10 | Nursing in Practice | Winter 2023
4REINSTATE
TIME FOR LONG-TERM CONDITIONS
‘ Practices and PCNs need to free up time for GPNs to empower patients to manage their long-term conditions , including diabetes , asthma and COPD .’
Nurses are ‘ very innovative , and there are many different approaches to supporting patients in managing their long-term conditions ’, says Jenny Aston , advanced nurse practitioner ( ANP ) at Granta Medical Practices , Cambridgeshire , and a Queen ’ s Nurse .
Ms Aston has set up group consultation clinics for patients with diabetes , to help them better understand and manage their condition . She says these group clinics show ‘ the power of patients in a group being guided by a facilitator and then having their own questions and concerns addressed by a clinical expert ’.
‘ Patients say the consultations are helpful , that they understand more about their condition , and don ’ t feel so alone .’
She also believes GPNs are well placed to offer holistic , person-centred guidance to patients about managing
long-term conditions . ‘ A well-trained , experienced GPN will have a rounded approach to helping patients with asthma , for example .
‘ And if GPNs can manage long-term conditions well there will also be fewer patients in A & E because their condition has not got out of control ,’ she notes .
But Ms Aston says time pressures can make it challenging to deliver this care and support . Practices and PCNs ‘ need to acknowledge that you need enough time to deliver patient-centred care to help patients manage long-term conditions ’, she says . GPNs ‘ need to be involved in planning the appropriate types and length of clinic appointments to benefit patients ’.
She adds that nurses require ‘ appropriate training and regular updates ’ to manage long-term conditions , as well as to ‘ understand and deliver individualised , patientcentred care ’.
“ GPNs need to be involved in planning the types and length of clinic appointments to benefit patients ”
5
PRIORITISE HEALTH PROMOTION
6SUPPORT
WELLBEING
‘ NHS England , PCNs , and GP practices should ensure GPNs have the time and resources to carry out their crucial role in public health promotion and disease prevention .’
Julie Roye , head of nursing for primary care at the East London NHS Foundation Trust , and a Queen ’ s Nurse , has brought together a multidisciplinary team , admin staff and population health leads to co-develop improvements to cervical screening uptake in a diverse patient population .
Ms Roye has recruited more nurses , opened evening sessions in response to feedback , enabled women to book their preferred appointment time and nurse via a text link – increasing their autonomy – and made sure texts and letters are delivered in appropriate languages for non-fluent English speakers . She has also ensured inclusivity for trans men and non-binary people .
Just nine months after the scheme started in August 2022 at Cauldwell Medical Centre in Bedford , uptake among 25- to 64-year-olds had increased from 52 % to 80 %.
‘ GPN employers , PCNs and nursing bodies need to support nurses with their health and care , so they can care for others .’
Dr Helen Anderson RN , research fellow at the University of York , and previously a GPN and ANP , recently led a study on the experiences of nurses working in general practice during the Covid-19 pandemic . The work has a particular focus on nurses ’ health and wellbeing – an area she feels strongly about .
Analysis of the study ’ s findings was based on a report in 2020 by The King ’ s Fund , whose premise was that for nurses ’ wellbeing needs to be met , they need to experience autonomy and a sense of belonging , and to feel they are making a valuable contribution – ‘ all needs that were challenged by the pandemic ’, says Dr Anderson . Many of the nurses she spoke to said that even before the pandemic they felt ‘ invisible ’.
Workload ‘ significantly increased over the pandemic , and seems not to have subsided ’, she says . ‘ Even those working 30 years or more in general practice are saying
Ms Roye ’ s efforts – which earned her a national award in 2023 – show the powerful impact nursing can have on health promotion and disease prevention .
‘ Nurses are well placed to do this work ,’ she says . ‘ They have such an influential voice – and the power to change health outcomes for patients . For example , they can help people with diabetes and hypertension to manage their condition by advising on diet and exercise .’
‘ It also means a lot to patients when nurses take time to talk about how to change and improve their health .’ But Ms Roye cautions : ‘ GPNs need the time and resources to make sure health promotion and disease prevention isn ’ t forgotten .’ And it is vital they feel ‘ appreciated , cared for and valued ’, she says . ‘ Your skills are important . You ’ re improving outcomes and going above and beyond to make a difference for patients .’
“ Nurses have such an influential voice – and the power to change health outcomes for patients ”
they ’ ve never seen the level and complexity of this workload before .
‘ As a consequence , nurses are suffering from anxiety , stress , and burnout , and some are leaving the profession .’ Dr Anderson wants GPNs included in higher-level decision making . Employers and practice managers need to remunerate them appropriately , she says , and general practice colleagues and the public need to be more aware of the highly skilled work they do .
‘ Their role is often overlooked , which is not good for anyone ’ s wellbeing or , ultimately , for the future of general practice nursing .’
‘ We need to strategically consider how GPNs are to be supported ,’ she says . ‘ We ’ ve reached crisis point . If we lose more GPNs this is going to have a significantly negative impact on general practice . And these nurses will be sorely missed .’
“ We ’ ve reached crisis point . If we lose more GPNs it will have a significantly negative impact on general practice ”