Teams and seams: skill mix in primary care

Teams and seams: skill mix in primary care ¶The study described in this paper is set against a background of rapid changes in primary (community) care delivery in the United Kingdom (UK) and consequently the methodology of the study has been shaped by three broad issues — workforce changes, increase...

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Bibliographic Details
Published in:Journal of advanced nursing 1998-11, Vol.28 (5), p.1120-1126
Main Authors: Jenkins-Clarke, Susan, Carr-Hill, Roy, Dixon, Paul
Format: Article
Language:English
Subjects:
attitudes to delegation
Chronic illnesses
Community Health Nursing
Community nurses
Delegation
Disease management
General practitioners
Health visiting
Hospitals
Humans
Immunization
Nurses
Nursing
Patient Care Team
Practice nursing
Primary care
Primary Health Care
Skill mix method
Teams
United Kingdom
Workforce
Workload
Workloads
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Summary:Teams and seams: skill mix in primary care ¶The study described in this paper is set against a background of rapid changes in primary (community) care delivery in the United Kingdom (UK) and consequently the methodology of the study has been shaped by three broad issues — workforce changes, increase in workload and changing roles and boundaries. Ten ‘ordinary’ general practices (general practitioners (GPs) and the ‘attached’ community nurses) participated in the study and a large amount of data were collected over a 2‐week observation period. Three study objectives are described, relating to workload, delegation and attitudes to delegation. The characteristics of the workload of the three main groups of community nurses (practice nurses, district nurses and health visitors) are described and compared. Thirty‐nine per cent of all the GP consultations (836) had a delegatable element and 17% were deemed to be delegatable in their entirety. General practitioners most frequently referred to delegation to practice nurses in the current team and nurse practitioners in an enhanced team. The study identified the activities most amenable to delegation to these two groups of nurses. Attitudes to delegation were sought through focus group discussions, with reservations being expressed by both doctors and community nurses. This study provides evidence that GPs are prepared to delegate a considerable proportion of their workload; this clearly has implications for the nursing profession.
ISSN:0309-2402
1365-2648
DOI:10.1046/j.1365-2648.1997.00388.x