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Thursday, 28 February, 2002, 00:29 GMT
Surgery balance of power shifts
GP
Doctors have little time to spend with each patient
A shortage of GPs could mean that many more patients see a nurse instead when they visit the surgery, suggests a British Medical Association report.

However, the proposal has run into opposition from other organisations.

Practice nurses can be found in many surgeries, but their responsibilities are limited, and historically they have been unable to write prescriptions.


Those who work within the NHS need to take a long, hard look at how they work and how they might improve the service and care they offer

Dr Ian Bogle, BMA
Under the BMA proposals, a highly-trained nurse would take much of the strain from the GP - offering advice, minor treatment and prescribing some types of medication.

Only patients needing help for more complex conditions, or a referral to a consultant, would need to see the GP.

Longer appointments

In theory, the family doctor would then be able to spend longer with them than the current average of only eight minutes per patient.

There are also hopes that more people will use NHS Direct - the government's advice helpline for minor ailments - and not trouble their surgery at all unless absolutely necessary.


The problem is that, regardless of the workforce problems we have in general practice, there will always be some patients who need quick access to a GP

Dr Maureen Baker, RCGP

BMA chairman Dr Ian Bogle said: "Those who work within the NHS need to take a long, hard look at how they work and how they might improve the service and care they offer.

"Our independent polling has found that patients want to spend more time with their GP.

"However, if they are suffering from a minor ailment, they are more than happy to be seen by a nurse or advised by a pharmacist."

However, Dr Maureen Baker, of the Royal College of General Practitioners (RCGP), warned against putting obstacles in the way of patients' access to GPs.

She told BBC Radio 4's Today programme: "The problem is that, regardless of the workforce problems we have in general practice, there will always be some patients who need quick access to a GP to assess their illness and come up with a working diagnosis and a management plan.

"This is a very complex skill. Nurses don't have those skills. GPs do.

"Patients who need that need to have quick access to GPs."

Nurse welcome

The document was welcomed by the Royal College of Nursing.

Dr Beverly Malone, RCN general secretary, said: "Nurses are keen to look at ways of breaking down traditional barriers and look at creative ways of working to improve care.

"The RCN has long argued that nurses are competent to deal with the wide range of ailments, illnesses and minor injuries that patients have."

The government has already announced that fully-trained nurses will be allowed to write prescriptions for a wide range of drugs for chronic conditions such as heart disease and diabetes, and antibiotics for infections.

The first nurses trained in this capacity should be ready to start work by April this year - but the Department of Health is as yet unsure how many have opted to train.

Liberal Democrat Evan Harris said: "The Government should not think that this is a solution to the manpower crisis, because we cannot just magic more nurses out of thin air.

"If more nurses are needed to provide extra services in GP surgeries, they will come from A&E departments and other areas of acute hospital care."

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 ON THIS STORY
The BMA's Dr Ian Bogle responds to Dr Maureen Baker
"We are not intending to make nurses junior GPs"
See also:

13 Apr 00 | Health
Patients 'prefer nurses'
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