Skill mix between nurses and doctors working in primary care-delegation or allocation: a review of the literature

Impact of the 2004 GMS contract on practice nurses:

“…27 This was also true after the 1990 contract, which was influential in the development and professionalisation of practice nursing, with role development particularly apparent in the incentivised areas of health promotion and chronic disease management. [8][9][10][11][12] For some of those interviewed, the contract had not changed the type of patients they were seeing substantially, but had increased the workload associated with these patients, including a greater emphasis on using the computer during the consultation and 'box-ticking'. This may then squeeze out the more holistic and patient-centred aspects of the consultation, such as providing patients with explanations about treatments.…”

“…2 With the possible exception of Liberating the Talents, 3 practice nurses are often missing from strategic policy documents [4][5][6][7] due to their position as contracted employees of GPs. As the workforce has increased, the workload of individual nurses has also increased, with more emphasis on health promotion and chronic disease management, [8][9][10][11] particularly when these areas were incentivised under the 1990 contract. 12 The new General Medical Services (GMS) contract, including the Quality and Outcomes Framework (QOF), was a UK-wide contract implemented in April 2004.…”

Comunicación, participación y liderazgo en la percepción del clima emocional en un hospital universitario de Andalucía, España

“…En los equipos asistenciales se evidencian relaciones interprofesionales satisfactorias, especialmente para la categoría profesional de enfermería, que, según refleja la bibliografía disponible, pese al alto grado de desgaste emocional asociado a la actividad asistencial 15,23,24 que puede generar una sobrecarga del rol profesional 25 , encuentran gratificante el trabajo directo con los pacientes y establecen más vínculos emocionales dentro del equipo 26 . Sin embargo, en los equipos asistenciales no existe un proyecto común suficientemente consolidado y el reconocimiento del saber se considera óptimo sólo por parte del personal facultativo, lo que puede representar una limitación para la correcta gestión del equipo 27 .…”

UK community health visiting: challenges faced during lean implementation

“…4 Initially the evidence base for this was relatively weak but over the early part of the next decade, questions grew and several studies were undertaken which examined existing patterns of work and different models of development. [5][6][7][8][9] As the impact of an aging workforce demographic collided with a steep reduction in education commissions, and NHS pressure to reduce budgets, some organizations espoused a corporate caseload model while others developed more systematic roles for support staff, using varying mixes of staff nurses and nursery nurses. 10 As we have moved into the 21st century, academic interest has grown in achieving a clearer understanding of the impact of the introduction of differing combinations of staff in a variety of public sector roles.…”