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Practice nurse morale at all-time low

26 September 2007

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Practice nurses feel like they have been totally left out of GMS discussions, despite an increased workload to achieve QOF (Quality and Outcomes Framework) targets.

This was the general feeling of delegates asked to comment on the new GMS contract at the Nursing in Practice London Event on Tuesday. In fact, several delegates were so unhappy with the new situation that they are considering leaving their practices altogether.

These comments came during a presentation on the National Audit Office’s (NAO) “Value for Money Study” looking at the benefits of the new GMS contract. Delegates were invited to describe their own experiences of how the new GMS contract had affected their jobs as part of the study, which will be published in January 2008.

Speaking specifically about QOF, while some of the audience could see that the targets did increase benefits to patients, the majority felt it was just a tickbox exercise, leaving little time to actually talk to the patient and provide holistic, opportunistic care.

And the lack of financial reward was also very disheartening. As one nurse commented: “We were led to believe that [the money earned by achieving QOF targets] was practice money, not GP money, but we haven’t seen any of it.”

Another nurse pointed out that nurses did 90% of the QOF work, and suggested that the government look at who did the work and offer them the incentive. A majority of those present felt that since the new GMS contract, GPs were working less.

When asked for recommendations to improve this situation, delegates agreed that practice nurses needed leadership, both within their PCTs and the Department of Health. It was generally felt that practice nurses had no one speaking up for them, and with the reorganisation of PCTs many had lost their leads.

The NAO would like to hear more from primary care nurses about their experiences of the new GMS (and PMS) contracts. In particular, how well were they designed and implemented? Have they improved recruitment, retention and patient care? And are they providing greater flexibility in service delivery? If you would like to contribute to the report please email your experiences to [email protected]

For more information on the Value for Money study go to the NAO website.

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