Key areas for action on the health and care workforce

Closing the gap: Key areas for action on the health and care workforce | Nuffield Trust |  The King’s Fund | The Health Foundation


Staffing is the make-or-break issue for the NHS in England. Workforce shortages are already having a direct impact on patient care and staff experience. This report calls for urgent action to avoid a vicious cycle of growing shortages and declining quality. The workforce implementation plan to be published later this year presents a pivotal opportunity to do this.

In this report, experts from the Nuffield Trust, The King’s Fund and the Health Foundation set out a series of policy actions that, evidence suggests, should be at the heart of the workforce implementation plan. This report focuses on nursing and general practice, where the workforce problems are particularly severe. The authors suggest a number of high-impact policy actions which, if properly funded and well implemented across the NHS would over time create a sustainable model for general practice and help to eliminate nursing shortages. These will require investment of an extra £900 million per year by 2023/24 into the budget of Health Education England.

Closing the gap: Key areas for action on the health and care workforce – full report

Closing the gap: Key areas for action on the health and care workforce – overview

See also: Offer £5,200 grants to nursing students and ramp up overseas recruitment to stop NHS workforce crisis | The Kings Fund


Increasing General Practice Nursing placements for student nurses

NHS England | February 2019 | Increasing General Practice Nursing placements for student nurses

A project in Sussex led to the development of General Practice placements for student nurses to experience General Practice Nursing (GPN). 

The nurse for Primary Care Workforce Tutor (PCWT) and the Tutor Lead for Advancing Nurse Practice reviewed the GP workforce data across Kent, Surrey and Sussex as collected by Health Education England. They identified an increased anticipated reduction of qualified GPNs across the region due to projected retirement in the next 2 to 5 years.

Collaborationnurse-815150_640.png with the university supported the vision of what an excellent placement should look like and the skills which could be achieved in the GP provider settings. The PCWT and the Tutor Lead for Advancing Nurse Practice have formed close working relations with the university colleagues, to support ongoing development of the programme.

The changes made to implement the programme included:

  • Providing students with opportunity to observe all aspects of the system and facilitating bespoke opportunities;
  • Developing an induction pack which was adopted by GP providers. This included the expectations of the practice, the student and the skills the student training is delivering, either supervised or unsupervised. This document continues to develop, especially as the team are moving towards hosting multi-disciplinary placements;
  • Developing a preceptorship programme to support newly qualified nurses awaiting their PIN;
  • Creating a workforce development conference locally.

Collaboration and co-production with the university supported the vision of what an excellent placement should look like and the skills which could be achieved in the GP provider settings.

The programme aims to bring the right education, training and development to enhance skills, knowledge and understanding to the future nursing and wider workforce (Source: NHS England)

Read the full case study at NHS England

NHS England: NHS body could help struggling ‘last partner standing’ practices

Pulse | January 2019 | NHS England: NHS body could help struggling ‘last partner standing’ practices

The ‘last partner standing’ – also known as ‘last man standing’ – indicates a situation in which one partner finds themselves bearing all the liabilities and obligations owned by the practice, after unsuccessful attempts to find new partners. Now Pulse reports that NHS England could take on the lease of practices that find themselves in this situation.

NHS England director of primary care workforce and infrastructure Ian Biggs recently presented the emerging themes of the upcoming General Practice Premises Policy Review at the Westminster Health Forum Event in London.

Mr Biggs said talks with the BMA GP Committee and the RCGP are ongoing but solutions – which include the introduction of a body that could shoulder the lease of practices in ‘last partner standing’ situations – are being explored (Source: Pulse).

Read the full story at Pulse 

FREE NHS WiFi at Crystal Peaks Medical Centre

NHS England | November 2018 | NHS WiFi at Crystal Peaks Medical Centre

Crystal Peaks Medical Centre is a  GP practice in a busy retail park in Sheffield; it installed NHS WiFi in July 2018,  NHS England have now produced a case study about this innovation and video interview with Dr Kirsty Gillgrass, a GP Partner at the practice. There are approximately 7,000 patients registered with the practice. It is a training practice with 5 GP partners and a large multi disciplinary primary care team. 

The practice, along with other practices in the neighbourhood, is applying for digital inclusion funding to encourage digitally excluded patients to take charge of their health and wellbeing and make use of patient online services.

Practice staff will encourage patients to sign-up for patient online services while in the waiting room, and staff will be able to use mobile devices to demonstrate to patients how to book appointments online and order repeat prescriptions.

Having access to free WiFi can also reduce anxiety for patients before their appointment. Being able to make good use of their time by accessing emails, checking social media or even downloading an ebook to calm their nerves can improve the patient experience (Source: NHS England).

Improving access and continuity in general practice

Nuffield Trust | November 2018 |Improving access and continuity in general practice

The report describes the Nuffield Trust’s key findings on the impact of improved access upon continuity of care, and provides a series of recommendations for commissioners and policy-makers. 

Improving access and continuity in general practice is based on four research questions:

  • What is the evidence that continuity within general practice benefits patients, or is important to health professionals?
  • Which primary care patients are more likely to want continuity of care, and how likely are they to report receiving it?
  • How might policy initiatives to improve access affect continuity of care, and to what extent is there evidence of this?
  • What factors might best support continuity of care in the context of improved access?
Image source:

The study combined:

  • a rapid literature review
  • interviews with nine providers, one commissioner of services, and site visits to two services that are seeking to combine access and continuity
  • analysis of data from the GP Patient Survey
  • two expert meetings involving clinicians, managers, academics and policy-makers


Download the evidence review 

Download the summary report 

Increasing continuity of care in General Practice

The Health Foundation is supporting five large-scale GP practices and federations to carry out targeted improvement work to increase continuity of care in their practices.

The Increasing Continuity of Care in General Practice programme will explore what continuity of care will look like, considering relationships between GPs and patients, and also examining whether better information and management practices can help increase continuity with the aim of bringing benefits to both staff and patients.


This programme is inspired by recent Health Foundation research which demonstrated that patients with ambulatory care sensitive conditions who see the same GP a greater proportion of the time have fewer unplanned hospital admissions. The programme has been developed with the advice and support of the Royal College of General Practitioners.

Each project will run for up to two years and each project team will receive up to £250,000 of funding to support the implementation, evaluation and dissemination of findings from their work.

Full story at The Health Foundation

Patients start testing the new NHS App

Patients at a number of practices across England have begun testing the new NHS App | NHS Digital

The NHS App provides simple and secure access to a range of healthcare services on a smartphone or tablet. Developed by NHS Digital and NHS England, the app will enable many patients to register without attending the practice, reducing administrative burden on reception staff.

Once registered, patients can:

  • check their symptoms using NHS 111 online and the symptom checker on the NHS website
  • book and manage appointments at their GP practice
  • order their repeat prescriptions
  • securely view their GP medical record
  • register as an organ donor
  • choose whether the NHS uses their data for research and planning

Feedback from patients and practice staff will be used to help improve the app before it is gradually rolled out to patients across England from December 2018.

Find out more on the NHS Digital Website