General practice nurses (GPNs) should be encouraged to take up positions on their local medical committees (LMC) and challenge the ‘status quo’, it has been suggested.
Ruth Colbeck, lead nurse at West Leeds Primary Care Network (PCN), discussed her journey into her local LMC and how other nurses should strive to do the same during a Royal College of Nursing General Practice Nursing (RCN GPN) Forum Webinar earlier this month.
Ms Colbeck, who started practice nursing in 2006, said she became a nurse representative on her LMC after being approached in 2021 about having a non-medical representative on the committee during their elections.
She said: ‘One of the drivers for me to move more into looking at leadership not purely from a nursing point of view, was that there was a lot of frustration in that I wanted to make changes but working within general practice, there was a very hierarchical system.’
Part of the reason was ‘wanting to make improvements, and frustration at not being able to do that because of what was deemed in some ways as “well, you’re just a nurse”.
LMCs are local statutory committees that represent GPs, and operate as a link between local GPs and the national negotiating body the General Practitioners Committee (GPC), a permanent committee of the British Medical Association (BMA).
GPC priorities include GP pay, terms and conditions, workforce and controlling workload in general practice and the GPC is involved in advice and negotiations with the Department of Health and Social Care and NHS employers.
Ms Colbeck contacted the LMCs across England – of which she said there were 68 – and received 38 replies and found there were only five nurse representatives across the country.
She said her project then started when she contacted the nurses on other LMCs to create a ‘getting together of nurses in a non-nursing environment’.
She said: ‘We found the roles we have amongst LMCs are different, for some of us it is more informal whilst others are developing training plans and being involved in the education of nurses and doctors within general practice.’
She sent questionnaires to all the LMCs about whether they had considered a nurse representative on their committees and to explore the barriers of doing this, but admitted responses were varied.
Ms Colbeck said: ‘One GP said the clue was in the name – it was a local medical committee – there for GPs to look at the business side of their contract work and them not being taken for granted doing the contract work that they do, and that nurses don’t have the ability to understand the business side, which I found quite offensive.’
‘He particularly wasn’t a fan of anybody other than a GP being able to take on board the responsibilities or the work that the LMCs do.’
She has however had more positive feedback from others and said: ‘More of the LMCs would like nurses to be on the board but don’t know how to go about it.
‘They sent emails to the practice managers to ask but this did not necessarily get disseminated across the board.’
Ms Colbeck told webinar participants the aim of her project was to get both the medical and nursing side together in these discussions and to get more nurses to take part in their LMC, while also encouraging the LMCs to take on board nurses and see the benefits of this.
She said: ‘Moving forward we want nurses so that we can work with GPs to promote general practice, and hopefully retain more staff because they can see it as a career path and recruit more staff because we can get out there… and make sure they know what is involved and what scope they’ve got with their training.’
She said she hoped an invitation to be an observer at the UK national LMC conference, which took place in Wales last week, would help ‘move things forwards’.
Paul Vaughan, RCN Council vice chair, said: ‘What a great example of career progression and leadership and challenging the perception of nursing and challenging the status quo around how people perceive general practice nursing. It is a great piece of work.’
A version of this article was first published by Pulse’s sister title Nursing in Practice.
Another trojan horse under our roofs?
Reception staff do clinical triage these day so why not treat nurses like GPs? All we do is treat coughs and colds and listen to people moan all day anyway.