The primary health care team : report / of a joint working group of the Standing Medical Advisory Committee and the Standing Nursing and Midwifery Advisory Committee.

  • Great Britain. Joint working group on the Primary Health Care Team.
Date:
1981
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Licence: Open Government Licence

Credit: The primary health care team : report / of a joint working group of the Standing Medical Advisory Committee and the Standing Nursing and Midwifery Advisory Committee. Source: Wellcome Collection.

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    higher than average, the establishment of additional practices was prevented by the MPC despite considerable evidence of an inadequate level of services in the area. (This point is discussed further in Chapter 5.) In this connection we regard thg recent report of the joint DHSS/GMSC* Working Party on Under—doctored Areas”~~ as a useful starting point, and welcome the proposed introduction of an improved initial practice allowance in practice areas considered to have inadequate GP services. However we also consider that further study of possible incentives to attract GPs into such areas would be valuable. 2.19 Two aspects of deployment of nursing staff were mentioned to us; the first was in relation to the need for a 24-hour, 7 days a week nursing service in the community to OSS Base oat ol en aemvice on the same lines as that provided by GPs. Some health authorities already provide a night nursing service and weekend cover, but for others there may be considerable resource problems if such a service needs to be newly introduced. We consider that the aim must be for every health authority to provide adequate basic night and weekend nursing services, although we recognise that this may take some time to achieve everywhere. 2.20 The second aspect of staff deployment which was mentioned to us was in relation to the balance of registered and enrolled nurses and auxiliaries ark the team. The range of duties undertaken by nurses working in the community is considerable, extending from those within the competence of a nursing auxiliary working under supervision to those duties which invariably require execution by a registered nurse with district nurse training who is responsible for the assessment of the patient's need for comprehensive nursing care, and including the use of management skills to Similarly, there are some tasks within the health visitor's remit which can be delegated to less qualified staff, so long as such activities are monitored by health visitors. The need to make proper use of the skills and experience of staff trained to varying levels of competence is one which we consider important, but it is often difficult to achieve. There is a need for patient-—dependency studies to be carried out, using more scientific methods. Such studies should be carried out for staff working both in the clinical and preventive fields. We found little research material to assist us in our deliberations in relation to patient-—dependency and the district nursing service, and even less in relation to the client groups cared for by health visitors. Clearly such research will take some time to accomplish, and in the meantime we consider that all Nursing Officers responsible for community services should carry out continuing appraisals of staffing requirements according to local needs. We also recognise that staff allocation and deployment levels will need to be sufficiently flexible to accommodate changes in dependency levels produced by developments in medical and nursing care, eg increased numbers of patients with catheters or cardiac pacemakers being cared for in the community. 2.21 It was also claimed that proper deployment of nursing staff was considerably hindered because some Family Practitioner Committees (FPCs) ae to provide information about the size of practice populations for which individual teams were providing services. We agree that information about the size, composition and health needs of the population served by the team is necessary, albeit on a strictly restricted and confidential basis, * General Medical Services Committee of the British Medical Association f