Sharing nursing students across a PCN

A senior practice learning facilitator has told how a PCN-wide training scheme for nursing students has eased placement capacity pressures and encouraged future nurses into general practice.

Hayley Ingleson, senior practice learning facilitator at Leeds Community Healthcare NHS Foundation Trust and Leeds Primary Care, launched the scheme in November 2022 across LS25/26 PCN in Leeds. 

She has since seen a direct link between students who engaged with the scheme and those who have returned to work in general practice after graduating.

Placement challenges

The issue of local placement capacity for nurses in general practice has been reported widely, including our sister title, Nursing in Practice’s General Practice Nursing Manifesto and subsequent roundtables.

Ms Ingleson said she first noticed the issue locally when she came into her role five years ago.

‘I very quickly recognised that there was not the placement capacity or experience in general practice, yet there was an appetite from students,’ she said.

Practices would often tell her that there was ‘an inference’ that nursing students were a ‘burden’, and that they could not accommodate the additional clinical pressures associated with student nurses, on top of completing their already increasing workloads.

Practice nurses also warned Ms Ingleson that they were struggling with the ‘one-to-one’ model for student nurse placements, and particularly struggled with mentoring students who were not based at that practice all the time.

Ms Ingleson said students also ‘struggle with understanding’ their role in practice, with many feeling ‘plunged into place’ without receiving enough guidance on their placement role and responsibilities.

In response to this, she arranged for seven local GP practices to share students across LS25/26, with each student being assigned an ‘assessor’ at a base practice who would assist with their supervision at different practices across the PCN.

‘If we don’t get people experiencing good quality placements, then ultimately we won’t get that output at the end,’ she explained.

So far, two of the four nursing students from the initial pilot scheme have returned to work in general practice in the PCN, with another planning to return after travelling.

The local community

As part of her scheme, Ms Ingleson has stressed the need for students to understand the unique health needs of their practice populations, especially when developing their health promotion skills.

In the first week of their placement, students meet with the integrated care board (ICB) data team to discuss how health needs in Leeds differ from other parts of the country, focusing the impact of the cost-of-living crisis.

Within the first three weeks of their placement, students also shadow healthcare support workers and nurses delivering NHS health and hypertension checks.

By weeks four to nine of their placements, the student nurses begin leading on NHS checks in clinics, with the goal of leading on three NHS health check clinics per week.

‘I really wanted the students to gain more of an understanding of what general practice is and what it is they’re doing, so understanding the population needs, the health needs, the health inequalities, building upon the curriculum that’s been delivered in the university,’ she said.

Ms Ingleson believes embedding students in local communities is vital to motivating them to return to the local area once they have graduated.

‘I think it gives you a little bit of a sense of belonging and rooting really,’ she said.

‘I think it did help them to contextualise the placement and understand the value of general practice nursing, which is essentially what I wanted them to see.’

Digital health training

Digital health training opportunities were also embedded into the placements, with nursing students going into the community on a weekly basis to speak to the public about digital health, including the use of health apps and digital records.

‘Because they’re our future generation, I really wanted to equip them with the skills and knowledge around digital health and digital inclusion,’ Ms Ingleson explained.

She added that digital skills were valuable to understand how healthcare messaging can be delivered in ‘non-traditional settings’ and ‘as a support mechanism to general practice’.

The city of Leeds is aiming to be digitally inclusive by 2030, and Ms Ingleson hopes her placement scheme will help to achieve this.

‘What better way to do that than to have our next generation of workforce equipped with skills to be able to support people with accessing apps that help them to self-manage their long-term conditions or that help them to access their own health records when ordering prescriptions, because that’s the way healthcare is going,’ Ms Ingleson said.

Ms Ingleson was brought in to support an ‘integrated working agenda’ across Leeds Community Healthcare Trust and Leeds GP Confederation. She is employed by the Leeds Community Healthcare NHS Foundation Trust, but also works on ‘development and sustainability’ of clinical placements across general practice locally.

A version of this story was first published on our sister title Nursing in Practice.