General practice workforce

There has been much discussion recently about the increasing demands on general practice, but little of that conversation has concerned the crucial role that nurses will play in meeting those demands. A shortage of nurses with the required skills will mean that surgeries face significant practical challenges in the near future.¹ But there are a number of encouraging developments in the pipeline. In particular, changes to the structure of the NHS have provided a once in a generation opportunity to properly support and fund the training of nurses working in general practice.

The population is living longer and the demands being made of the NHS are constantly increasing. Successive governments have sought to relieve the pressure on hospitals and to meet more of those demands in out-of-hospital settings. The pressure on hospital budgets has already resulted in increasing amounts of follow-up work being attended to in general practice. Yet the funding of GP surgeries is down for the third year in a row, as RCGP chair Clare Gerada pointed out at the RCGP conference. Inspections by the Care Quality Commission are causing anxiety across the country, and health secretary Jeremy Hunt added to the pressure when he told the King's Fund that he wanted GPs to adopt a 'named clinician' role for vulnerable patients and to take back greater responsibility for out-of-hours care. He plans to recruit a further two thousand doctors, but recognises that even this number may not be enough to satisfy calls from the public for access to care around the clock.² Health Education England figures presented to the RCGP annual conference suggested that this number of trainee GPs was unattainable.