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PATIENTS

Unit Three
Competences from a patient’s perspective

Key Messages

Once you have read this Unit, you should have an understanding of:

  • how the competence of a general practice nurse (GPN) in undertaking varying roles is assessed
  • how the skills of a GPN can be certified
  • how you can feedback on the competence of a GPN.

All GPNs have a basic nursing qualification as a registered nurse. This gives them a 'licence to practice' in any aspect of general nursing, and proves to employers that they have professional standards and behaviour.

Nurses working in general practice see many different types of patients, from the very young to the very old, or they see people who are healthy or suffering from a minor illness, as well as patients with serious conditions and long-term illnesses.

Additional study

In order to build on their skills, GPNs often choose to take extra study in particular areas, such as asthma or diabetes. Once they have learned more about a specialist area (eg by attending a short course at university or college), the practice will usually encourage them to run clinics for patients with this condition. The nurse may run these clinics on their own, or a GP may be on-hand to assist if needed. The practice will not allow the nurse to lead these clinics unless they are absolutely sure they know a lot about the condition and how to manage it.

Nurses are often very good at running clinics for long-term conditions because they like teaching patients about how to manage their illness themselves. They encourage the patients to become the experts,1 so that they can cope with their condition more effectively.

When nurses attend courses they often have their practical skills assessed, as well as taking an exam or writing an essay. This is because they recognise that the most important thing to get right is the care of patients. Nurses tend to be very cautious about taking on new skills.

The Nursing and Midwifery Council Code of Professional Conduct2 states that nurses must only accept responsibility for those activities in which they are competent. This means that they will refuse to undertake anything for which they have not been properly trained.

Appraisals and levels of pay

GPNs should have an appraisal every year. This is a chance for them to discuss their strengths and weaknesses. They are therefore able to identify the type of further education needed to improve their required skills. The GP surgery should encourage them to take further study and this is why you may sometimes hear that GPNs are away on study leave - they are learning how to deliver the best and most up-to-date care for patients.

Many GPNs will have their job descriptions reviewed in the near future as practices switch to the NHS pay scheme Agenda for Change (AfC).3

AfC is a scheme based on a system of fair pay that depends on the type of work that is undertaken, and the skills and knowledge needed to do the job. GPNs will have their knowledge and skills assessed using the NHS Knowledge and Skills Framework4 to check that this matches their job description. This new system means that nurses will be striving to gain more knowledge each year in order to progress up the pay scheme.

Some GPNs will choose to specialise in the care of patients with long-term conditions and may get to know certain patients really well as they will see them regularly. Other GPNs may choose to learn new skills in how to assess and treat patients with minor illnesses. These GPNs may see those patients who need appointments the same day because they have suddenly become ill.

All GPNs will have the option of taking further study to become nurse independent prescribers5, so that they can manage patient care without needing to ask a GP to write prescriptions for them. Whatever GPNs choose to do, patients can rest assured that nurses will have their competence assessed - either at college, university or in the practice - before they take on new tasks. GPNs are also regularly updated on all areas of practice.

Some practices undertake annual patient satisfaction questionnaires. The feedback from these enables the GPN and the employer to address any issues.

References

  1. Department of Health. The Expert Patient. London: Department of Health; 2001. Available at: http://www.dh.gov.uk/assetRoot/04/01/85/78/04018578.pdf.
  2. Nursing and Midwifery Council (NMC). Code of Professional Conduct. London: NMC; 2002.
  3. NHS Modernisation Agency. What is Agenda for Change in Plain English? Available at:
    http://www.modern.nhs.uk/agendaforchange/Afcplain.pdf.
  4. Department of Health. The NHS Knowledge and Skills Framework. London: Department of Health; 2004. Available at: http://www.dh.gov.uk/assetRoot/04/09/08/61/04090861.pdf.
  5. Department of Health. Policy and Guidance. London: Department of Health; 2006. Available at: http://www.dh.gov.uk/PolicyAndGuidance?MedicinesPharmacyAndIndustry/Prescriptions/Nonmedical.

 

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© Crown Copyright September 2006.
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