Current measures are too doctor-centric, given that GPs make up less than a third of the general practice workforce, according to researchers from the University of York Centre for Health Economics.

The researchers assessed a variety of measures of general practice provision. They found that just one in three of the 30 most under-doctored PCTs identified in the White Paper 'Our Health, Our Care, Our Say' remained in the bottom 30 when factors other than the level of GP provision were included. 'While the set of worst-provided PCTs varies with the choice of GP supply measure, need adjustment, and population base, the set of 30 identified by the White Paper contains a core of around 10 PCTs which are among the worst provided on most possible alternative definitions,' the researchers said.

'GPs make up 30 per cent of the staff in general practice and the mix of GPs, practice nurses and other staff varies considerably across PCTs,' they added. 'We suggest that consideration be given to broadening the definition of the general practice staff from GPs to include practice nurses and possibly non-clinical staff as well.'

RCN Practice Nurse Association chair Kate Howie backed a change in how under-doctored areas are defined. 'It would reflect that we are moving towards a whole team approach with a more skill mixed model.'

She said NHS cash could be misdirected if inaccurate definitions of the adequacy of services were used.

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