Practice nurses could take on more consultations in primary care states a report into general practice from thinktank Reform.
Experts interviewed for the research explained that GPs could pass 50% of appointments to other professionals such as practice nurses or pharmacists. It is estimated that other parts of the primary care workforce could administer the 57 million appointments for common conditions and medicines-related problems each year. ‘This alone could deliver up to £727 million of savings per year,’ said the report.
‘It is good to see the contribution of nurses working in general practice recognised, but their contribution already goes beyond handling less complex GP work,’ said Professor Alison Leary, chair of healthcare and workforce modelling at London Southbank University and a registered nurse. ‘Practice nurses are already managing long-term conditions and it was good to see in this report the explicit contribution that case managing nurses can make. Sadly the value of these roles is not always seen. There is plenty of anecdotal evidence of loss of community matrons and other nurse care managers.’
The report also describes the focus on recruiting GPs as an ‘inefficient allocation of NHS resource’. Between 2004 and 2014, the number of GPs increased at a faster rate (15%) than the number of practice nurses (11%).
This trend may continue with the government’s commitment to recruit 5000 more GPs by 2020. There are plans to increase other primary care clinicians by 5000, but it is still unclear how many of these would be nurses.
‘The limitation here is the supply of nurses. To make a model like this work some real thought would need to be given to the pipeline and how nurses can move into fairly complex roles,’ added Professor Leary.
The report also looked into different clinical areas and identified diabetes as an area in which practice nurses could make a big impact. One interviewee for the paper estimated that 90% of diabetes appointments could be conducted by nurses.
Analysis by King’s College London, published in the report, explained that larger practices are more likely to employ nurses with postgraduate qualifications in diabetes care.
The analysis found that practice nurses ‘could become a key factor in the further reduction of HbA1c levels and the achievement of diabetes control.’