This paper reviews the current rhetoric on changing professional role boundaries and mixing skills in general practice, particularly in relation to the general practice nurse. The issues relating to the effectiveness and efficiency of the general practice nurse role and to the professional development of general practice nurses, can be placed in a matrix, represented by parameters which relate to teamworking and to the 'doctoring/nursing relationship'. The question is asked: 'How can the reality of current nursing roles within general practice meet the rhetoric of the current NHS (Primary Care) Bill?' By providing conceptual matrices which place the key issues of general practice nursing in contingent relation, questions which relate to, for example, changing professional roles and the appropriateness of a general medical services infrastructure for primary health care can be explored — a process of contingent quality improvement.

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