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Prove that you value your staff

I read with interest GPs' views on practice nurse pay ('Practice nurses must earn their pay rises').

I agree that, historically, some practice nurse pay has been favourable and I welcome Dr Julie Barker's approach to paying practice nurses. It's quite fair to expect practice nurses to have a good understanding of the QOF and be aware of the issues around GP pay.

It's obvious to all that the practice nurse role has changed significantly and that some roles involve, as Dr Phil Dommett suggests, some data collection and low-level decision making.

But this is simply not true for many roles, which involve significant clinical decision-making and often save partners substantial sums of money. This perhaps highlights the diversity of skill in any primary care team.

Unfortunately, I feel Dr Barker is in the minority in her approach. Many practices use Agenda for Change pay scales but not the associated terms and conditions. The majority of practice nurses in my area do not have annual increments and certainly no QOF-associated bonuses.

Any disagreement around pay should focus on patient care and equity and if GPs really value their staff, they will act accordingly.

From Karen Mayne, advanced nurse practitioner, Hertfordshire PCT

I write regarding Dr Ila Basu's recent letter 'Practice nurses must earn their pay rises'.

I am dismayed to read his suggestion GPs are not exploiting practice nurses. First, the plural of anecdote is not fact.

I find it remarkable that despite having had a practice nurse for more than 12 years, Dr Basu has only just come to recognise that the practice nurse he employs 'does only a quarter of the job description'.

Of course, he does not go on to say what else the practice nurse may be doing.

Second, he also states that 'the practice nurse is not involved with the QOF'. Again, this is a remarkable statement. Is he really suggesting a practice nurse has no contact with patients, the outcomes of which contribute to QOF points?

Far from ensuring an efficient and effectively run practice, these points suggest a clear lack of management.

From Ann Batchelor, practice nurse, London

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