Advanced nurse roles in UK primary care
- 3 July 2006
- journal article
- task transfer
- Published by AMPCo in The Medical Journal of Australia
- Vol. 185 (1), 10-12
- https://doi.org/10.5694/j.1326-5377.2006.tb00440.x
Abstract
Nurses increasingly work as substitutes for, or to complement, general practitioners in the care of minor illness and the management of chronic diseases. Available research suggests that nurses can provide as high quality care as GPs in the provision of first contact and ongoing care for unselected patients. Reductions in cost are context dependent and rarely achieved. This is because savings on nurses’ salaries are often offset by their lower productivity (due to longer consultations, higher patient recall rates, and increased use of tests and investigations). Gains in efficiency are not achieved when GPs continue to provide the services that have been delegated to nurses, instead of focusing on the services that only doctors can provide. Unintended consequences of extending nursing roles include loss of personal continuity of care for patients and increased difficulties with coordination of care as the multidisciplinary team size increases. Rapid access to care is, however, improved. There is a high capital cost involved in moving to multidisciplinary teams because of the need to train staff in new ways of working; revise legislation governing scope of practice; address concerns about legal liability; and manage professional resistance to change. Despite the unintended consequences and the high costs, extending nursing roles in primary care is a plausible strategy for improving service capacity without compromising quality of care or health outcomes for patients.Keywords
This publication has 20 references indexed in Scilit:
- Variations in practice nursing: implications for family health services authoritiesHealth & Social Care in the Community, 2007
- Impact of nurse practitioners on workload of general practitioners: randomised controlled trialBMJ, 2004
- Cervical screening and health inequality in England in the 1990sJournal of Epidemiology and Community Health, 2003
- Identifying predictors of high quality care in English general practice: observational studyBMJ, 2001
- A survey of specialist and advanced nursing practice in the UKBritish Journal of Nursing, 1999
- Identifying, evaluating and implementing cost‐effective skill mixJournal of Nursing Management, 1999
- Costs and Remuneration for Cervical Screening in General Practice in the West of ScotlandJournal of Health Services Research & Policy, 1996
- Effectiveness of health checks conducted by nurses in primary care: final results of the OXCHECK studyBMJ, 1995
- The role and self‐perceived training needs of nurses employed in general practice: observations from a national census of practice nurses in England and WalesJournal of Advanced Nursing, 1994
- Explaining outputs of primary health care: population and practice factors.BMJ, 1991