7
FOCUS ON PROFESSIONAL DEVELOPMENT
‘ All nurses should be given the time for professional development to progress their careers . NHS England , PCNs and practices should encourage and support the ANP role to grow in general practice .’
Historically , general practice nurses have had little or no opportunities for career progression . But all that is changing . ‘ Now there are career pathways for GPNs where they can increase their knowledge , skills and training ,’ says Jenny Bostock , a clinical director at Ramsgate PCN , an ANP at Dashwood Medical Centre in the town and a Queen ’ s Nurse .
She says many practice nurses ‘ want to develop their role and to become , for example , ANPs , or nurses specialising in a particular chronic disease ’.
But she says those who choose a career in practice nursing can feel isolated . Particularly for those new to the profession , a lack of support can be ‘ a big issue ’.
‘ It ’ s important they feel supported , and that if they have any issues , they are able to talk things through ,’ Ms Bostock says .
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ANPs do ‘ complex work and may need support from a senior clinician if , for example , a patient presents with a condition that is not textbook clear ’, she says . Without such support , ‘ ANPs can ’ t increase their scope of practice ’.
The business needs of practices can prevent GPNs carving a career pathway of their choice , Ms Bostock says . For example , if a practice has two nurses in respiratory care , a third may not be required . To help address this , she says , ‘ practices within PCNs need to work together to share staff resources ’. This would allow nurses to develop their skills across practices , rather than be restricted by the needs of a single surgery .
‘ General practice is great for career development ,’ she says . ‘ But nurses need support and time for training , and those who enter general practice should be encouraged to put themselves forward for leadership positions to help to shape and develop general practice nursing .’
“ General practice is a great place for career development but nurses need support and time for training ”
8ADDRESS
MENTAL HEALTH
‘ It is important for general practice nurses to consider parity of esteem – valuing the patients ’ mental health needs equally to their physical health .’
A mental health nurse for 20 years , Georgina Callard had always worked in secondary care . But since 2018 , Ms Callard , a Queen ’ s Nurse and a professional nurse advocate , has been based in general practice in Northamptonshire .
She sees adults experiencing the full range of mental health issues , such as anxiety , depression , psychosis and mania , and suicidal ideation . GPNs refer patients to Ms Callard and signpost their concerns to her . Equally , she refers patients to GPNs at the practice to look at physical health needs such as asthma reviews .
Ms Callard has provided refresher training to GPNs at the practice on mental health issues , and nurses can seek her advice about their patients ’ mental health .
Her role helps to ensure patients receive an early diagnosis . Feedback from the local mental health team is that referrals to secondary care have reduced since she joined the practice .
Feedback from GPNs and patients at the practice has also been positive , she says . ‘ Patients appreciate there is someone there for their mental health issues , and nurses appreciate they have a practitioner they can refer patients to relatively quickly .’
She says it ’ s equally important for GPNs to consider patients ’ mental health as their physical health . ‘ Our mental health and physical health go hand in hand . For example , when people are anxious it can impact on their physical health .’
She acknowledges that ‘ time , workload pressures and confidence ’ can be barriers to considering patients ’ mental health needs . But she says it ’ s important for GPNs to have the knowledge and understanding to signpost patients experiencing mental health issues to the right support , and that basic mental health training can help .
‘ And it ’ s also about GPNs feeling confident to ask patients , “ Are you OK ?” “ What can I do to help ?”.
“ GPNs need the knowledge to signpost patients experiencing mental health issues to the right support ”
9TARGET
IMMUNISATION UPTAKE
‘ GPNs need to play an important role in overturning the decline in childhood immunisations uptake .’
Uptake of child immunisations is declining , with vaccine hesitancy , particularly post pandemic , and inequality of access among the reasons for this trend .
GPNs can play a key role in reversing this decline . For Hina Shah , a GPN and lead nurse in immunisations for Spinney Hill Medical Centre in Leicester , getting to the heart of why vaccination appointments were being ignored or refused has helped boost uptake .
In just five months – between April and September 2021 – Ms Shah and her colleagues cut the practice ’ s child immunisation target list from 330 to zero .
To achieve this , locum nurse support has been extended to make vaccination appointment times more family friendly and to increase access to the service . Parents who decline vaccine appointments several times
are contacted by the practice team and are offered face-to-face appointments , at which Ms Shah can address their concerns and reassure and educate them about the benefits of vaccinating their children .
She believes it ’ s vital that GPNs work to address the decline in childhood immunisations uptake . ‘ Many diseases can be prevented by vaccinations . If we don ’ t overturn this decline , children are potentially at greater risk of diseases , and there will also be an impact on healthcare , including secondary care .’
GPNs ‘ can make a real difference to improving uptake ’, says Ms Shah . ‘ But they need to be persistent and , if necessary , put in the extra effort and make that extra call , to find out why parents are refusing immunisation for their children .’
“ If we don ’ t overturn this decline in uptake , children are potentially at greater risk of diseases ”