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Guest blog - How the Lambeth nurse leads model works

Paula Marsden, Anne Macrae and Louise Ashwood explain how they set up the Lambeth nurse leads. A group which supports nurses working in general practice within the borough.

In May 2013 two senior general practice nurses (GPNs) and two nurse practitioners (NPs) came together to develop and maintain a quality primary care nursing workforce.

We were concerned about the lack of training opportunities and problems of recruitment and retention.

We took responsibility for each of the borough’s localities which involved visiting each practice within that locality and getting to know the nurses, GPs and practice managers. This enabled us to establish a register of all GPNs and trained mentors and also to begin to assess training needs.

We also took responsibility for certain domains including:

• Working with universities to increase student nurse placement within general practice and recruiting practices to host these students. Currently there are four practices who take students and two more interested. We negotiated a tariff of £140 / week £70.00 from the university and £70.00 from the CCG.
• Ensuring all health care assistants (HCAs) obtained the Care Certificate and were receiving the appropriate training and support. Each HCA was visited and their needs assessed.  Help was offered to progress to nurse training.
• Education and training - commissioning relevant courses and training. We hold bimonthly practice nurse forums which always involve a teaching element such as asthma, COPD, diabetes or wound care from independent specialist speakers who work locally thus being able to offer up to date, local guidelines and policies. It is of course an opportunity for meeting other colleagues for discussion and support.
• Recruitment of new GPNs and preceptorship. Organising mandatory annual updates for mentors. In Lambeth, there are now 38 level two mentors and three ‘sign off’ mentors.

As this model developed, we (now two GPNs and one NP) visit practices to meet all new nurses and HCAs and are the first port of call for many queries from nurses, GPs and managers. This way we can maintain a live register of all nurses, mentors, HCAs and assistant practitioners (APs). We also find that we have become involved not only with the CCG but also other external agencies such as the LMC, RCN, Health Education England, The Capital Nurse Project and Local Care Networks.

We are also represented at the local and regional steering group meetings for immunisations and cytology.

We are involved with the commissioning of training and education with Kingston, Kings College and London South Bank universities, also Education for Health.

We organise two childhood immunisation updates a year and a flu update for all nurses and HCAS /APs.

A non medical prescribing update is organised annually and an annual nurse practitioner study day.

All GPNs, HCAs and APs are offered clinical supervision.  Groups have a structure and also a contract. They meet every 6-8 weeks for two hours - to reduce professional isolation, for information sharing and also exchanging information about best practice, new guidelines and training. For example, revalidation and the various tools discussed between nurses.

The nurse leads meet every six weeks in order to update registers, discuss any concerns, plan training and study days and also feed back from various meetings, conferences and forums attended.

We believe one of the reasons this model works is because the workload is shared, emails are responded to readily and there is never a period when there is not a nurse lead available.

We work six hours each per week. 

Key advice for setting up your own 

• The team should be working clinically within general practice in order to understand what is happening and the pressures being faced. We find that it gives us credibility when offering advice and support.
• Gain the respect of GPs and practice managers. We are not there to police the nursing workforce but to help and support them.
• Gain support at a senior level from your CCG / CEPN
• Be thoroughly committed to developing and maintaining a quality professional workforce.
• Make sure working as a member of the team is enjoyable.

Contact details

• Paula Marsden - NP Binfield Road Surgery: paulamarsden@nhs.net
• Anne Macrae - PN Herne Hill Group Practice: annemacrae@nhs.net
• Louise Ashwood - PN Paxton Green Group Practice: louise.ashwood@nhs.net       

Last updated : 20 Jun 2017

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