Open access to the practice nurse

The work of practice nurses to whom patients are allowed ;open access' was analyzed. The attendance rate for the population registered with the doctors was 964 per 1,000 patients per year. It was found that in nearly half of the attendances the nurse was the person of primary contact for the health care team and that she dealt with three quarters of these cases without referral to a doctor. Further research is required into the management of these patients by the nurse. Although it is the opinion of the practice doctors that the nurses' care was adequate, open access presents them with such a wide range of problems that their work has moved ahead of the legal restrictions placed on general practitioners concerning the delegation of work.