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Nurse teams could solve out-of-hour GP concerns


The majority of out of hours primary care could be provided by community nurses and nurse practitioners, Scottish politicians have been told.

A report by the Scottish Parliament’s health and sport committee highlights the role community nurses and nurse practitioners could play in providing out of hours primary care.

The committee was told the Grampian Out of Hours Medical Service used a team of advanced nurse practitioners to deal with remote and rural areas and, since 2004, only one patient had said they preferred to be seen by a doctor.

The service’s lead nurse, Linda Harper, told the committee: “As far as the six dimensions of quality are concerned, we certainly provide safe, effective, efficient and person centred care, which for patients is the most important thing.”

The scheme is now the subject of research commissioned by the Department of Health in England, which the committee reported was expected to find approximately 70 per cent of patients could be dealt with out of hours by multiprofessional teams, supported by GPs and telemedicine.

Out of hours provision in the UK was mostly given up by GPs in 2004. In England, the responsibility for filling the gap was handed to primary care trusts leading to concerns about the use of overseas doctors and nurses.

Concerns about access to primary care out of hours have also been raised in Scotland, particularly in remote rural areas.

Royal College of Nursing primary care adviser Lynn Young told Nursing Times that England should take note of the Scottish committee report. She said it was “ignorant” to view out of hours provision by nurses as being of poorer quality than that given by doctors, and it was about getting the “blend of nurses and medicine right”.

She said PCTs and politicians needed to “open [their] eyes, and look at what is working well”.


Readers' comments (7)

  • Yep cheap option. What would happen if all the nurse practitioners and community nurses told the scots parliament to get stuffed!?

    Lynn Young is a typical RCN lackie. Why the hell should nurses do the jobs that Dr's were given the option of opting out of? Whilst being given a huge pay rise in the process.!

    Any nurse who signs up to do this is a muppet.

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  • Already happening where I work, and Lynn Young, it is working because NP's are rarely able to seek appropriate and safe support from medical colleagues due to the 'service' being hammered by management. That does not mean working well. In defence of the GP's they are also unhappy but at the same time hold the NP's in high regard.

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  • Doesn't this say a lot about Dr's. Opting out of out of hours care at the drop of a hat. It speaks volumes about their diminishing sense of duty.

    How do Dr's sleep at night knowing a nurse is administering life or death advice to their patients. Quite simply many many GP's just don't care.

    And i'm well qualified to say this having worked with GP's for the last 8 years and also working within OOH care. I've seen situations and standards of care involving GP's which were criminal...literally!

    Hypocratic oath....hypocritical would be more appropriate.

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  • Martin Gray

    NPs are a cheap solution to the OOH problem, and the reason the role exists at all is because it was targeted at reducing junior doctor hours and to free GPs to see more 'needy/relevant' patients ( in other words deal with the day to day dross); the fact we also end up being asked/told to deal with the chronic disease management as well seems to have skipped attention.

    Actually, as an ANP working in primary care, I enjoy the autonomy and being able to use the clinical skills I have acquired; I just believe we should be properly remunerated for the work we do. It gauls me that managers get paid ridiculous salaries, with perks, yet can't/don't perform well enough to justify them, or their jobs for that matter.

    But, bear this in mind, whichever party gets into power today they have all one aim in common, to reduce the deficit. There have already been reports that management is planning to reduce the number of clinical staff and cut salaries by reducing the grading of nurses(replacing band 6 with band 5; be the same nurse though).

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  • First thing, I absolutely agree that this is a despicable cheap option where Doctors have been given less hours/duties/responsibilities and more pay, and Nurses are being expected to fill the gap without the pay.

    However this CAN be a good thing too. Obviously Nurses are able to do this job, we have the skill, the education, technical ability and autonomy to be able to do this.
    It will be a good thing for Nursing if this was finally recognised, and we start demanding a GP's pay for it.

    If you want us to do the job, pay us the proper wage. It is as simple as that.

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  • P.Damien, I have to take you up on one of your comments though.

    'How do Dr's sleep at night knowing a nurse is administering life or death advice to their patients.'

    What exactly do you mean by this? Are you suggesting that a Nurse is not capable of this role? In many cases I would prefer a Nurse to give me advice rather than a Doctor.

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  • What i meant was that Dr's sense of duty and duty of care towards patients is vanishing fast. Not that nurses can't do the job...because they obviously can and in some cases i would suggest better.

    Nurses who do these duties though are hardly helping the cause of nursing to better itself professionally. They are working for peanuts compared to medics and they are doing the same job! Fools.

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