Nursing in Practice Autumn 2022 issue | Page 8

8 | Nursing in Practice | Autumn 2022
‘ I ’ m confident we can deliver what we need to , but it ’ s often at a detriment to ourselves ’
Lucy Brotherton , lead practice nurse based in the south west This year we ’ ve tried to work more collaboratively within our PCN – running more central clinics , pooling resources , particularly when it comes to Covid vaccinations . We are predominantly focusing on flu and working closely with the PCNs so our patients will get their Covid vaccines at other practices within the PCN .
Discussions have happened earlier this year because of the amount of planning needed . There ’ s more to discuss in the logistics , it ’ s trying to predict every scenario .
Obviously the Covid restrictions are different this year , but we ’ ve been sticking to the strict infection-control policies , looking at how we move patients through the building , how our reception staff manage the flow . We ’ ve had to give slightly longer appointment times so that we can follow the IPC guidelines , so that means fewer appointments . We ’ re also asking people to wait in their cars or outside the building , limiting the number of people standing in the waiting rooms . It ’ s going to be very busy – there ’ s not been a decline , if anything people are more aware of the benefits of
We ’ re trying to find people who can deliver the services we need right now , and it just seems an impossible task vaccinations , and those that may have turned down the flu vaccine before are more keen , particularly the younger groups .
There ’ s also the challenge of where you ’ re going to store all these vaccines , as well as your routine vaccinations for child immunisation programmes . It is about trying to maintain a minimum but required stock level of your routine vaccinations , ensuring you ’ ve got ample space for flu and Covid supplies . When they were doing Covid vaccinations from the vaccine centres , that eased some of the pressure , but now that has come back onto primary care to manage .
The flu vaccines tend to arrive in dribs and drabs , whereas you tend to have one big delivery of Covid vaccines , so it ’ s trying to plan that with your staff and appointments . It will be a huge challenge for staff that are already quite worn out .
I don ’ t think anyone expected two years in to still be coping with the backlog of work . And we just cannot recruit staff with the necessary experience . We ’ re trying to find people who can deliver the services we need right now , and it just seems an impossible task , there are shortages across the board .
I ’ m very confident we ’ ll deliver what we need to deliver – but it ’ s often at a detriment to ourselves and our teams .
such as 7,000 more beds , including innovative virtual wards , and boosting the recruitment of new staff in primary care ’.
They added that the Government had made ‘£ 520m available to improve access and expand general practice capacity during the pandemic ’ saying GP appointments had ‘ returned to pre-pandemic levels ’, with 1.3 million on average per working day in June 2022 .
However , nurses are cynical about whether ‘ throwing money at the problem ’ will provide meaningful support for primary care this winter . They want a proper strategy for recruitment and retention .
‘ There is always a need for more [ winter ] funding but there needs to be long-term investment as well , in terms of attracting more people into general practice ,’ says the RCN ’ s Helen Donovan .
‘ It is pay , but it ’ s also recognising the skills and expertise and experience general practice nurses have . They have really advanced skills – a lot are prescribers . And it ’ s often down to language – you often hear about the doctors and GPs rather than general practice . The nurses need to be recognised for what they ’ re doing .’
Cost of living may hit vaccine uptake
Requiring patients to make multiple journeys for their vaccinations could hit uptake – not just due to vaccine fatigue but also rising costs , such as fuel .
‘ Nurses are going to be seeing people who are not able to heat their own homes and their long-term conditions are going to get worse . There ’ s the physical impact that they ’ re going to be seeing in the patients , and the impact on the nurses knowing that they can ’ t do anything about it ,’ says the QNI ’ s Dr Crystal Oldman .
Food banks in the Trussell Trust ’ s network provided more than 2.1 million parcels to people facing financial hardship across the country between 1 April 2021 and 31 March 2022 – a 14 % increase on the same period in 2019 / 20 and the first time the trust has surpassed two million parcels other than at the height of the pandemic .
Barnsley Healthcare Federation ’ s Ms Parkin says the severity of the recruitment problems could worsen winter pressures , citing the federation ’ s inability to fill a medical director vacancy for more than two years .
Ms Parsons says it ’ s important to boost existing services that are known to be effective : ‘ We can ’ t just keep creating services – we need to do something about the services that are there and reinforce what we ’ ve got . General practice works but we do need a review .’
A report ¹ released by the Health Foundation ’ s REAL ( research and economic analysis for the long term ) centre earlier this year found that healthcare services in England could still face a shortfall of up to 38,000 nurses even if the Government makes good on its promise to recruit an extra 50,000 . The number of FTE nurses in general practice is projected to decline by around 0.6 % each year over the next nine years .
‘ When I started in general practice , occasionally we had clinics with empty appointments . They were a bit of a break and a catch-up . It hasn ’ t happened for years ,’ adds Ms Parsons . ‘ The concern is that we have a depleted , exhausted workforce heading into the winter season . We know staff are tired ; they ’ re going to get sick and they ’ re going to be more sick if they ’ re tired .’
As winter approaches , nurses also continue to face the misconception that practices are not open for in-person appointments , with some even being abused by patients .
‘ I often think we should publish the figures – how many people did we speak to on the phone , how many did we see each week ?’ says practice nurse Ms Aikman .
Ms Parsons says dissatisfaction with other healthcare services often arrives at the door of general practice and is leading to a high turnover of reception staff and care navigators .‘ You ’ re constantly training new staff ,’ she says .
‘ People see the pressure in A & E – they can visualise it . They can ’ t visualise it in general practice , they just think somebody is refusing to see them .’
‘ We will always strive to meet demand in primary care and nursing staff will continue to work as hard as they can ,’ concludes Ms Parkin .
‘ However , we need the tools , we need the staff , and we need the staff who are in work to be fit and well .’
Reference
1 Shembavnekar N et al . NHS workforce projections 2022 . London , Health Foundation , 2022 . bit . ly / 3xjSZRe .
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