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GP work not cut by nurse practitioner

Nurse practitioners do not cut GP workload, according to research.

The study of 34 practices in the Netherlands, 20 of whom were assigned a nurse, found no reduction in the number of GP consultations for three major conditions – asthma/ COPD, dementia and cancer – in those practices with a nurse.

Study author Professor Bonnie Sibbald, deputy director of the National Primary Care Research and Development Centre, said the findings would apply equally in the UK. She said GPs had to actively manage what nurses did otherwise they would be 'doubling up' the work.

'If you just add in a nurse or a nurse practitioner and expect doctors' workload to go down that won't happen unless you actually manage the process,' said Professor Sibbald

'Unless you say doctors will now stop doing this the work won't go away and you get a doubling-up of services because of service-driven demand.'

The Dutch study (BMJ, April 6) found GP workload actually increased in the short-term because nurses were identifying more problems that demanded the GP's attention. This was partially offset by a reduction in the number of contacts out-of-hours.

Dr Vicky Pleydell said her practice in Catterick Garrison, North Yorkshire, had just appointed a third nurse prescribing practitioner to replace a GP. She said GPs had to be 'proactive' in working out who does what.

Dr Pleydell said: 'It's an enormous role for the receptionists and we've worked very hard with them and had them sit in on both nurse and GP consultations to get them to understand what we do so they can apply it to the appointment system.'

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