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'Underpaid' practice nurses set to snub expanded role

By Nigel Praities

Practice nurses may be unwilling to take on the expanded role being lined up for them by the Government, new research suggests.

A study showed nurses already felt underpaid and overworked, with the Royal College of Nursing warning they will be increasingly reluctant to take on more work without more money.

University of Glasgow researchers also found practice nurses were unhappy to be lumbered with large quantities of protocol-based chronic disease management work under the QOF and were not paid enough to help hit targets.

The research – published in this month's British Journal of General Practice – comes just weeks after Pulse revealed the Department of Health was instructing PCTs to staff their Darzi centres with three nurses for every GP.

It also reopens a debate over the pay and conditions of practice nurses with some GPs calling for a Government-led review of the work nurses are taking on.

The findings come as new data from the NHS Information Centre show practice nurses are seeing a far greater proportion of patients than they were a decade ago.

While the number of consultations for practices in England has increased from 21,100 in 1995 to 33,900 in 2007, the proportion of nurse consultations in general practice rising by two-thirds since 1995, from 21% in 1995 to 35% in 2007.

But Karen Didovich, senior employment advisor at the Royal College of Nurses, said practice nurses were increasingly dissatisfied with their pay and conditions, which would have detrimental effects on their future role in general practice.

‘If GPs want to retain nurses that are highly skilled and working at a high level they need to review what they are paying them.

‘The nursing role is going to expand, both in terms of the kind of skills and knowledge they are going to need and taking leadership roles in primary care, such as nurse-led walk-in clinics becoming more common. Nurse's pay needs to reflect that.'

Dr Kailash Chand, a GP in Ashton-under-Lyne, Lancashire, and a GPC member, said he had severe reservations about nurses taking on more GP work and that practices were struggling with year-on-year pay freezes.

Dr Chand said there should be a review by the Department of Health before the role of nurses was expanded: ‘Nurses make a tremendous contribution for healthcare, but you shouldn't ask very good air stewardesses to start flying the plane.'

Nurse consultation Controversy over practice nurses

Nov 07 – Nurse leaders accuse GPs of ‘raking it in' after a NHS Working in Partnership Programme survey shows huge disquiet over practice nurse pay levels
Mar 08 – Recommendations from WiPP say GPs must treat nurses better, with better pay, contracts and training
Sept 08 – Pulse reveals the Department of Health PCTs to work to a staffing blue-print of three GPs and nine nurses for Darzi polyclinics
Oct 08 – Central NHS data show a 67% increase in nurse consultations since 1995

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