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The Government expects practice nurses to take on the burden of PSA testing from GPs under controversial plans to further increase the skill mix in primary care.

The Department of Health has suggested a protocol for nurses to follow which includes discussing pros and cons of testing with asymptomatic men, carrying out tests and arranging appropriate follow-up.

But GPs have claimed the move would fuel spiralling use of a 'pretty unhelpful test' and questioned whether it was appropriate for nurses to carry out such complex discussions.

The department revealed its plans in a new report ­ Making Progress on Prostate Cancer ­ claiming practice nurses were 'ideally placed to advise the often difficult to access older male population'.

All nurses will shortly receive copies of the Prostate Cancer Risk Management Programme in advance of a paper early next year setting out the details of the Government's proposals.

But Dr Nick Summerton, a GP in Goole, East Yorkshire, and head of public health and primary care at the University of Hull, said he would be 'wary' of nurses taking on such a complex role.

He said at least two PCTs were planning local enhanced services for prostate cancer management and this would be a much better approach.

Dr Graham Hornett, a member of the department's advisory group on prostate cancer and a GP in Wonersh, Surrey, said: 'There's no need to put extra pressure on practice nurses who are already overladen with work. I feel it might lead to more unnecessary tests.'

A Cancer Research UK study published in the summer found the rate of PSA testing in general practices had leapt by more than a third since 1999, despite the lack of evidence that testing reduces mortality (see Pulse, July 12).

Nurse PSA protocol

·Advise, inform and educate men with no symptoms about prostate cancer

·Exclude the possibility of UTIs in all men over 45

·Discuss PSA test

·Take the blood test in men making an informed choice to do so

·Discuss the results, and where necessary arrange a repeat test, digital rectal examination, or urgent referral

By Emma Wilkinson

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