Bonus E Nurse Fellowship examples

[00:00:06] Munir Adam: Hi, it's Munir Adam here. Welcome back to Primary Care uk, and this is a bonus episode. It's, if you like an addendum to the fellowship episode, which was episode 10 of season one. In that episode, we talked about the GP and GPN fellowship scheme, and while they had taken off as far as GPs were concerned, it was less successful for the GPNs and only in very limited places where opportunities developed for the other professions.

But since then, the eligibility criteria for GPNs has improved and whereas before, it was mainly for those who were newly qualified, it now does include nurses who are new to practice, and since then there's been renewed interest with lots of nurses wanting to find out what fellowships might look like in reality. 

In this brief bonus episode that is targeted mainly at nurses, the three G P N Spin program directors in London, share examples of what's available. We hope that this will be helpful for those nurses in particular who are thinking of taking up a fellowship and organizations that are involved in arranging or supporting this.

[00:01:11] Charlotte: We're gonna talk about the projects that some of the general practice nurse fellows have been able to do, and hopefully give you an idea of the scope and the possibilities of the things that can be achieved by the GPN fellows within practice. What we'll do is we'll start off just with an introduction.

So my name's Charlotte Cooley. I am the G P N Fellowship Lead for North London SPIN Project. 

[00:01:35] Debbie: I'm Debbie Brown. I'm the um, clinical director for Lewisham C PN training Hub um, director of general practice nurse for Southeast London Training Hub and also program director for GPN Spin Fellows. 

[00:01:48] Dawn: Hi there. My name's Dawn. I am a practice nurse. I also work for Wandsworth Training Hub working as the program director for the spin fellowship for new to practice nurses and that's across Southwest London. And then also overseeing placements within Wandsworth as well. 

[00:02:06] Charlotte: So what we'll do is we're gonna talk about some of the projects.

So when the fellows sign up to the fellowship scheme, we talk about undertaking a project within their practice or pcn or within a wider part of the system. And sometimes some of the nurses can feel a little bit unsure about what they're able to do, and some of the practices feel that they need a little bit of guidance about what the possibilities are.

The project time allows the nurse to really come up with an idea and it can be a developmental idea for their own career. It can be something around quality improvement in practice, and it can be around kind of , a complete area of clinical care that they have a particular interest in. So I think the easiest way to try and understand what this can mean for practices and the nurses is to start listening to some of the ideas that have already been put into place.

Outreach example

[00:02:57] Charlotte: So Debbie, I'll come to you first. If you can explain, I know you've had a great project in Southeast London with one of your GPN fellows who's worked alongside a gp. So if you just wanna explain what the project title is and then what the kind of aims were and then what they achieved at the end of this. . 

[00:03:14] Debbie: So this was one of our first GPNs undertaking the fellowship. . And one of our new qualified GPS worked together on this project and it was really trying to understand the inequalities around patients receiving care if in their own home or in another place, another residential setting. Unable to get into a practice.

And so this wasn't just around looking at diabetes, this was looking at all aspects of care. So the project started in with patients in their own homes and domiciliary visits and starting to work with the district nurses, looking at all the other people that actually go into a patient's home. Another setting where a patient's actually residing.

It then went on very quickly to care homes and it was just trying to understand what care does a patient need in their own home that they're not getting, cause they cannot come to the practice. And it was around all the data collections. They worked with their IT teams. And one of the great things I think came out of this was the growth.

It started off with a very small. And then very quickly it grew organically purely because when you start to look at patients not receiving the same care and service if we'd look at diabetes and especially the nine care processes in which obviously includes the index, the diabetic eye screen complications service um, just making sure that it doesn't matter where patients reside, they should all be able to access the same level of care.

So this is still an ongoing program and it's grown and developed utilizing a lot more of our allied health professionals pharmacists physiotherapists, OT. So this is really growing to be an organic holistic assessment of a patient requiring any services, other settings, and enable to get into general practice to have these undertaken. 

[00:04:57] Charlotte: It sounds like Debbie, to me, I mean you've got like a few things there that you've already mentioned around kind of the networking, working across the pcn, addressing some of the inequalities across the area.

Have you had any feedback from the nurse that was involved in terms of their understanding or their career development or how it's benefited their practice? 

[00:05:15] Debbie: Yeah, absolutely. So she's grown in confidence from being a newly qualified nurse working in general practice to really developing her own skills being able, say again, to have the confidence to network, to have those conversations, to really be the patient's advocate.

