Nurse training needs a “radical review” to meet the “urgent” need for professionals with the skills to care for patients with long term conditions, the new chief inspector of primary care has said.
Steve Field, who took up his post at the Care Quality Commission on Tuesday, told HSJ he was more worried about the “competencies and quantities” of practice and community nurses than about the numbers of GPs.
The Royal College of General Practitioners has warned an impending shortage of GPs is a barrier to making general practice accessible to patients seven days a week.
Professor Field said that although “undoubtedly” there was a need to train more GPs, more nurse delivered care could help improve the accessibility of primary care for patients as well as continuity, with patients more able to see the same health professional on different visits.
“Patients also want continuity and that continuity can come by doing the urgent care in different ways with more self-care and better use of the pharmacist, [and] continuity through using nurses and pharmacists for [patients with] long term conditions,” he said.
However, Professor Field, a GP based in the West Midlands, warned there was a shortage of appropriate skills within the current nursing workforce, while in many areas practice nurses and community nurses were not working well together.
“I think it’s completely bonkers that in many areas you’ve got practice nurses who are just about talking to the community nurses,” he said.
“We need a radical review of nurse training so we have more nurses placed in primary care so that very quickly - and I think it’s urgent - we have enough nurses trained to support long term condition care now.”
He called on Health Education England, which is responsible for commissioning nurse education, to look at the nurse training programme.
“It strikes me there are an insufficient number of well trained nurses to take on quickly the long term conditions load as general practice reforms. I’m probably more worried about the nurse competencies and quantities than I am about the doctors.”
A spokesman for Health Education England said the body would work with the Nursing and Midwifery Council and universities to ensure training was responding to the needs of “older patients with more complex needs”.
However, he said much of the workforce that would be delivering new services were existing staff and there was a need for a “frank discussion” about the responsibility of employers to ensure staff are given “appropriate development opportunities”.