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Skill mix in primary care

BMJ 1994; 309 doi: (Published 16 July 1994) Cite this as: BMJ 1994;309:195
  1. R Bhopal
  1. Department of Epidemiology and Public Health, School of Health Care Sciences, Medical School, University of Newcastle, Newcastle upon Tyne NE2 4HH.

    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 …

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