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Unit Two
Employment of general practice nurses from a patient’s perspective
Key messages
Once you have read this Unit, you should have an understanding of:
- processes and checks that need to be in place prior to employing a general practice nurse (GPN)
- qualities needed for the various roles within general practice nursing
- selection processes for a GPN post
- appropriate standards of care that will help to ensure patient safety and satisfaction.
As a patient, you are likely to feel more comfortable in a practice that has clearly defined roles for staff - details are provided through the practice information leaflet, posters or the practice website.
You will want to know that the practice has a policy regarding risk management and patient safety, for
example that staff have the right qualifications for their role and are up-to-date with new procedures
and legislation, including criminal-record bureau checks. This applies to anyone working in the practice,
including both permanent and locum staff. You will also want to know that any matters that are
discussed with the practice are confidential and in line with the Data
Protection Act. Ask the practice
manager about this if you have any concerns.
The title of GPN covers a range of different roles. Several sample job descriptions are available for you to view to see the set of skills needed within these roles. See Tool - Job descriptions for GPN roles. .
All qualified nurses working in general practice must be registered with the Nursing and Midwifery Council (NMC; www.nmc-uk.org) - this is a professional organisation that regulates the nursing profession and, therefore, protects the public. To be become registered, nurses must have completed a 3-year, university-level training programme that has equipped them to work as a registered nurse in any health care setting.
The practice may also employ health care assistants - these are not registered nurses, but support staff.
Details relating to their role and qualifications can be found at www.wipp.nhs.uk.
Nurses working in general practice often work at different levels, for example:
- senior nurse nurse practitioner
- advanced nurse practitioner
- specialist nurse.
These titles (senior nurse, nurse practitioner etc) may currently be used by any registered nurse at the right level. However, the majority will have undertaken post-basic study in specialist areas of nursing - for example, they may have continued studying to undertake a degree or higher degree ('Masters'). The practice information leaflet will list your GPN's qualifications and any special interests. If a nurse is managing your care and you want to know about their qualifications, then please ask. Nurses encourage patients to ask about all aspects of their care and will understand that you want to know that they are adequately trained, especially if your care used to be managed by a doctor.
Although GPNs must be registered general nurses, they do not have to take extra qualifications unless they want to work at a more-advanced level. Nurses have to re-register with the NMC every 3 years and, in order to do so, must provide evidence that they have kept up-to-date with clinical practice through regular study.
When applying for a job as a GPN, applicants will receive a job description that outlines
the role and a person specification. See Tools - Person specification for a GPN role and
Tool - Job descriptions for GPN roles , which list the essential and desirable skills required.
When a nurse applies for a job, their skills and qualifications will be matched against what is (ideally) required; if they seem to be suitable for the post, they will be interviewed. Some practices ask patient representatives to sit on the interview panel for GPN posts to ensure that a patient view is considered before employing a new member of staff. This will normally be done by the practice, who will approach either the patient forum or a Patient Advice and Liaison Service (PALS).
If you are interested in becoming a PALS representative, contact your local primary care trust (PCT) or health centre and ask for details, or phone NHS Direct on 0845 4647. Alternatively, access your local NHS trust website (www.nhs.uk/england/authoritiesTrusts/default.cmsx). Additional information on patient groups can be found on the National Association of Patient Participation (NAPP) website (www.napp.org.uk).
Once a nurse has been successful in gaining a position, the practice will conduct certain checks, including ensuring that:
- references from former places of employment are good
- the nurse is currenty registered with the NMC
- the nurse's personal identity and qualifications are valid
- the nurse does not have any entry with the criminal-record bureau.
After the new GPN is in post, it will be the responsibility of the practice or PCT, depending on who the GPN is employed by, to ensure that they are competent at their job. They will be assessed by a senior nurse or GP to check that they perform their role in a proper manner. Sometimes, practices will use a competence document to record that this is consistently carried out (See Unit: Competences of general practice nurses).
Standards of care
Each GPN has an annual appraisal with the practice to discuss their performance. However, there should also be a system in place to provide regular monitoring of a GPN's performance and feedback should be given at regular intervals. If you wish to give feedback on a GPN's performance, speak to the practice manager, who will pass on your comments (positive or negative). If there are serious concerns regarding a GPN's lack of competence, the practice may need to report this to the NMC. However, before reporting occurs, the NMC requires written evidence to show that the practice has tried to address the problem. There is no need to refer to the NMC if the problem can be solved locally.