And that has enabled her now to be thinking about her future career in general practice. And what else would she be aspiring to, which she wouldn't have thought of before. 

[00:05:39] Charlotte: That's brilliant. That sounds like an amazing project. And do you think there will be scope for another fellow to take over that project? Is that the plan? 

[00:05:46] Debbie: So, absolutely. So from that the next fellow that actually worked in that PCN undertook a part of that was looking about information that you give to patients and carers. But they've done this in conjunction with the cohort of patients to make sure the message that patients ha receive is in the right format for.

[00:06:03] Charlotte: That sounds great. Thank you very much for explaining all of that. 

Educator example

[00:06:05] Charlotte: Okay Dawn, so I'm gonna come to come over to you cuz I know you've been doing some work with the local universities in your area. And this is around the sort of development of nurse educator fellowships, is that right? 

[00:06:16] Dawn: Exactly, yes.

In southwest London we've been working with the University of Roehampton and Kingston University to develop a fellowship for either a nurse or a gp to work within their lecturing team at both of the universities. So this is a really cool opportunity for our GPN nurse fellows. Both universities have got an amazing simulation centers.

So the nurses would start off working within the simulation centers with all of the undergrad nurses, also with the nurse associates as well. And gradually gaining confidence there and then going into other parts of the lecturing team and facilities as well. Both of the universities are also offering a educational qualification as well for those who haven't already got one. In Rockhampton University we've already got a GP fellow there and we've got one nurse fellow who's about to begin after Easter. So that is really exciting and they'll be able to work together. And then at Kingston University we've got a couple of spaces, so we are hoping that those will get filled. Both universities have really supportive teams and are really keen for the fellows to flourish within the educational environment. So it's a fantastic opportunity. 

[00:07:37] Charlotte: I mean, it is a great bridge, isn't it, into somebody who wants to get into an educational role. 

[00:07:41] Dawn: You are right. As a newly qualified nurse it's almost a seamless move because they're coming from education to go straight back into it. They'd have so much to give and really understand it from the students point of view as well. 

[00:07:55] Charlotte: I mean, it's something that I think trying to make any entry into any new area. It sounds like Roehampton and Kingston are being really supportive in terms of that educational pathway.

[00:08:05] Dawn: They are. Absolutely. And I think they're being very flexible as well, so they really want to make it work for the GPN fellow and yeah, it's, it is a great opportunity. 

Workforce development example

[00:08:15] Charlotte: What I'll do is I'll mention one of the projects that one of the GPNs has done in Northeast London, and that's around workforce development.

So they used their fellowship time to develop their nursing team. So this was around being the workforce lead for their primary care network, engaging in some of the training hub support that was there, and it was available in terms of supervision and mentorship of the nurses within their team. They looked at their HR processes, they looked at their interview techniques, all of the things that they needed to become aware of as a newly qualified nurse or new to primary care in terms of being able to support learners, support student placements, and then ultimately to then take on and train their own team within house. So it was really important in terms of sort of growing your own talent and then being able to recruit and retain a really a really solid team within the practice.

So over the whole two years, the nurse went from not really understanding HR recruitment and supportive learners to then being able to really see where her team was gonna develop over the next five years. So there's huge amount of scope for the projects that the fellows can do. And I think the key thing really is about embedding them within their practices so they feel confident and secure to be part of the team and have a voice across their primary care networks.

Final comments

[00:09:38] Dawn: And that's it. It is, it's a real opp opportunity for networking as well, isn't it? To create relationships and connections, which can then be a real gift to the others within their team as well and enable everybody to be working more collaboratively. 

[00:09:55] Debbie: It's a win-win, isn't it? You know, just listening to all of the projects that are being undertaken across London, I mean, it's fantastic to hear that people are embracing this and wanting to move forward.

And what I'd also hope on the back of this, that some of our new to Spin Fellowship, GPN Fellowships will want to actually write this up as academic work and get these published cuz there's some fantastic work that would be great to be shared. Cuz as we know in the nhs, we like the great big wheel. It goes round around. We don't need to keep reinventing that wheel. We just need to be learning from each other. Yeah. And moving forward. 

[00:10:27] Charlotte: Brilliant. Okay. Thank you both very much today. Thank you guys.

 [00:10:35] Munir Adam: And Charlotte, Dawn, and Debbie we'll be back soon with more about the nursing role.