Opinion  

Researchers from the University of York have said measures to identify under-doctored areas should take account of nurses and other staff (GP count ingnores nurses' role). They add that if this approach was adopted, just one-third of the 30 most 'under-doctored' PCTs would remain in the bottom third.

The government has actively pursued the expansion of skill mix in primary care. Many policy initiatives, including nurse prescribing and the new GMS contract (which is now a practice-based contract) have paved the way for nurses to take on more responsibilities. Yet the DoH repeatedly fails to recognise that nurses have these wider roles and now deliver a significant amount of the UK's primary care.

This research provides one such example. Extended hours is another. GPs were balloted on whether they were prepared to open their surgeries for longer, but what about nurse-led practices, or those run by practice managers? The ballot failed to acknowledge that some practices are not led by GPs, and these individuals have had no say on an issue that has massive implications for them.

On the subject of nurse-led practices, Catherine Baraniak (Nurse-led practices already exist and work) points out that where they have been established they are successful. But, rather than attempting to expand and replicate this model as part of the patient choice agenda, the DoH has decided that private businesses provide the answer.

It's all very well training nurse practitioners and encouraging nurses to take on advanced roles, but the DoH must acknowledge nurses' contribution and back successful nurse-led initiatives.

As the University of York research shows, new policies can result in big changes on the front line. At the very least the DoH must ensure that the way it measures progress keeps pace with these changes and reflects the valuable contribution of all members of the healthcare team.

Emma Bower, editor, Independent Nurse, emma.bower@haymarket.com