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Cecilia Moretti, PHC RIS
In the international context of shifting priorities, from acute to primary care focused models of health service provision, the role of general practice has assumed a central role in Australian governments’ thinking about how to move forward. The new face of general practice involves patient-centred care provided by GP-led, integrated primary care teams, with practice nurses (PNs) occupying an increasingly important place within these teams.
Annual Survey of Divisions (ASD) data for 2004-2008 show PN numbers increasing by 42%, from 4 987 to 8 575 over this four year period. Simultaneously, the proportion of practices engaging PNs increased from 37% to 54%. While these increases were evident across all regional categories, non-metropolitan practices were much more likely to engage PNs than their metropolitan counterparts. Initial funding through the Nursing in General Practice Initiative specifically targeted non-metropolitan areas where workforce pressures were most evident. However, with the subsequent extension of program funding to all regions, non-metropolitan practices have remained the primary engagers of PNs. This signals that practice nursing is a highly valued, tried and tested commodity in these workforce-strapped areas.
Divisions of General Practice are also increasingly engaging PNs to participate in their health programs. Between 2004 and 2006, the proportion of Divisions engaging PNs rose from 5% to 19%, hovering at around 22% over the next two years (see Figure 1). While these proportions appear to have stabilised, PN FTE (full-time equivalence) has increased steadily from 6.71 to 33.49 FTE over the same period (see Figure 2), indicating that among Divisions engaging PNs, level of use is increasing.
Considerable variation exists in the actual Divisions reporting PN engagement, so it is not the same committed Divisions reporting each year. Between 2006-07 and 2007-08, around half of participating Divisions opted out and a similar proportion of new Divisions opted into engaging PNs. It is possible that PN movement from Division to practice-based employment may account for some of this variation, as nurses consolidate their value from a general practice business case perspective.
For more information view the presentation, The evolving role of practice nurses in Australian General Practice: 2004-2008 available on-line at <www.phcris.org.au/publications/presentations.php#431>
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