GP’s more reliant on nurses

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Staffing shortfall leads to extension of other primary care staff

GP surgeries in areas with a high patient to doctor ratio are now relying on the help of nurses and other non-medical professionals to try and cope with the rising pressures of patient demands.

Many areas are struggling to recruit GP’s, with fears that as GP’s retire there will be no one to replace them, with more than one in three GP’s due to retire in Swale over the next three years for example. This is leading to practices relying more fully on the wider primary care community, with some surgeries even signing up to a ‘grow your own practice nurse’ scheme being piloted by Health Education England.  The initiative aims to encourage nurse mentorship within practices.

Growing general practice

Dr Fiona Armstrong, chair of Swale CCG, has told the Health Service Journal that regions will need to create a “team of people who can be called on” including community matrons, district nurses, primary mental healthcare workers and dementia healthcare workers in a bid to fill gaps in service, although she also comments that “sometimes it’s that kind of specialism that’s required, not necessarily the GP.” 

GP Simon Glencross agrees with these views, saying “If it worked well, it would ease some of the frustrations of referrals from one to another, and members of a team all working for different bosses and all having different rules.”

Ian Stidston, director of Essex’s commissioning team said plans were focusing on “designing…primary care teams to have less reliance on GP’s by taking on more nurses and nurse practitioners” whilst Luton CCG on the other hand has raised concerns about the varying skills of some nurses employed this way, worried about maintaining high levels of service.

Maureen Baker, chair of the Royal College of GP’s said “Patients benefit greatly from the complementary skills and expertise that practice nurses and other members of the practice team provide, particularly in health promotion and prevention of illness. However, there are times when patients will specifically want and need to see their GP, and there should be enough capacity in the system to do this.”