The letter below was sent to Rt Hon John Reid MP, Secretary of State for Health by Dr Beverly Malone, General Secretary of the RCN:

Agenda for Change and Practice Nurses

The RCN firmly believes that the new General Medical Services (GMS) contract can only be successful if general practice is well supported by skilled, knowledgeable and experienced nurses.   In order for this to happen it is essential for GP-employed nurses to have access to Agenda for Change, in the same way their NHS-employed nurse colleagues will.   The RCN would therefore like you to urge GPs to implement Agenda for Change.

The RCN has been working in partnership with the Department of Health and employers to ensure the positive implementation of Agenda for Change, with improved patient care being the focus of our thinking.

The new GMS contract is also being supported by the RCN as a key platform to support service modernisation.   We believe that this modernisation can only be delivered if the employment environment of practice staff is also modernised.   Achieving progress on the management of chronic disease, minor illness and access to services requires a well supported, resourced and skilled nursing workforce paid on Agenda for Change terms and conditions.

Primary care services have become a focal point for the delivery of health care reform (NHS Plan, 27 July 2000).   Nurses working in general practice are at the heart of reforms and development, many of them pioneering and radical ones, taking on new roles and developing innovative practice.   Research undertaken by Nicola Walsh (Breaking the Mould, HMSC 2002) shows that PMS pilots provide examples of some of the enlightened new ways of working developed by nurses.   Practice nurses and nurse practitioners, while employed by independent contractors, invariably work closely with NHS staff to ensure that NHS targets are met.   General practice nurses are an essential and integral part of the NHS family.

The RCN is most concerned that nurses currently employed by GPs will not benefit from Agenda for Change.   GPs must understand the value of a modern pay system and be motivated to implement Agenda for Change for nurses and other staff members.

There are some key labour market pressures which all employers, including GPs, will need to respond to.   The nursing population in general is ageing, but practice nurses have an older population profile than nurses on average; 46% of practice nurses are currently over the age of 45.   It will be essential to recruit and retain nurses of all ages in general practice if a staffing crisis and the consequent collapse of general practice services in a number of particularly hard-pressed areas is to be avoided.

While the RCN is working hard to persuade GPs of the merits of Agenda for Change we believe that action by yourself on this issue will add considerable value to our important campaign.

I look forward to hearing your views on this.

Yours sincerely

Beverley Malone RN, PhD, FAAN
General Secretary