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Nigel's surgery 26: Practice Nurses
On our inspections we consider whether staff, including General Practice Nurses (GPNs) have the skills, knowledge and experience to deliver effective care and treatment.
Training and continuing professional development (CPD)
There is no standard, mandatory, entry-level training for nurses who wish to begin working in primary care. Their particular training needs depend on the role they are being employed to do. This varies between and within practices. An effective induction process should identify specific training needs.
Depending on the professional background and experience, a new GPN may already be competent in some aspects of the role. For example, wound care and venepuncture. This will depend on their professional background and experience. Other skills will need to be attained once in post. For example, immunisation, management of long-term conditions and sample taking for cervical screening. Taking a foundation course in practice nursing will provide the required theoretical knowledge. Supervised practice in the practical setting must underpin this knowledge. Public Health England set the competence standard for immunisation and sample-taking for cervical screening. Training must be with an accredited provider so that these standards can be met.
There should be a system of governance in place. This enables the provider to show how they have assured themselves of their GPN team’s competence for their role they are employed to do.
To register with the Nursing and Midwifery Council (NMC) every three years, nurses must have undertaken CPD. This must be at least 35 hours of learning activity relevant to the nurse’s practice. The NMC also requires the nurse to maintain a personal professional profile. The profile should show how the learning activity has informed and influenced practice. Practice nurses should be supported by their employer to fulfil these NMC requirements.
GP practices should make sure staff, have the skills, knowledge and experience to deliver effective care and treatment. This includes practice nurses.
Practices should ensure:
- staff have the right qualifications, skills, knowledge and experience to do their job
- their learning needs are identified
- they receive appropriate training for each element of their role
- they are encouraged and given opportunities to develop.
GP practices are responsible for supporting staff to deliver effective care and treatment. This support includes effective appraisal. Staff should have had an appraisal in the last 12 months. They should be able to describe the impact this has had on their practice. The appraiser will vary depending on the individual practice. In a larger nursing team, it is likely there will be a lead nurse or nurse manager who can fulfil this role. In many GP practices this will not be possible. Nurses’ appraisals will be carried out by a GP, a practice manager or both.
Nurses cannot legally practise in the UK unless they are registered with the NMC. A GP practice employing nurses must make sure they are registered before they begin work. Their registration should be regularly checked throughout their employment. This includes locums and temporary staff. If a nurse is an Independent Prescriber, this qualification should be on the NMC register. The employer should use the NMC registration confirmation service. Any paperwork the nurse provides is only valid on the day it was issued.
Nurses are required to revalidate with the NMC every three years. Revalidation is the nurse’s responsibility. It demonstrates a continued ability to practise safely and effectively. It raises awareness of the Code and professional standards. It encourages nurses to stay up to date in professional practice. It also strengthens public confidence in the nursing and midwifery professions. Practice nurses need a line manager to act as ‘an appropriate confirmer’. This does not have to be an NMC-registered nurse, midwife or nursing associate. For example, they could be a GP. The employer should have systems in place to make sure nurses have completed revalidation.
The term indemnity insurance refers to an insurance policy that compensates an insured party for certain unexpected damages or losses up to a certain limit.
The Clinical Negligence Scheme for General Practice (CNSGP) provides indemnity cover to all staff working in NHS General Practice (GP) services in England. This includes practice nurses, locums, self-employed workers and trainees. The scheme is operated by NHS Resolution.
The Royal College of Nursing provides guidance on the RCN indemnity scheme and changes to the scheme.
- Last updated:
- 01 October 2020