LEADERSHIP
20 | Nursing in Practice | Summer 2023
LESSIONS IN
LEADERSHIP
Speaking out for nursing
A place on the Local Medical Committee board has allowed Ruth Colbeck to provide a unique perspective for her healthcare colleagues and advocate for the future of general practice nursing
Key issues that underpin your practice nursingin practice . co . uk
General practice nursing has often been looked on as an ‘ easy option ’ – offering nurses regular work without having to do unsocial hours . In fact , the role is like no other , and has growing influence within primary care . We have a huge scope of practice and expertise , literally caring for our patients from cradle to grave . Some days you can find yourself doing a baby vaccination clinic in the morning , and then seeing 80- and 90-year-olds in the afternoon to review their long-term conditions .
So why do we often feel that nurses in general practice don ’ t have a voice or a seat at the table ?
GP surgeries are individual businesses that provide NHS services through the GP contract . The way this work is carried out can differ greatly between surgeries . They can often follow a hierarchical structure , with doctors being partners , acting as both employers and managers . This can make it awkward for nurses to speak up , walking a fine line between ensuring patient safety and ‘ rocking the boat ’ with their employer . Other areas such as pay , and terms and conditions vary widely too .
I think there is often a lack of understanding about what general practice nurses can do across the different levels – nursing associates , senior practice nurses , advanced clinical practice nurses . There needs to be greater appreciation of the value of each of those roles , the differences between them and how we can complement each other and the medical and administrative staff as well .
We need more publicity about what the role of general practice nursing entails , both for service users and our colleagues .
I have worked in general practice for 17 years , and started out with little understanding of the role and its differences from working within other areas of the NHS . During this time , I have developed the clinical part of my role and also built up my leadership skills .
I am naturally quite chatty and inquisitive , but have been further empowered by my role as Leeds Local Medical Committee ( LMC ) non-medical rep . The LMC put out an advertisement asking if anyone non-medical was interested on being on the board and , even though I didn ’ t really have a clue about what it entailed , I put together a short statement about myself , what I do and what I hoped to bring to the LMC , and was voted onto the board .
Through the role I have been able to get a broader perspective and understanding of why certain decisions
I ’ m passionate that nurses should be encouraged to take opportunities that offer professional development
are made at that level . You realise it ’ s not just that you are not being listened to . Understanding the wider context improves your confidence to contribute , and you can offer workarounds . ‘ Ok , we can ’ t do it like that , but what about doing it this way ?’ Gaining this broader appreciation gives you greater self-belief and negotiating power .
I ’ m also a nurse rep on the Yorkshire faculty of the Royal College of General Practitioners , which again offers a bigger-picture perspective . It enables you to identify where your role is complementary to your colleagues ’ and how theirs complements yours , and assess how you can work as a team more effectively , rather than fighting for glory . It ’ s not about who ’ s best in practice , it ’ s about who ’ s working most effectively and cohesively to provide the best outcomes for patients .
Both roles show me that if I speak up , some people will listen . Not everybody , but some will , and that sets a ripple effect and makes positive changes . I am passionate that such opportunities should be promoted to nurses , who should in turn be encouraged and supported to apply for them . They can offer huge professional development by equipping nurses with the knowledge of what is happening in their practice and surrounding area , and giving them the confidence to offer solutions .
As well as encouraging our existing workforce , we also need to encourage more young people to explore practice nursing as a valid career option . Providing placements for students will help do this and also dispel the common misunderstanding about needing to work in the NHS when they first qualify .
I have recently moved from working in a GP surgery to a primary care network ( PCN ), across a group of practices working together to provide services at scale – such as happened with the Covid-19 vaccination rollout . My role is 50 / 50 clinical and leadership . This allows me to continue the face-to-face patient contact that I love , while also being able to support and encourage the nursing teams across the area .
I can honestly say I love working in general practice . I ’ m now seeing adult patients who were children that I vaccinated , some of whom are even bringing in their own children . You get to provide continuity of care over years and become part of the community . And I don ’ t know what could be much more fulfilling than that .
Ruth Colbeck is lead nurse at West Leeds Primary Care Network