Value of practice nurses questioned

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FUNDAMENTAL questions need to be asked about the value of practice nurses, the Department of Health has been told after a study has shown their numbers have shot up in the past three years.

Practice nurses are in the main relatively well paid half of them are on the rate for top ward sisters or higher and since 1990 and the new GPs contract their numbers have risen from below 10,000 to more than 15,000 in England and Wales.

But the increase raises questions over whether they represent good value for money and are a cost-effective way of providing care, according to the study, commissioned by the Department of Health from the Social Policy Research Unit at the University of York.

The survey shows that 99 per cent of practice nurses are female, 97 per cent are white, and a third took a break from nursing before becoming a practice nurse.

Their tasks range from giving the immunisation and vaccinations, for which GPs receive target-based payments, to visiting people aged over 75 for checks required under the GPs' contract. Some run clinics for asthmatics and diabetics, whose care is increasingly being transferred from hospitals to GPs' surgeries.

Nearly all run general health promotion clinics while half are involved in minor surgery, with smaller proportions running child health clinics, family planning and ante-natal or post-natal classes. About half of them visit patients at home. Practice nurses have proved popular with GPs who can directly control their work, but the report says that work overlaps with that of other health workers.

Nurses Count: A National Census of Practice Nurses; SPRU, University of York, York YO1 5DD; pounds 6.50