GPs are likely to back a proposed directed enhanced service (DES) that would see the average practice lose £17,700 but be able to earn it back by working three extra hours a week. If they reject the offer, ministers have threatened to cut their income by double this amount.
The DES requires additional GP time, and does not mention nurses. But GPC negotiator Dr Stewart Drage said: ‘If practices choose to do the DES, all practices, given that they are expected to provide routine services, are likely to want to have nurses around.'
RCN practice nurse association chair Kate Howie said: ‘Nurses may have to work different hours even if they don't work extended hours. We may find GPs working in the evening leave a gap in the day that nurses need to fill.'
Lead practice nurse for Sussex Downs and Weald PCT Jenny Greenfield said: ‘Practice nurses are feeling very unloved. Just like QOF, this looks like a change that will be imposed without consulting nurses. There was a local GP meeting on extended hours last night, but practice nurses were not invited. They should be involved.'
Catherine Baraniak, a nurse partner in Derby, called for a more flexible DES that allowed practices to use GPs or advanced nurses to cover extra hours.
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