Randomised controlled trial comparing cost effectiveness of general practitioners and nurse practitioners in primary care
Nurses could cost the NHS less than general practitioners in certain circumstances, suggests a study from the University of Manchester in this week's BMJ.
Venning and colleagues compared the health outcomes and costs of nurse and General Practitioner consultations across 20 general practices in England and Wales. Overall, just under 1300 patients attending for same day consultations were randomly assigned to a GP or a nurse practitioner.
The results showed that consultations with nurses were almost twice as long as those with GPs. Nurses were also two thirds more likely to order more tests, carry out more opportunistic screening, and significantly more likely to ask patients to make a repeat appointment. But there were no significant difference in prescribing patterns or health outcomes for the patients treated. And patients were also more satisfied with nurse consultations, a fact which remained even after adjusting for length of time spent with the patient. And there was scarcely any difference in cost between doctors and nurses, although costs to the NHS were 12.5 per cent lower for nurses. The authors suggest that if nurses were able to shorten their consultation times or reduce the return appointment rate, they could even be cheaper than general practitioners.
Contact:
Dr Pamela Venning, Nurse practitioner and honorary lecturer, University of Manchester School of Primary Care Email: pamelavenning@gofree.co.uk