Nurses demand PBC involvement

Practice nurses feel GPs are preventing them from becoming involved in practice-based commissioning (PBC).

Royal College of Nursing primary care adviser Lynn Young said PBC was heavily dominated by doctors at the moment and the college had received reports of nurses showing interest but having 'doors shut in their faces'.

Only about a third of the 200 nurse delegates at the Practice Nurse Association conference in St Albans, Hertfordshire, this month said they were involved in PBC or knew what was happening locally.

About 50 per cent of delegates had special interests and 30 per cent wanted to develop new services. Almost all wanted to develop new skills if the opportunity was granted to them.

Ms Young said: 'Why should PBC be a medical activity? This is too important to be left to doctors. At the RCN we are struggling to find a way to deal with this.'

Ms Young said that the college was holding numerous workshops around the country teaching nurses about PBC. It also intends to recruit nursing directors for the new PCTs and SHAs to promote nursing involvement in PBC locally.

However, Ms Young said reconfiguration was hampering PCTs' ability to manage the PBC process and that many nurses were distrustful of GPs after they had shown reluctance to share quality framework profits.

One delegate said she was doubtful PBC, if left in GP hands, would improve health inequalities because doctors only responded to incentives.

However, Dr Peter Smith, president of the National Association of Primary Care (NAPC) said a survey of 105 members showed 86 per cent were involved in PBC but 36 per cent of those involved were receiving no incentives, despite a directed enhanced service (DES) for PBC (GP, 30 June 2006).

'What else is interesting is that only 2 per cent felt a lack of incentives were a barrier to PBC. The biggest barriers they perceived were PCTs being obstructive, data quality and time.'

The level of involvement in PBC in the NAPC survey far exceeds the findings of a GP survey last month that rated involvement at 42 per cent.

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