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Teams and seams: skill mix in primary care
S Jenkins-Clarke1, R Carr-Hill, P Dixon
1Centre for Health Economics, University of York, England.
Journal of Advanced Nursing
|December 5, 1998
Summary
General practitioners (GPs) can delegate a significant portion of their workload to nurses. This study explored delegation in UK primary care, revealing potential shifts in nursing roles.
Area of Science:
- Healthcare Management
- Nursing Practice
- Primary Care Research
Background:
- Rapid changes in UK primary (community) care delivery.
- Key issues include workforce changes, increased workload, and evolving professional roles and boundaries.
- Ten general practices participated, involving general practitioners (GPs) and attached community nurses.
Purpose of the Study:
- To examine workload characteristics of community nurses (practice nurses, district nurses, health visitors).
- To assess the potential for delegation within GP consultations.
- To explore attitudes towards delegation among GPs and community nurses.
Main Methods:
- A 2-week observation period in ten UK general practices.
- Data collection focused on workload, delegation feasibility, and attitudes.
- Focus group discussions were used to gather qualitative data on attitudes to delegation.
Main Results:
- 39% of GP consultations had a delegatable element; 17% were entirely delegatable.
- General practitioners most frequently considered delegation to practice nurses and nurse practitioners.
- Identified specific activities suitable for delegation to these nursing groups.
- Both doctors and nurses expressed reservations about delegation.
Conclusions:
- General practitioners are willing to delegate a substantial part of their workload.
- The findings have significant implications for the evolving roles within the nursing profession.
- Delegation presents opportunities and challenges in UK primary care settings.