Can nurses drag healthcare into the 21st century?

10 April 2012

Let me put my neck on the block and say that GPs cannot cope. Not because of any shortcomings on their part, but simply because they are swamped. Demand continues to outweigh supply and it's not going to get any better.

Government policy aims to improve access to health services at convenient times, but official figures released last week showed that patients are still waiting more than two days for a GP appointment. We have to look at other ways of providing basic health-care services.

Many of us have been recommending people make better use of their pharmacists and even the practice nurse instead of demanding to see a doctor. Most GP consultations do not actually require a GP to handle the query and could be quite competently managed by an allied health worker. But there is still a pervading public attitude that "doctor is best", and anyone else falls short of the mark. I hope this is going to change.

In what I think is a bold, innovative move, Boots is running a pilot scheme offering a nurse-led health advisory service from its stores as part of a drive to improve access to local health services. I suspect a number of other companies will soon follow suit. Now all those minor enquiries that take up most of the day's appointments can be dealt with elsewhere, leaving GPs to deal with the genuinely ill patients, as they are so well trained to do.

Yet, incredibly, the "fuddy-duddy, unwilling-to-move-with-the-times" British Medical Association's GP committee is already announcing its disapproval, asking: "Why would you see a nurse whom you don't know when there are already nurses available at your local surgery, backed up by a doctor?" Well, BMA GP committee, as any patient will tell you, you can't get an appointment, and you never see the same person twice anyway. So a quick, convenient and above all accessible nurse-led service from a high street pharmacist seems to me to be a godsend.
As usual, the medical profession drags its heels over anything it sees as maverick, new or that may take away some of the importance and status it feels is due to it (I'm allowed to say this, I'm a doctor). Sexual health screens, travel vaccines, basic health advice, mole checks, giving up smoking and obesity advice as well as simple health checks can all be done quite successfully by competent nurses, and if they encourage more people to take a greater interest in their own health by getting the occasional blood pressure or blood glucose check, then I heartily embrace the idea.

Oh, and no need to worry about the quality of information offered — you can guarantee these nurses will be so heavily weighed down by protocols that they won't be able to lift a finger without all the relevant boxes being ticked. But combined with the knowledge base of pharmacists, the public will have access to a broad and extremely useful service that should start to drag healthcare into the 21st century.
Follow me on Twitter @DoctorChristian

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