As the UK prepares to head to the polls for the third general election in less than 5 years, the NHS has become a bargaining chip once again, with the political parties setting out their plans to an electorate with political fatigue. Headlines about our beloved NHS always have the capability to stir up voters, and the major political parties all have something to say about healthcare. In no particular order we've had promises of 50 000 more nurses and 50 million more GP surgery appointments a year, greater funding for close to home health services, training more GPs and making greater appropriate use of nurses, physios and pharmacists, and various promises to reinstate the nursing bursary in one form or another. Whether all of these plans are credible—or whether they'd have the desired effect—is not something to address here, but one thing that stands out in this election is that nursing is firmly on the agenda, and for once so is primary care.
After reading all the different manifestos, it seems that there is finally the widespread acknowledgement that general practice is key to a well-functioning NHS. As the gatekeeper to the rest of the NHS, it makes sense to ensure general practice can cope with the demands placed on it. A well-funded and well-staffed primary care service would have knock-on improvements on the rest of the health service and is likely to save money overall. As our population ages, prevention of ill health will become ever more important and general practice is best placed to provide this to patients. The focus on delivering care close to home is also a good thing, and something that is popular with patients.
The realisation that we need more nurses is to be welcomed too. Encouraging these new nurses into general practice, however, may be more difficult. Although progress has been made with raising the profile of practice nursing to students and newly qualified nurses, there are problems that have not been addressed, such as practice nurse pay and their terms and conditions compared to nurses working on Agenda for Change contracts (NHS Employers, 2019). We all know that if the next government is serious about rescuing general practice, tackling the retention and recruitment of practice nurses is key. Until nurses working for the NHS in general practice have parity with those working elsewhere in the health service, it will be impossible to attract—and retain—enough nurses to make general practice fit for the future. In recent weeks I have seen stories of practice nurses being adversely affected by their employment terms—one leaving general practice due to lack of maternity pay, and one losing pay due to sickness. Neither of these things would have happened if nurses working in general practice were on Agenda for Change conditions. This disparity is unfair and needs to be dealt with urgently by the next government—whoever they may be.
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