Family Medicine Groups (FMGs) are the most recently developed primary care organizations in Quebec (Canada). Nurses within FMGs play a central role for patients with chronic diseases (CD). However, this complex role and the nursing activities related to this role vary across FMGs. Inadequate knowledge of nursing activities limits the implementation of exemplary nursing practices. This study aimed to describe FMG nursing activities with patients with CD and to describe the facilitators and barriers to these activities. A multiple-case study was performed with ten nurses practicing among patients with CD in FMGs. Five data sources were used to provide an in-depth description of nursing activities and the facilitators and barriers to the development of these activities. After qualitative data analysis, findings show that nursing activities are clustered into five domains: Global assessment of the patient, Care management, Health promotion, Nurse-physician collaboration, and Planning services for patients with CD. Activities vary depending on contextual factors identified in each case. This multiple-case study provides a clear description of nursing activities with patients with CD. There is a need for improved nursing activities and expertise in domains of activities that are less present in FMGs, such as case management and interprofessional collaboration.

The 'empowering employment principles' illustrate the features most conducive to role evolution, thus providing a tool for practice nurses and their employers to enhance opportunities for nurses to develop their role.

The provision of education for pactice nurses has been poor historically (Stilwell, 1991). Until about 1998 they had no nationally recognized qualification; as a result, courses were often provided in an uncoordinated way and varied considerably in content and quality from region to region (Prime, 2003). In addition, practice nurses have usually been independently employed by GPs and have therefore put together their training in consultation with their employers, whose priorities were naturally dictated by the demands of their practices (Carey, 1996; Hawksley, 1997). While this approach may produce nurses well trained for a particular role, there is a great disparity in educational standards and opportunities for professional development among the group.

Many nurses new to general practice struggle to access appropriate education. Sue Crossman and Gill Rogers explain a new piece of work that aims to develop a minimum standard to raise the quality and consistency of training in London This article presents a general practice nurse (GPN) education standard developed by Capital Nurse in London with an expert group of stakeholders with relevant experience in the field. The goal is to reduce variation in the content and quality of education courses that prepare nurses to work in general practice, providing a kitemark that identifies whether courses meet this standard. This work attempts to address the inequalities experienced by many nurses new to general practice, who struggle to determine the education they need to achieve competence in their role. The standard has been called the GPN ‘Qualification in Specialism Standard’ and is to be adopted and tested by Higher Education institutions across London in 2020.

Sue Crossman discusses the results of a recent survey of UK practice nurses which raises concerns about the availability of professional development support and the effects this could have on patient safety