Authors' recommendations: Two high quality reviews (Laurant, 2004; Horrocks, 2002; details in Appendix Table 4) provide core evidence for the effects of substituting nurses for doctors in primary care for unselected patients with common problems. Two additional reviews (Dierick-van Daele, 2008; Hollinghurst, 2006; also in Appendix Table 4) explore the cost implications of the substitution. The results of these four core reviews are reiterated in Table 2 below.“…NPs provided care of equal quality to GPs and greater continuity of care would be expected when NPs work full-time.These results were achieved by NPs who had followed a training program, which equipped them to make both diagnostic and treatment decisions, in addition to the usual program of the Master in Advanced Nursing Practice (ANP). This additional input is recommended to prepare the NPs for their specific role in primary care.It cannot be assumed that similar results will be achieved by NPs working in different settings, with different groups of patients or with different level of education or experience…How primary care is provided is an important policy question and depends on the extent to which NPs gain authority. The process of implementing and evaluating ANP roles is as complex and dynamic as the roles themselves…A widespread national and international debate about the appropriate mix of skills in primary care is needed to develop greater understanding of the potential value of the NP role, and in particular, the NP in general practice.” (Dierick-van Daele, 2009)“The employment of nurse practitioners to provide first contact care in the UK is likely to cost the same or more than the employment of salaried GPs, according to currently available data. The decision to employ one type of professional rather than the other should depend on the extent to which they offer other necessary skills or fulfill other responsibilities in general practice than cost.” (Hollinghurst, 2006)

Project Status: Completed

URL for project: http://www4.va.gov/VATAP/docs/NurseLedPrimaryCare2010.pdf

Year Published: 2009

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: VA Technology Assessment Program

Contact Address: Liz Adams, VA Technology Assessment Program, Office of Patient Care Services (11T), VA Boston Healthcare System Room 4D-142, 150 South Huntington Avenue, Boston, MA 02130 USA Tel: +1 617 278 4469; Fax: +1 617 264 6587;

Contact Name: elizabeth.adams@med.va.gov

Contact Email: elizabeth.adams@med.va.gov

Copyright: VA Technology Assessment Program (VATAP)