GMS architect says 'use nurses instead of GPs'

One of the principal architects of the GMS contract believes practices can offer 50 per cent more appointments if they cut GP numbers and recruit more nurses.

Former GPC deputy chairman Dr Simon Fradd, says practices can dramatically increase productivity by reversing the traditional balance between nurses and GPs.

A practice of 7,000 patients could operate with a single GP alongside one advanced 'first-contact' nurse for every 1,200 patients, and further support from other practice nurses and healthcare assistants, Dr Fradd believes.

The model would cut the number of GPs required for a practice of this size by 75 to 80 per cent, and triple advanced nursing staff.

Rather than 'doing GPs out of a job', Dr Fradd believes his plans will liberate them to take on additional work transferred from hospitals, and to take on practice-based commissioning (PBC).

'GPs have said they are too busy to take it on, and PCTs have not had the imagination to make it work, but this solves these problems,' said Dr Fradd.

'I have always felt nurses could do more - this is something I have been developing over 20 years,' he added. 'I hope GPs will look at this model and say "I can reduce my workload and bring more work out of hospital".'

With former GPC chairman Dr John Chisholm, another key figure behind the GMS contract, Dr Fradd is a director of Concordia Healthcare, a firm that runs two practices in southeast London.

The firm uses advanced nurses to triage all callers who want same-day GP appointments, and has found the majority of calls can be dealt with by nurses. It is conducting a review on how GPs can be re-deployed.

Jenny Aston, chairwoman of the Nurse Practitioner Association at the Royal College of Nursing, said: 'There is huge scope for using nurse practitioners in this way and putting GPs back in a consultant role.'

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