What is the challenge your project is going to address and how does it connect to the theme of 'How can we improve across system boundaries?​

The NHS Long Term Plan’s broad ambition to shift care from acute to community settings relies heavily on safety critical roles such as district nursing. However, between 2009 and 2022 the number of District Nurses (DNs) fell by nearly 50% (RCN 2023). The Five Year Forward View highlights the importance of general practice leading this change, but we had an estimated shortfall of around 1,700 WTE General Practice Nurses (GPNs) in 2021/22 and this is projected to grow to around 6,400WTE (close to 1 in 4 posts) by 2030/31 (The Health Foundation 2022). Also a survey conducted by the QNI in 2015 highlighted that by 2020 33% of existing GPNs were due to retire. GPNs are employed directly by individual GP surgeries and DNs are employed by community trusts. Historically they have worked separately. However, with the formation of primary care networks (PCNs), we have an opportunity to bring these workforces together to pool resources and increase opportunities for learning and support.

What does your project aim to achieve?

ShiftPartner is a digital innovation that is being used within MSEFT (www.shiftpartner.com). Nurses create bespoke profiles with evidence of their skillsets and capabilities. Managers post shifts with specific requirements and clinician and shift are matched up automatically. It enables managers to understand the knowledge, skills and preferences of staff at a granular level to quickly and efficiently find the right person for the job. This also enables clinicians to work across perceived boundaries and experience other settings. This Q-Exchange project would use this technology to capture the skills and learning needs of nurses across primary and community care. The aim is to promote more joined up working and increase productivity. Culture, role erosion and retention will also be explored as part of the pilot. New opportunities for work, learning and mentorship will be opened up which should foster relationships, aligning with Dr Fuller’s vision of integration in her Stocktake Report (2022).

How will the project be delivered?

A pilot site would be identified within MSEFT. There are two elements to this project. 1. To use ShiftPartner technology to gather granular level data about knowledge/skills, training needs and preferences of the nurses; to open up opportunities across the two settings. 2. To explore the culture of each organisation to understand what motivates DNs and GPNs; to highlight perceived barriers to developing professionally and collaborating with colleagues across the organisations. An impact assessment will be carried out to understand the risks vs benefits of introducing this innovation. Nurses will have new opportunities to work locally and to build relationships with their colleagues. An MOU would be signed at the start (between the PCN practices and Community Trust) to set out the governance arrangements (i.e. that safer recruitment processes are in place, that references have been sought, that DBS checks have been carried out, and that there are clear lines of accountability).

How is your project going to share learning?

Experiences and expectations of nurses and managers will be surveyed at the start and then measured at the end of the pilot, to understand the benefits and review the effectiveness of this project. We have a behavioural scientist and data analysts within the ShiftPartner team who will get the most from the data, looking at cultural issues and wider trends that impact on staff retention. They will support us to evaluate and present the learning from this, so we can review and refine the model, as needed, so it is ready to scale. They will also use the rich data collected from the bespoke profiles to provide details of the wider skillmix. Knowledge gaps and training requests will be brought together into a learning needs analysis that can be mapped against current training provision. We would like to share the learning from our research widely through publication in nursing/medical journals.