The General Practice Nursing 10 Point Plan (GPN 10PP) (NHS England, 2016) has given an investment of £15 million from the General Practice Forward View (GPFV) funding allocation, to support action that will address the significant workforce challenges and support improvements in general practice nursing by 2020.
The Queen's Nursing Institute (QNI) was commissioned by NHS England to develop an induction template specifically designed to enable employers to ensure that nurses in a first destination role in general practice are well supported when taking their first career step in primary care.
Gathering evidence
As a programme manager at the QNI, one aspect of my role has been to develop and write transition resources, such as Transition to District Nursing and more recently Care Home Nursing, which I had found relatively straightforward, as in my previous role as a senior lecturer in a university I had taught widely in these aspects of nursing.
I was less familiar with general practice nursing and in particular with the orientation and induction of nurses into this discipline and, initially, I did wonder whether I was the right person to write this document. As the work continued, I began to realise that my ignorance was an advantage, as I came with absolutely no preconceived ideas about the discipline and took a neutral approach to the evidence I collected. I scrutinised and analysed every aspect of the template with a new and fresh approach to how newly qualified nurses would approach this area of nursing.
The induction template was developed to enable employers to ensure that nurses are well supported when taking their first step in primary care
The QNI has a systematic approach to this type of work, which involves gathering evidence from a wide range of perspectives. I set about the process with an extensive literature search of the subject matter. This search reaped some good quality and relevant studies, as well as several induction templates that had been performed in the same or similar settings.
I then developed a questionnaire that was circulated via Survey Monkey to our networks, requesting insight and input into what the challenges were around orientation and induction into general practice. It was important that this questionnaire went to all stakeholders that were to be represented within the template, for example student nurses, nurses thinking about moving into general practice, existing general practice nurses, employers—including GPs and practice managers—and Higher Education Institutions. The response was tremendous and this assisted me when formulating my ideas around the format of the template.
External review
I then set about developing an external review group that would represent all perspectives of this work and I also took advice from NHS England colleagues regarding relevant participants. The review group consisted of representatives such as student nurse groups, general practice nurses, GPs and practice managers, as well as input from Health Education England, the Royal College of Nursing GPN Forum, Care Quality Commission, several universities and colleagues at the QNI. I visited all the regional delivery boards of the GPN 10PP to update widely on this work and undertook telephone interviews with the external reviewers. I also attended the newly formed Association of Academic General Practice Nurse Educators (AAGPNE) to get an understanding of how academic programmes for practice nurses were being developed.
After drafting a first plan of the work, I chaired a small focus group of six general practice nurses where the document was scrutinised for accuracy and to ensure that there were no fundamental omissions. The external review panel were then sent the second draft for feedback before final edits and publication.
Need for a comprehensive induction
My personal reflection of developing this template was I felt very privileged to meet such committed and experienced nurses who had developed professionally, despite (at times) lack of acknowledgement and professional identity of other nurses working in adjacent specialities in the community setting. I was struck by how complex the role of the general practice nurse was and how it most definitely would appeal to newly qualified nurses, because all the knowledge and skills attained as a pre-registration nurse can be utilised in this role. Developing this template highlighted the urgent need for a comprehensive induction and orientation programme for all nurses new to general practice. This most certainly will assist with recruitment and retention of nurses in the primary care setting.
I was struck by how complex the role of the general practice nurse was and how it most definitely would appeal to newly qualified nurses, because all the knowledge and skills attained as a pre-registration nurse can be utilised in this role.
The General Practice Nurse Induction Template document is available on the QNI website: https://www.qni.org.uk/resources/gpn-induction-template/
It is also hosted on the GPN Single Point website: http://bit.ly/gpnsinglep (you will need to request access via england.gpnsinglep@nhs.net)