Nurses as NHS gatekeepers

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7356.165 (Published 20 July 2002) Cite this as: BMJ 2002;325:165

Nurses tend to use social rather than medical model of care

  1. Annabelle L Mark, professor of healthcare organisation (a.mark@mdx.ac.uk)
  1. Middlesex University Business School, London HA5 5AG
  2. University of West Indies, School of Clinical Medicine and Research, Queen Elizabeth Hospital, Bridgetown, Barbados, West Indies

    EDITOR—The BMA's suggestion that nurses might act as gatekeepers1 is not supported by the evidence from a three year study of NHS Direct West London linked to a cooperative population of 0.9m.2

    Although the computer triage based on the medical model is intended to manage and control demand, evidence suggests that when nurses stopped being employed by the cooperative and became employees of NHS Direct, general practice referral patterns changed considerably. In particular, requests for visits by a general practitioner have …

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