A survey carried out by Nursing in Practice of over 1,400 primary care nurses, has found that 29% are unclear about what practice-based commissioning (PBC), means.
The policy intended to give more decision-making power over NHS resources to general practice, and allow them to design and delivery completely new services or commission others, is set to change the face of primary care.
However, the survey results show that nurses are significantly under-represented in the PBC arena. Seventy-three percent of practice nurses said they were not involved in their practice PBC plans, and more worryingly, 56% said that there were no nurses involved at all.
The main reasons given for this were that "nurses hadn't been invited to PBC meetings", that "only GPs and managers are involved", and that responders "don't know enough about it".
"Clearly PBC is not developing in the way we would like to see," commented Lynn Young, Primary Care Adviser for the Royal College of Nursing. "The RCN has been busy extolling the virtues of multidisciplinary PBC for some time now and we need to see far more progress achieved during 2008."
When asked what was preventing practices from becoming more engaged in PBC at present, 58% of nurses replied that this was down to inadequate resources available to support the workload.
This follows the results of a recent survey by the Department of Health where 76% of respondents felt that PBC had not made a difference to the way practices operate, and almost half (49%) rated the quality of managerial support provided by their PCT as "poor".
With PBC comes the prospect of more involvement with the independent sector, in the form of alternative providers. However, 62% of primary care nurses in the NiP survey felt that the introduction of private sector providers posed a major threat to the quality of general practice and to patient care.
Your comments: (Terms and conditions apply)
"No the nurses here in the practice are not involve
in the PBC. We were not even aware of it" - Name and address supplied
"It is true nurses are under represented in the pbc arena and consultation. Communication is the key to information and knowledge with all aspects of health service changes both in primary as well as secondary health. It takes good communication by all if we are to work together rather than be divided. I work with effective and communicative GPs which means I am informed of not only the process but allowed to contribute where and when necessary to the process" - V Henry, London
"I am involved in PBC, I am the nurse representative for my area. However I have realised that I have not been able to feed back much information to other nurses in the locality" - Name and address supplied
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