General Practitioners and Nurses Collaborating in General Practice

Abstract

In 1998 the Fremantle Regional Division of General Practice (FRDGP), Silver Chain and the Health Department of Western Australia (HDWA) initiated an eleven-month trial which aimed to increase clinical integration by establishing professional partnerships between GPs and nurses. The project placed nurse in four general practices where they consulted with patients and undertook other activities that helped clarify nurse and GP roles within these partnerships. In addition to exploring some of the processes underlying development of partnerships, the project reported direct benefits for all stakeholders. For patients these included improved access and better quality of care. At an organisational level Silver Chain and general practices reported increased service provision and efficiency, additional promotion and marketing opportunities, improved networks with other providers, and opportunities for new business developments in service provision. From the professional practitioner perspective, doctors and nurses reported improved knowledge about the other profession and that the trial was an opportunity to explore role developments in the general practice context. Implications for expansion and development of a nursing role in general practice were discussed. The results suggest that further development of effective nurse/GP partnerships requires collaborative planning, close monitoring, and ongoing support for the processes of improved teamwork.

An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice

“…A lack of clarity around nursing roles and scope of practice were reported as clear barriers to GPs and nurses working together (Condon et al . , Lockwood & Maguire , Rosemann et al . , Akeroyd et al .…”

“…Respect and trust were overwhelmingly represented as facilitating collaboration in general practice (Condon et al . , Lockwood & Maguire , Pullon , Akeroyd et al . , Pullon et al .…”

“…It was further reported that hierarchical structures and government subsidised fee for service, were biased towards the remuneration of doctor/patient encounters (Condon et al . , Lockwood & Maguire , Pullon et al . , Finlayson & Raymont ).…”

Evolution of practice nursing in Australia

“…2004a, Le Sueur & Barnard 1993, Linn et al. 1985, Lockwood & Maguire 2000, Vincent et al. 2001, Whitecross 1999, 2000, Willis et al.…”

“…No published investigations have measured the effect that specific practice nurse interventions have on service delivery, consumer satisfaction, management in general practice or patient health outcomes in the Australian context. A limited number of short‐term trials have demonstrated positive outcomes following the placement of community nurses within general practices (Lockwood & Maguire 2000, Waldon 2004). In the UK, however, early trials of the efficacy of practice nurse interventions have shown positive health outcomes in chronic disease management (Campbell et al.…”