Why is GPN training so varied, unstable and optional? For many years now there has been a recognised speciality training programme for doctors who wish to become GPs and yet for many new GPNs the training is ad hoc and inconsistent, which also impacts on recruitment and retention of nurses in Primary care. It had to be time for change and following a successful proposal and consultation with many stakeholders, including NHSE, ICB, ICS and the QNI, the Staffordshire GPN Foundation School was developed. This commenced in September 2023 and was designed for both newly qualified nurses and those new to general practice nursing, organised in a similar way to the established GP training scheme. Ultimately it could facilitate progression along the career framework to Specialist Practice GPN or Advanced Clinical Practice roles whilst also incorporate training for health care support workers and nursing associates.
GPNs are core staff for General Practice and provide holistic, patient-centred and often complex, multi-faceted care across the whole age range and all fields of nursing. The role is not for the faint hearted as it demands great flexibility and versatility with very broad knowledge and clinical skills.
In Staffordshire, 47% of GPNs are over the age of 50 and this is replicated nationally. Unfortunately, very few GP practices succession plan adequately and this is often due to financial constraints, estates issues and simply being busy getting on with the day-to-day work in general practice.
The ARRS roles have added another dimension but since their implementation, some practices have given up recruiting nurses due to the difficulties with recruitment and retention. However, GPNs are specialist generalists and must be valued as core staff integral to the survival and success of general practice.
The GPN role, caring for patients and their families across all walks of life, building therapeutic relationships and rapport, is such a privilege and a nursing career like no other. A structured training programme is vital so that patients receive equitable care across the country. The Staffordshire scheme has developed a centralised recruitment and employment model on behalf of Practices, with a 12month fixed term training contract (salary funded by Practices / PCNs to support sustainability). This enabled the necessary structure and organisation, standardised pay and terms and conditions during the programme, quality assurance of learning environments and wrap around support. Our programme places value in our practice supervisors and assessors, offering support and assistance in clinical practice and linking into other schemes available in our area e.g. Retire and Return nurse educators and GPN Facilitators.
Each trainee has a funded place on the Fundamentals of GPN university course and in addition attends the GPN School for one session a week. The school has a complimentary curriculum focused around the core capability and career framework to enhance university sessions and also includes a bespoke leadership programme, well-being, resilience, clinical supervision / peer support and clinical topics. External speakers also attend and there are shared sessions with the GP Training Scheme which has been a highly successful multi-professional learning approach. In cohort 1 we have a 93% retention rate. We have also facilitated nurses due for retirement to stay on in educator roles. In cohort 2, due to commence in September 2024, we are looking outside the boundaries of Staffordshire to encourage a regional spread of the programme.
Our programme has aimed to replicate the successful GP training scheme raising the profile of GPNs and the value that we place in the nursing service they deliver. We see it as our ambition to continue to drive forward the much-needed change to establish a GPN Deanery, providing a national pathway into General Practice Nursing. The path is not easy, we need to look to our NHSE colleagues, the NMC, BMA and the RCN to promote the importance of GPNs and facilitate the funding required for this.
Please help us to keep the momentum going.