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ICBs should focus on career progression in primary care says report

ICBs should focus on career progression in primary care says report
By Jess Hacker
9 March 2023

Primary care staff need a greater sense of career progression, with ICBs encouraged to work with universities to improve training and development opportunities, leaders have said.

Integrated care boards (ICBs) must be able to plan and deliver leadership and advanced opportunities to staff working in general practice and across primary care, leaders told Healthcare Leader.

In the title’s new report, May the workforce be with you: What primary care wants, launched today, leaders indicated they were particularly concerned by the limited opportunities open to general practice nurses, optometrists and health visitors.

The report – which considered opinions from leaders in general practice, pharmacy, dentistry, optometry, and nursing – looked at the current issues concerning each profession and what solutions they expect from the incumbent ICBs.

It comes as ICBs are set to pick up responsibility for providing optometry, pharmacy and dentistry.

Dr Crystal Oldman, chief executive of the Queen’s Nursing Institute (QNI), said the lack of a prescribed career development pathway is a major problem for general practice nursing.

She said: ‘There isn’t that clear pathway that compels you as a newly qualified nurse to take up a prescribed programme in order to have the knowledge, skills, attributes, and confidence to deliver on that GPN role. There’s not that professional or organisational requirement.’

The Royal College of Nursing’s (RCN) primary care lead, Heather Randle, also said: ‘Practices nurses are looking for good career progression, to opportunities such as leadership, teaching and advanced practice.

‘There needs to be planning for training and development based on individual needs. ICBs can offer these and other opportunities that will not necessarily be available to GPNs working in a small general practice.’

ICBs also need to take nursing leadership more seriously, she suggested, flagging the presence of a medical director on most ICBs, but no a nursing director.

This is worsened when considering the ‘the consistency of the offering’ in general practice is often less for nurses than it is for their secondary care colleagues.

Dr Peter Hampson, clinical director at the Association of Optometrists (AOP), flagged that many optometrists are ‘qualified and equipped to provide a far wider range of services’, but lack the opportunity to do so.

He said: ‘Many have additional, higher qualifications, including the ability to prescribe medications, and even those without higher qualifications have an extensive portfolio of skills that are currently underutilised. It makes simple sense to utilise the full range of skills in optometry, so more care is managed in the community.’

He added that development opportunities and career progression are two of ‘the three most important factors students and graduates cite when considering their career option’.

Similarly, almost half (48%) of health visitors in England stated that they plan to leave health visiting in the next five years, with leaders citing poor career progression opportunities and work-related stress as key reasons.

Alison Morton, executive director of the Institute of Health Visiting (iHV), said: ‘The government’s commitment to prioritise the recovery of health visiting will require several approaches to improve workforce capacity and support the recruitment, retention, and career progression for health visitors.’

Last month, Healthcare Leader revealed that as many as 1,274 people have handed in their resignation and terminated their employment with their ICB since July.

At the top end, some organisations saw nearly 100 people hand in their notice, with the total number of leavers across 39 ICBs breaching 2,000 people.

In total, ICBs employ 2,074 nurses and midwives, while the majority of employees – 13,074 – are classed as administrative and clerical staff.

A further 777 medical and dental staff are directly employed by their ICB.

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