Letter:
I read a recent article in Pulse, written by a GP, suggesting that general practice should learn lessons from their veterinary counterparts. The article described how veterinary nurses are prohibited from giving vaccinations to animals on the grounds that, not being qualified to assess an animal, they may make an inappropriate judgment on their administration. The article goes on to suggest that prescribing nurses, pharmacists, and physicians’ associates are trying to push GPs out of their jobs.
Having worked as a general practice nurse (GPN) for 18 years, of which 12 have been as a non-medical prescriber, I found the article quite offensive. I have lost count of the number of vaccines I have given during my time as a GPN. Whether I am giving a baby their first vaccinations, or travel vaccines, or one of the hundreds of flu, Covid and pneumonia vaccines, I always assess the patient to ensure they are well and it is appropriate to give. I also will gain the patient’s, or in the case of a baby, the parents’, consent. It is worrying that this GP doesn’t seem to be aware that to give any vaccine GPNs and the wider nursing team undergo an initial training programme and have annual updates to ensure they are fully competent.
“It is in all our interests to work together”
Vaccinations are just part of the wide scope of practice GPNs undertake in their daily work. They lead on the assessment and management of long-term conditions such as asthma, diabetes, and cardiovascular disease, educating patients about their condition and assisting them to manage it themselves on a day-to-day basis so they understand when they need to seek further support and advice. They play a big part in cancer screening particularly in cervical screening, and support women in choosing a form of contraception that is suitable and safe form them. Just like GPs, we undertake additional training with regular updates for each area we work in.
At a time when general practice, along with many areas of the NHS, is on its knees, we should be working together to overcome some of these difficulties. From a personal point of view, I have joined my Local Medical Committee (LMC) and Royal College of General Practitioners (RCGP) Faculty as a non-medical rep to work with my GP colleagues and raise the voice and profile of GPNs. Both groups have welcomed me and value the perspective I can give on contract issues that involve the nursing staff.
I was aware that there weren’t many GPNs in LMC roles, and I contacted all 68 LMCs across England to find out just how many of us there were. Out of the 33 replies, I found that there are only five, including myself. We now meet regularly to support each other and look at how we can expand this and other lead roles for nurses to increase the collaborative voice of general practice.
We are certainly not trying to push GPs out of their role but work with them to preserve and improve general practice for both patients and staff in all roles within general practice. Therefore, it is in all our interests to work together.
The veterinary analogue is a false one, on two grounds. First, nurses are in fact trained to make appropriate judgements and, second, they do so in communication and with the consent of those receiving, or the guardians of those receiving, the vaccine. Nor is such a remedy required in the first place, given that the supposed ailment it addresses, ie, that associate staff are plotting to push GPs out of their jobs, is itself insufficiently diagnosed or evidenced.
Ruth Colbeck, lead nurse, West Leeds PCN
