A shake-up in the NHS could see nurses compete with doctors' surgeries by running their own independent organisations offering more services to patients.
A report by health minister Lord Darzi will say nurses should be more entrepreneurial and create "businesses" offering physiotherapy, immunisation programmes and health checks funded by the NHS.
They will be encouraged to run their own social enterprises for the NHS which could even involve employing NHS doctors, in a bid to shake up the GP surgery system.
The plans will include the provision that nurses who leave local primary care trusts to run such social enterprises will be able to keep their NHS pensions.
Lord Darzi will say staff should be given a "right to request" that a nurse-led organisation be created. Primary care trusts must then consider the request, and if agreed on, a new independent NHS organisation would be established to provide services to patients using NHS resources.
Backing the proposals, Gordon Brown said: "Building on the success of the foundation trust model in the NHS, which sees a million people actively engaging in the governance of their local hospitals, I believe that over the next decade we will see a growing proportion of our services provided by independent public service providers and social enterprises."
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Does this sound like a good idea to you? Would you like to create your own business? Your comments: (Terms and conditions apply)
"I think this is an excellent idea for those nurses who are up to the challenge of providing a patient-centred service tailored to individual needs" - V Henry, N15
"I think this is a great idea. We can still have our limitations monitored by ensuring nursing registration bodies keep up with changes. This means reflecting the changes in codes of practice and in accordance with DH intiatives and directives. The business plans even encourage nurses to employ doctors who are governed by key principles of the medical council. So, having this skillmix in an entrepreneurial atmosphere means better working partnerships as opposed to a dictatorial stance or high esteem always projected by doctors or in favour of doctors. Even without this idea people are still being treated outside the NHS on a private basis. The introduction means more choice, reasonably good pricing for the feel of private care and timely care to mention a few. Lastly this proves respect for other health disciplines as autonomous practitioners working collaboratively to give a fresh look to providing care." - Jim, London
"YES! But who will decide my limitiations on professional development as my current employing GP does (eg, nurse prescribing that requires a medical supervisor)?" - Lynne Hayward, Manchester
"This sounds like insanity. No equity of service across the land and a whole host of people developing business plans, clinical governance structures and no extra money. What about the rights of citizens to NOT be treated outside the NHS? What on earth is wrong with letting innovation etc florish in the existing structures instead of yet more change for change sake!" - Jill Rakowski, Berkshire
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