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Using a nurse more costly than employing salaried GP

Using a nurse to provide first contact patient care costs the same or more as employing a salaried GP, research has revealed.

The study by the University of Bristol found the increased length of nurse consultations and the level of involvement required by GPs meant the overall costs were virtually even.

An average nurse practitioner consultation cost GP practices £9.46, the research found, compared with £9.30 for a salaried GP. The cost to the NHS, which included training, was £30.35 and £28.14 respectively.

Author Dr Chris Salisbury, professor of primary health care at the University of Bristol, said nurses were not necessarily value for money.

He said: 'If you just wanted as much work for the best value for money don't assume employing a nurse would be a cheaper way of doing it than employing a doctor.

'Reasons need to be wider than simply looking at cost. There is no evidence that it's going to be cheaper.'

Nurse consultations took up 16 minutes of total clinical time, almost seven minutes longer than GP consultations.

Some 17 per cent of the clinical time relating to a nurse practitioner initial consultation was time spent by GPs on follow-ups within two weeks and writing prescriptions.

The findings, published in the July issue of the BJGP, came as a leading academic told MPs the evidence to support skill mix was 'wholly inadequate'.

Giving evidence to the Health Select Committee's investigation into workforce planning, Professor Bonnie Sibbald said research she had reviewed showed 'on most occasions you will not get gains in productivity or reductions in cost'.

Professor Sibbald, professor of health services research at the National Primary Care Research and Development Centre, said: 'People believe nurses would save money when substituting general practice; the evidence base is that doesn't happen.'

Nurses tended to consume more resources, cancelling out salary savings, she added.

Dr Mary Church, chair of GPC Scotland, said nurses and GPs should both do what they have been trained to do.

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