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The new GMS contract - GPs voted YES

Marilyn Eveleigh,
Consultant Editor

In a previous copy of NiP, I suggested that nurses should be fully involved in advising the practice on aspects of the GP contract - nurses will be responsible for ensuring the quality and organisation of clinical care, as well as planning for the targets set. Fifty per cent of the funding is awarded for quality.
This contract is essential reading for all primary care nurses, especially practice nurses, and I urge you to see a copy. It is available on Here are a few goodies that you should consider:

  • The contract is a practice contract, not a GP-specific contract. This means that frontline nurses can and should take on a business interest in the surgery. It allows nurses to become partners in the practice or to form a limited company, employing a GP to provide sessions.
  • Nurses will be able to become specialist providers of services such as sexual health, vaccinations and immunisations, and minor surgery, as some practices may choose not to offer certain services to patients - these specialist nurses can become alternative providers.
  • Many services will need remodelling and new, more targeted ways of working must be introduced. The lowest target for payments for chronic disease management is set at 25% (the highest is 70%) - most practices reach about 30% at present. The emphasis should be on those patients who are likely to have greatest gain from a review - and not those who have regularly attended with a stable disease. What is your coverage of chronic disease patient reviews? Find out and start planning ­alternative ways of reaching those who do not attend.
  • To increase coverage will require teamwork and better skill mix. So, in comes a one-stop service for patients where they can have their disease monitored and their immunisation status considered, family planning needs met and get health promotion advice, all at the same consultation. Talented and experienced practice nurses will need to delegate basic and routine tasks such as electrocardiogram and spirometry measurements to healthcare assistants - this will free them up for interpretation of results and clinical management or appropriate referral of the patient.
  • Such expanding roles and responsibilities will require the support of PCT Lead Nurses for professional advice, access to appropriate training and continuing professional development. They will be involved in the interpretation and analysis of ­clinical data from practices. It is likely that PCTs will facilitate more joint working across practices for practice nurses.

All these issues are outlined in an NHS Confederation briefing paper The role of nurses under the new GMS contract - ­available from 0870 444 5841 or email:

The NiP Events conferences in London (September) and Birmingham (October), as well as those planned for the new year, will devote sessions to outline, debate and share the role of nurses and this contract. I hope you are coming! It will be the most amazing collection of key professional, political and practical opinion leaders that you will ever get in just 2 days - and it is completely free!! Programmes are available from and I really urge you to preregister, as places are limited. There is a registration form in this issue or you can call Nikki on 020 2714 0504 for more information. See you there!