8 | Nursing in Practice | Autumn 2023
COVER STORY
The contribution of GPNs is
being ‘ airbrushed out and ignored ’, says QNI chief
As general practice nurses are overlooked by national plans and at the mercy of individual employers over pay , Dr Crystal Oldman warns NHS England to wake up before it ’ s too late
General practice nurses ( GPNs ) experience ‘ a pattern of being ignored ’ despite their vital contributions within the health service , according to the chief executive of the Queen ’ s Nursing Institute ( QNI ).
In an exclusive interview with Nursing in Practice , Dr Crystal Oldman says GPNs must be given the recognition they deserve by NHS England . The way the work of GPNs is being ‘ airbrushed out of everything ’ is leaving a damaging and lasting impact on their morale , she warns . Dr Oldman believes workforce remains the biggest challenge facing primary care and community nursing . She says a lack of workplace support , being excluded from national plans and feeling undervalued by those at the top , is jeopardising the mental wellbeing of GPNs .
She stresses that NHS England must take action now to show GPNs ‘ how important they are ’ or risk losing them from the workforce .
Being ‘ ignored ’ damages morale Dr Oldman is concerned that nurses working in general practice do not benefit from the same ‘ wellbeing infrastructure ’ and support offered to those working for larger organisations , such as NHS trusts .
In 2020 , the QNI launched a listening service offering emotional support to primary care and community nurses , called Talk to Us . And in a concerning revelation , Dr Oldman estimates half of the calls received by the charity come from GPNs .
According to Dr Oldman , NHS England ’ s new Delivery plan for recovering access to primary care has worsened GPN morale , given that they have been largely ‘ ignored ’ within the blueprint .
The 46-page plan , published in May , promises to provide ‘ millions of patients ’ with quicker and easier access to NHS care through investments in better technology for GP teams and through an expanded role for community pharmacists .
But with little mention of GPNs and the omission of nursing leaders from the plan ’ s development , the nursing workforce and its representatives – including Dr Oldman – have not hidden their disappointment with the document .
In a sign that managers are aware of these omissions , just 24 hours after highlighting the plan ’ s ‘ missed opportunity ’ to engage with GPNs , Dr Oldman was invited to a meeting with NHS England on the issue .
We really need something from NHS England to give an indication of how important GPNs are
‘ I think we will see quite a lot more working together with NHS England around this ,’ she says . Dr Oldman has since held meetings with the plan ’ s author , national director for primary care and community services Dr Amanda Doyle . ‘ I ’ m ever hopeful that we can get the general practice nurses back on board with this .’
But the damage to morale from the recovery plan has already been felt . ‘ They felt ignored yet again and this is a pattern of being ignored , which I will bring up with Amanda ,’ says Dr Oldman . She points to other examples , such as during the Covid-19 pandemic when GPs were given ‘ accolades ’ for continuing to work and for immunisation programmes , while the efforts of GPNs in helping to keep surgeries open and rolling out the vaccine went unrecognised .
Pay frustrations ‘ The way in which they are airbrushed out of everything is not helpful for their morale ,’ she adds . ‘[ We ] really need something that comes out of NHS England that gives an indication of how important they are .’ While unsure of what this may look like , Dr Oldman suggests there are conversations to be had around funding and professional development for GPNs .
GPNs are also ‘ tired ’ and ‘ fed up ’ with a lack of recognition around their pay and terms and conditions . While the QNI is not a trade union and is not involved in pay negotiations , Dr Oldman highlights the frustration of GPNs around the way in which they are remunerated , including how this is dependent on individual employers . ‘ That is disappointing as well for them ,’ she says .
The government announced it was funding a 6 % pay uplift for salaried GPs in England for 2023 / 24 in the summer , which should also apply to all salaried practice staff , including nurses employed by GP surgeries providing NHS services . But GPNs have been voicing concerns that the situation remains dependent on their employer ’ s decision over whether or not to pass on the benefits of the uplift .
While the Royal College of Nursing has been lobbying to ensure GPNs get the 6 % pay rise to which they are entitled , at the time of writing , negotiations were ongoing between the British Medical Association and the government to determine the specifics of the
JON BERKELEY