GP is at the cusp of significant developments – and nurses should be part of that

Case study summary

There has never been a better time to become a general practice nurse.


There has never been a better time for nurses working in general practice. Led by a policy shift across the NHS, the delivery of care is moving from hospitals to the community, meaning nurses are playing a bigger role in the delivery of care and the shape of healthcare itself. However, with more than 33% of general practice nurses expected to retire by 2020, if it is to sustain the potential of this workforce, the NHS will need to recruit more general practice nurses.

Mia Skelly is a general practice nurse in south London. Her day is varied and she assists in the delivery of most aspects of patient care. She didn’t plan her move into primary care; having worked in A&E and abroad in Africa, she decided to take a role in primary care nursing. She had no idea how much she’d enjoy it or how it would broaden her career. She agrees general practice nursing provides amazing opportunities for the care of patients – but more nurses are needed.

“We need to encourage more nurses to choose this as a career, and promote why it’s worth doing. It’s true that there are challenges in primary care and in general practice nursing, but there’s also really exciting things happening. We’re at the cusp of a new wave of significant developments – and nurses should be part of that,” she argues.

Skelly thinks the problem is that among their peers, general practice nursing has not always been seen in a positive light. “People say it’s a quiet job that isn’t challenging with few opportunities or career progression. For me, one of the most common things people say is that the role is not for newly qualified nurses”, she says.

None of these things are true – and perceptions need to change. Skelly argues “we need to recognise, as a profession, that general practice nurses can make a significant difference to the delivery of healthcare. As a general practice nurse, I feel a real sense of responsibility – because I know that I make an impact on individual patients and the wider system. If I can help someone to manage their asthma effectively in primary care, they can avoid ending up in hospital later down the line. The real value of general practice nursing needs to be shouted from the rooftops.”

Variety is a key factor for Skelly. “No day is the same,” she says. “As a general practice nurse, as with anyone working in primary care, you are dealing with patients who have multiple and complex issues. Often the reason they have visited you is not the thing they need most help with – sometimes patients will have other issues on their minds. They may come in for a routine procedure, a vaccination for example, but through our discussions it might become clear that there’s more going on. Often, I’m able to help them in a way that neither of us had intended or expected”.

General practice nursing is different from nursing in secondary care in hospitals, but while Skelly had training to help her transition, she is keen to point out that it is not necessary to have prior experience in secondary care. “They are very different skillsets. General practice nursing is a challenging, dynamic and varied role, different to working on the wards. But feeling challenged is a great way to learn”.

In addition to her initial training, there are many opportunities to learn, from long term conditions management to child immunisation. Skelly continues to take advantage of such opportunities to learn new skills, and plans to move towards being an advanced nurse practitioner in the future, which would give her the ability to prescribe independently. “I genuinely feel my career is limitless. I don’t worry about stagnating in my work.”

“I would recommend any nurse, at any stage in their career, to explore general practice nursing. Every day I leave my workplace feeling like I’ve made a difference to the lives of the patients I’ve seen, and that I’ve added value to the wider healthcare system. I love my job for enabling me to do that – and I look forward to being part of a nursing workforce that plays a greater role in the changing shape of healthcare in the UK. I hope others will try general practice nursing, and feel the same.”

Health Education England have recently published the General Practice Nursing Workforce Development Plan. The plan looks to improve training capacity in general practice, increase the number of pre-registration nurse placements, introduce measures to improve retention of the existing nursing workforce and support for return to work schemes for practice nurses. The plan builds on the general practice nursing service education and career framework, a resource that for the first time ever, offers a consistent approach to General Practice Nursing in England for both registered nurses and the health care support workforce in the primary care sector.