19 vaccine programmes has been helped by nurses working over and beyond their normal working hours to deliver the vaccines on such a huge scale.  

In a time when nurses have had to have an improvise, adapt and overcome mentality, and have continued to provide excellent patient care in difficult circumstances, the absence of acknowledgement of that feels deflating. I’m sure it does for my GP colleagues too. Furthermore, the idea that somehow general practice has been closed to patient care runs the risk of tarnishing the workforce development efforts of general practice nurses, which has continued throughout and is vital in order to sustain general practice.

Hopefully going forward this work will be acknowledged and the hard work that nurses have put into primary care during the pandemic will be recognised widely. I know that personally I have nothing but admiration for my nursing colleagues both at a local and national level who have worked tirelessly during the last 18 months.