BMJ 1994;309:195-196 (16 July)

Letters

Skill mix in primary care

EDITOR, - Iona Health emphasises that decisions on changes in skill mix should be driven by needs and not costs.1 At a time when demand for services is outstripping supply, however, an eye to costs is wise. The rapid development of the role of practice nurses was spurred by the availability of finance (reimbursement of 70% of the salary costs; the nurses perform fee for service tasks; and reimbursement for health promotion work) at least as much as by patients' needs. Practice nurses have been shown to be effective and popular with patients. Whether they are cost effective, however, is another matter.

Health mentions that nurse practitioners in Burlington, Canada, saw only half as many patients as doctors and that Stillwell saw patients at 20 minute intervals. In a study by Fallon et al in Glasgow,2 where walk in clinics were held by nurses, the consultation time available was 15 . . . [Full text of this article]


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Relevant Article

Skill mix in primary care
I Heath
BMJ 1994 308: 993-994. [Extract] [Full Text]

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