This week sees the first substantive political announcement from new Health Secretary Therese Coffey since her appointment in early September.
Unfortunate and unforeseen circumstances meant that she had almost a fortnight to think about her first significant move without the usual media or political pressure.
Perhaps, unsurprisingly, she chose to focus on primary care first, given her high profile in the public psyche and the national media’s obsession with access to appointments since the pandemic. .
It can therefore be seen as an easy win with the public and the media and something most voters can relate to, rather than the minutiae of health service funding.
Based on TV interviews before the announcement, at the heart of his plan is a promise to improve access to GPs in England, including same-day appointments for those who need them.
For example, the government has indicated that no one will have to wait more than two weeks for a routine GP appointment, although currently one in five appointments takes longer.
“Like most pressure points within the health and care sector, the main access issues are currently linked to a critical shortage of staff in all areas as well as the fallout from the pandemic”
To achieve this, GPs will apparently be able to redistribute funds to hire additional staff, including nurses, while pharmacists will be asked to take on more work to free up appointments. Simple…
Extending more of the primary care workload from GPs to other roles is of course nothing new, as evidenced by the advent of non-medical prescribing by nurses and pharmacists in the early 1990s. 2000.
But, like most pressure points within the health and care sector, the main access issues are currently linked to a critical shortage of personnel in all areas, as well as the fallout from the pandemic.
Primary care, as a setting, has tended to struggle with the perception that this is where nurses go to work later in their careers. Therefore, the potential threat of a pension bubble is always present.
For example, over the summer a report by the Health Foundation think tank warned that the NHS faced a ‘crippling shortage’ of GPs and GP nurses over the next decade.
Its forecast showed that the current shortage of around 1,700 full-time nurse practitioners would grow to around 6,400 vacancies by 2030-31, the equivalent of one in four vacancies.
Meanwhile, he also warned that there is currently a shortage of around 4,200 full-time GPs, which is expected to rise to around 8,900 GPs in 2030-31.
As always, the nursing profession is looking for ways to remedy this. There is work going on in some places to try to promote primary care by providing clinical placements for students.
For example, as shown in Nursing schedules in August, nurse educators from Anglia Ruskin University and the Suffolk and North East Essex Training Center are working on such an initiative which is helping students consider general practice nursing as a future career.
Digital Learning Days allow students to participate in virtual counseling sessions and develop skills in health promotion and disease prevention. Students also spend one day a week in a doctor’s office to consolidate their learning.
However, such examples are still in the minority while the majority of other settings and branches of nursing are also looking to increase the number of the same pool of recruits, who take time to train.
So spreading the workload from one incredibly stretched part of the primary care workforce to another incredibly stretched part of the primary care workforce doesn’t seem to add up to me.
To put it bluntly, Dr. Coffey (PhD, in case you were wondering why she didn’t dive into frontline general medicine) didn’t mention where those nurses would come from.
I hope she is aware of the global nursing shortage and that there is not a surplus of nursing staff sitting around drinking tea and waiting for the call to come to the rescue of overstretched GPs.