Doug wrote
" We should be employing NPs and at the same time telling that surgeon (Mary
Hawking thread) we would be delighted to take on that subcut heparin
or whatever."
The non core services debate is about two things. First of all GPs need to make
sure they are not simply landed with more work every time the local trust comes
up with a good way of saving themselves money. Examples of this would be
monitoring anticoagulants or 2nd line RA drugs. GPs who take on this work
without a murmur of complaint may well be those who feel generally put upon and
disheartened with general practice.
The second point is that we should be able to become providers of services in
our own right. This means defining some services as being outside of those a GP
can be expected to provide. We can then develop a service in our own surgeries
for the benefit of our patients. The money we are paid to do this can be split
between the cost of an assistant to see the "extras" and profits for the GP for
providing an improved and extended service.
In summary if we choose to take on work we should be paid for it.
As for nurse practitioners I think it is impossible to generalise about them. I
have heard of extremely good ones providing first rate diabetic and asthma
clinics. I have also come across a less inspiring breed. Whether or not someone
can come up with an academic way of measuring their usefulness is not really
relevant. We know how useful our own nurse is and what benefits she can provide
for the surgery.
Ian Quigley
http://ourworld.compuserve.com/homepages/ian_quigley
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