Professor Mark Harris Project: Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales Funding: Australian Primary Health Care Research Institute Stream Funding; and a University of New South Wales Faculty Grant

More than three-quarters of Australians have at least one long-term health condition - such as heart disease or diabetes - and about 50% of GP - patient consultations involve the management of such conditions.

To improve the quality of chronic disease care and GP workloads, there has been an increasing emphasis on the role of general practice nurses and administrative staff. The trend has been supported by policy initiatives, such as Medicare items for care plans which may involve these practice staff.

This study evaluated for the first time in Australia the impact on quality of chronic disease care of enhancing the role of nurses and practice staff. One of the largest studies of its kind, this cluster randomised control trial involved 60 general practices in urban and rural NSW, ACT and Victoria, and 2,196 patients with diabetes or cardiovascular disease.

The study demonstrated that where the role of non-GP staff was increased, the proportion of patients whose care was planned increased, referral to external services decreased, and patients assessed the quality of their care to be better. This was achieved without disruptions to how the practice team worked or reducing job satisfaction.

Confirming the positive impact of enhancing the role of general practice nurses and administrative staff, the study’s results have important implications for initiatives that support chronic disease care in general practice, including divisions of general practice programs and national and state health policies.