Nurse-led practice is a model for change

Primary care in the UK has long been dominated by GPs who have clung on to the power – and money – for decades. But a pioneering group of nurses has shown that turning conventional thinking on its head can have a positive impact on patient outcomes and experience of care.

Nurses are very much in charge at the Cuckoo Lane Surgery in Ealing, west London, having overcome initial resistance from some local doctors. Patient numbers are rising, and a recent inspection by the Care Quality Commission saw the nurse-led service receive an ‘outstanding’ rating.

Even doctors have realised they have much to learn from nursing staff

The model of care on offer is different to that typically found in the nation’s surgeries. Here, patients are much more likely to see a nurse practitioner than a GP, with around four in five people assessed, diagnosed and referred without seeing a doctor.

This is not an argument for nurses to take over general practice, but for more flexible thinking around the delivery of primary care. Our current model of GP-led practices works for many, including large numbers of practice nurses, but it does not produce the best results for everyone. In part, this is because too many decisions taken by GPs are driven by financial incentives; by contrast, the Cuckoo Lane practice is a social enterprise that does not make a profit.

This new model is hard to argue against given the success of the nurses in Ealing. The practice enjoys the highest satisfaction rates among surgeries in the area, with almost 100% of patients saying they would recommend it to family and friends. Staff are happy too, and even doctors in the area have realised that they have as much to learn from nursing staff as the other way round.

One of the nurses involved in running the Cuckoo Lane Surgery says she hopes their story will inspire others to follow suit, improve patients’ experience of primary care and help develop staff from all professional backgrounds along the way.