The scheme, commissioned by Health Education England North West, saw three groups of practice nurses take part in leadership seminars and training from September 2018 to March this year.
“Practice nurses often don’t get the breadth of training and certainly don’t get exposure to other parts of the health system”
It follows a successful pilot programme in 2015, developed and implemented by chief nurses Judi Thorley and Sally Rogers and evaluated by Coventry University.
The evaluation found the scheme had significant benefits for general practice nurses including boosting skills, confidence and networking.
It found practice nurses had the ability to lead change but more needed to be done to harness these skills and promote the role, which “requires championing at all levels”.
The latest version of the General Practice Leadership for Quality programme was co-ordinated by Ms Thorley and Moira Angel – both former chief nurses now working independently.
Practice nurses have much to offer but can often find themselves “unintentionally professionally isolated” and can also struggle to access training to develop their skills, said Ms Angel.
“Practice nurses often don’t get the breadth of training and certainly don’t get exposure to other parts of the health system,” she said. “They are not in an acute trust where you may have a training department to call on and some of the GPs just don’t recognise they need training.”
Nurses were selected to take part in the 2018-19 leadership programme through a recruitment process supported by NHS England leads for practice nursing.
General Practice Leadership for Quality programme
In all 38 nurses from three areas – Cheshire and Merseyside, Lancashire and South Cumbria and Greater Manchester – embarked on the scheme, which saw them learn about leadership styles and theory.
The programme kicked off with an introductory webinar, which was followed by six full-day workshops.
Sessions included looking at nurses’ own leadership skills and personality traits, exercises designed to boost skills and confidence, and discussion of wider healthcare policy and primary care’s key role in strategies such as the Long Term Plan for the NHS in England.
The programme also saw practice nurses develop and pitch quality improvement ideas in a Dragons’ Den-style contest. Winners from each group repeated this exercise at a showcase event at the end of March.
The winning idea – developed by nurses from Lancashire and South Cumbria – involved the use of digital technology and mobile phone apps to help people with cardio-vascular disease reduce their risks of heart attacks, stroke and other complications.
This concept will now get further funding and support to allow it to be trialled in practice during 2019-20.
Ms Angel said findings from a mid-term evaluation of the programme showed it had a “profound” impact on some participants and had led to nurses playing a more prominent role locally.
Nurses who took part said they found the programme “inspiring” and felt “empowered”.
“The leadership programme has helped me both personally and professionally. I feel I have become more confident and assertive within my role,” said one lead practice nurse, who said she had successfully obtained a pay rise for herself and other practice nurses at her surgery after doing the course.
Others said they had made changes to clinical supervision for nurses, set up regular nurse meetings and had been encouraged to apply for lead roles in new primary care networks.
One reported a dramatic confidence boost. “I feel as if I have moved from being a mouse to being on top of a mountain,” she said.
“They are now all linked into to the integration programmes in their local areas”
Ms Angel said the chance to meet, network and share experiences with other practice nurses was a key element.
“It has been quite profound for some people. We have had an input but it has been as much talking to their colleagues, being able to reflect on themselves and hear a bit more about what’s going on in the rest of the nursing world,” she said.
“Some weren’t aware of what was going in terms of integration of services but they are now all linked into to the integration programmes in their local areas and beginning to sit on committees,” she said. “Some of them have influenced the way things run in practice.”
This included setting up patient forums, developing care pathways and prevention programmes around conditions like diabetes, and championing new ways to interact with patients through social media.
The hope is the course will become an accredited qualification in the near future with discussions under way with universities and the NHS North West Leadership Academy.
A final report is due to be published in September and the programme will also be evaluated by Health Education England North West six months down the line.
Ms Angel said there was ongoing interest in the scheme and the pair hope to run the programme again in Lancashire and South Cumbria in 2019-20.
General Practice Leadership for Quality programme