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Entrepreneurial and business-minded nurses

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One consequence of the current reforms in primary care has been the rise of the entrepreneurial nurse.

Shortly after Labour came to power in the late 1990s nurses were encouraged to become more entrepreneurial and run Personal Medical Services (PMS) practices in primary care. A small number of the now more than 3,000 PMS practices are nurse-led and one of the first was led by nurse Catherine Baraniak in 1998 in Derbyshire.

The trend really took off last year when former NHS chief executive Sir Nigel Crisp issued his letter Commissioning a Patient-led NHS in July.

This letter announced a shift of role for primary care trusts from being providers of services to commissioners.

One of the ideas was to have PCTs contract out service provision to GPs, existing NHS bodies, foundation trusts, NHS staff setting up their own organisations, and the independent and voluntary sectors.

This allowed nurses the opportunity to become the providers themselves. A small yet growing number of nurses are now partners in health centres and GP practices.

The Prospective Nurse Partner Network, set up last year, has seen a sharp rise in numbers since Commissioning a Patient-led NHS and increasing numbers of nurses are seeking business advice on how to set up their own services.

The Queen’s Nursing Institute has reported a rise in interest and set up its nurse partner network to teach nurses how to negotiate partnership agreements, how to buy premises, pensions and indemnity insurance.

At the 2006 RCN Congress the vast majority of nurses voted for a motion calling for the college to develop practical support for nurses working as entrepreneurs. The college has a guidance paper for would-be nurse entrepreneurs.

The NHS Alliance has also published a practical guide for nurses wanting to become providers of primary and community care services.

Sarah Chilvers is one such business minded and successful nurse. Ms Chilvers set up her own business in 2001 in partnership with GP Rory McCrea. The company ChilversMcCrea Healthcare now provides NHS services and runs around 20 general practices under contracts from different PCTs.

Current health secretary Patricia Hewitt is also keen that nurses set up social enterprises – organisations that are run along business lines, but where any profits are reinvested into the community or into service developments. Employees are often stakeholders or shareholders.

Nurses are not automatically business minded and those seeking to follow the example of the existing entrepreneurial nurses have to know about employment law, understand and handle finances, sort out pension and insurance issues, and change relationships with nurse and doctor colleagues.

Updated: September 2006

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