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Report reveals failings at 'risky' nurse led practice


Failures at a Norfolk health centre highlight the need to understand the “significant risk” of nurse-led primary care practices, according to the author of a damning report into care failings.

NHS East of England commissioned an independent report following four serious incidents, a patient death and the suspension of two GPs at Downham Market Health Centre in 2010-11. The report, published last week, found there was a “serious deficiency” of safe care and a “complete breakdown” in monitoring and accountability arrangements.

A single nurse was left fulfilling the lead management role at the practice, as well as a clinical role. This nurse then went on sick leave amid allegations of bullying “from most staff members, including GPs” and the suspension of two GPs left the practice relying on locums.

Care at the practice “may have resulted in harm” to patients, it said. “Despite the practice sliding into managerial failure, the staff held it together, going well beyond their job descriptions to ensure the provision of care to their patients.”

Both NHS Norfolk and Norfolk Community Health Care, which ran the practice until April, were criticised in the report, which said Downham Market “was allowed to slip beneath the managerial radar of both organisations”.

Former Royal College of General Practitioners chair Professor Mike Pringle, the report’s lead author, told Nursing Times the organisations should have been aware of the “significant risks” involved in nurse-led practices.

He said: “I’m not suggesting that nurse-led practices can’t work, but it is a more difficult model to make work… it requires making sure that the right structure is in place.”

Nurse-led practices needed to be led by a team of nurses, rather than an individual, and should have GPs with a “long term commitment” to the practice, rather than locums, he said.


Readers' comments (8)

  • What the hell? Am I missing something here? In what way are 'Nurse led practices' dangerous? Or is this yet another combination of poor journalism and Nurse bashing?

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  • That's right blame the nurses- all GP practices are amazing aren't they? The problem is there should be standardised processes that all general practices should follow and adhere to and stop all the dodgy issues in all general practices. But at the end of the day they are businesses so they can do what they want really and really soon they are going to be in charge of billions of our hard cash...............

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  • nurses in practice always go above beyond
    in thier dedication to the patients, reaching targets to line the gp pockets! do they never get rewarded for their effortd? not in my experience! they just get bullied to do more, get qulaifications take on more responsilbilities and get paid the same!!! GP are only interested n their own pockets. I agree with the above - it is their business and therefore they can do what they like. GODS.

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  • “I’m not suggesting that nurse-led practices can’t work, but it is a more difficult model to make work"

    can someone please tell me why?

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  • Exactly Louise!

    Evidence has proven that Nurse led services are often cheaper, better and can offer more than GP led services.

    Sounds like a bit of Nurse bashing nonsense to me.

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  • There's not nearly enough information in this piece to be able to make any kind of informed opinion on the subject.
    What does strike me is the fact that the lead nurse needed to go off sick, 2 GP's were suspended and yet the 'nurse led' model is being held as a reason for failure.
    Doesn't hang together by my estimation!

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  • Interesting to read that although the headline shouts "nurse led", 2 GPs have been suspended! Another attempt to slag off nurses.

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  • michael stone

    mike | 4-Oct-2011 1:25 am

    I don't think you are missing anything - as a clear description of who was doing what, and who was supposed to be 'running' that practice, that report is worse than useless !

    I wonder if my usual assailant will immediately chip in with 'you are an idiot, Michael Stone' to a post which agrees with mike ? I'm waiting !

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