At the London General Practice Awards on 6 February 2025, Liz was commended with a Long Service Award. Reflecting on her achievement, she shared:
“I think it’s my ‘stickability’. Starting off in 1991, the general practice nurse role was very new. There were no formal peer support networks, so a few colleagues and I set one up. The Bexley and Greenwich practice nurse forum, which met in the evenings in our own time. We paid a membership and invited speakers. You had to be someone who could ‘dig your own furrow’ and put your head above the parapet to bring people together.”
Liz’s nomination recognised her efforts in various aspects of nursing and education. Judges were impressed at how she had “supported other professionals and had the vision to advance general practice, despite the challenges.”
Liz continued, “The nomination came to recognise the fact that I have pioneered in many different strands of the development of general practice nursing, as well as supporting other professionals and having the vision of taking general practice forward because it’s not been easy.”
Early career
Liz trained as a nurse in the army before taking a career break to start a family. She rejoined nursing in 1991 at The Coldharbour Surgery Eltham Greenwich.. “The landscape had greatly changed between starting my nursing career and returning after having a family. I applied for several jobs in secondary care but did not get them because I was not a diploma nurse and was not deemed to be of sufficient seniority, even though I had 14 years of experience. They wanted me to start from the beginning again because I was not diploma trained,” she said.
Over the next four and a half years, Liz pursued skilled-based learning in managing long term conditions such as diabetes and asthma. She earned her nurse practitioner diploma as one of the first 75 nationally. After obtaining her degree, she became one of the first nurses to pass the non-medical prescribing program.
Training the next generations of nurses
After starting the nurse forum, Liz’s interest in ensuring general practice nurses had the right skills and qualifications grew. She transitioned into training, gaining more qualifications and eventually teaching at university courses. “I’m passionate about making sure that every person that comes into general practice, regardless of their role, can work to their highest level and feel supported and integrated as part of that primary care team,”
Liz finds great satisfaction in seeing the success of those who came through apprenticeship programs. She recounted, “There’s somebody in particular who I worked with many years ago. She was a receptionist and was just exceptional. Due to her personal circumstances, she has not followed her dream of being a nurse. I managed to get her onto the nursing associate program as an apprentice. She completed the program and then went on to do her registered nurse apprenticeship, all of that in general practice. So, she’s now a qualified registered nurse.”
“That was amazing because that nurse thought she’d reached her pinnacle by working in the reception area. She could not see how she could go to university and do her nursing qualifications, which was what she always wanted to do. But at that time, we were pioneering apprenticeships in general practice with nursing associate being one of the first ones, and I was really pleased to be part of that.”
Liz enjoys seeing the nurses she has trained over the decades as their careers progress. “The one closest to home is the practice nurse that I go to now for my long-term condition management. She is somebody that I recruited about seven or eight years ago, and she has now completed her PGC in general practice nursing. She is an expert in some of the long-term conditions, that I now go to see her for.”
Changes over the years
In May 2025, Liz will celebrate 50 years as a qualified nurse, witnessing significant changes throughout her career. “When I first came into general practice, we didn’t even have computers. The surgery opened at 9:00am and closed the doors between 12:00 noon and 3:30pm. During that time we would sit around a little table and handwrite all the prescriptions. The doctor would return at half three to sign prescriptions and do admin until the evening surgery from 4:00-6:30pm. We had at least a two-hour break from seeing patients to do admin.”
Reflecting on technological advancements, Liz said, “I remember the day when we had multiple-use speculums and other equipment that had to be sterilized, so you did a lot of cleaning, scrubbing, and sterilising. Now, everything is single use.” She continued, “But again, technology is helping, isn’t it? We have e-consults and telephone consultations. It’s just about getting everybody to be able to do it and educating the public on how to access it in the most efficient way.”
Liz noted the dramatic shift in practice hours and patient demand. “It was a mega change when we had to be open 10 hours a day without that period where the door was locked. In recent years, patient demand has ‘gone through the roof’. It is no longer a morning session or an evening session; we have to be open all day, sometimes 12 hours a day on extended opening. That causes huge pressure within the practice because you never get a break. There is an expectation around that 10-minute appointment and keeping it to the time.”
Having spent 35 years in general practice, Liz is now self-employed. She works with South East London Workforce Development Hub as the multi-professional clinical lead and lecturer.
Dr Michelle Drage, CEO, Londonwide LMCs presents Liz Nicholls with her award in February 2025.