Monica Fletcher, chief executive of Education for Health, which offers courses in respiratory and heart disease, said she feared that, because so many GPs were achieving maximum quality points, they no longer saw the need for practice nurses to take further training.
Ms Fletcher said 80 per cent of her students were from primary care and the majority were nurses, but numbers had fallen by a third this year, while the number of students paying for themselves had jumped from 8 to 25 per cent.
The figures follow reports from some universities of an increase in the number of students paying for their own nurse practitioner courses.
Ms Fletcher said that PCTs were also slashing training budgets and resorting to in-house training or one-day courses.
'The problem is that these courses are nowhere near the quality of taking something like an asthma diploma, which is more likely to actually change behaviour,' she said.
'From the increase in numbers of people paying for their own courses, it is obvious that nurses themselves feel they need longer courses.'
Ms Fletcher said she was worried that the new GMS contract had developed a tick-box mentality and nurses were being trained in skills that would gain points rather than broaden their knowledge about a condition.
The QOF should start setting standards on the levels of training to treat chronic disease, she said. Research showed Education for Health's six-month allergy course for GPs and practice nurses improved patient outcomes but the QOF gave few points for allergy care despite its clear link to asthma, she added.
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