This site is intended for health professionals only

Changing times: working together for the benefit of all

Marilyn Eveleigh

Within the close relationships in the surgery, GP partners/ employers, administrative staff and practice nurses are acutely aware of the new position of being in a Primary Care Group/Trust (PCG/T). Developing locally focused healthcare brings increased pressures, driven by additional "targets" and "new project money". In an effort to meet ongoing patient expectations and protect them from uncertainty, the strain falls on the individuals who work as the "practice team". It does not feel any more comfortable for those attached nurses who have traditionally been employed by community trusts.

In such a climate it is easy to turn to the bits of the job we like the best and avoid group dialogue for fear of further anxieties that could be raised. Yet this is the most important time for surgery teams to be sharing the burdens, voicing internal concerns and communicating effectively to support each other. There is good material to work with:

  • GP seniors have weathered previous changes.
  • New partners bring different perspectives and enthusiasm.
  • Practice nurses have developed an expertise and crucial role in delivering general medical services.
  • Practice managers are curious about new PCG/T expectations and are capable of implementing new changes.
  • Practice administrative and reception staff are eager to build on their surgery experience: a significant number want to develop as healthcare assistants.

Funding sources to provide development/education for the various groups are now amalgamating or working more closely together. Multidisciplinary opportunities are likely to be more common as doctors and nurses share workloads, utilising skills appropriately and delegating with confidence to those best placed to meet patient needs.

Such sharing can come about only through a mutual understanding. Practice nurses need to understand the culture of independent contractors, and GP employers must be aware of the scope of professional practice the nurse embraces. GPs need assistance from practice nurses to meet their contractual obligations, and practice nurses need identified support from and regular dialogue with GPs to reach their potential.

To encourage that understanding and to aid the practical application of best practice within the surgery are among the chief aims of Nursing in Practice. We hope to stimulate the sharing of learning, knowledge and perspectives among GPs and nurses.

In the spirit of fostering the above aims, this edition of the journal is a special issue planned and produced in cooperation with the Royal College of General Practitioners. It is being distributed as a supplement to the RCGP Members' Reference Book 2001/2002 (MRB), which will bring it to the attention of many thousands of doctors and of many nurses who may not have seen the groundbreaking first edition. Everyone associated with the journal is delighted with the process and results of the collaboration, and we extend our profound thanks to the RCGP. Particular mention should be made of the invaluable contribution made by the MRB's Editor, Professor J Scott Brown. I am delighted to say that Scott's input will not be lost as he has graciously agreed to join the journal's Editorial Advisory Board in a personal capacity as an independent and highly experienced GP.

We hope you enjoy the fruits of our labour.