General Practice Nursing Alliance comments on Meeting the
Cahllenge: Report of the Ministerial Review Group
We welcome the opportunity to comment on the recently
released MRG report.
We would like to do this first in general terms, around some of
the key themes and then address some specific
recommendations.
Themes
The following themes all have a direct impact on the quality of
care we can deliver and have our full support.
• Putting patients at the centre of new models of care,
working towards seamless transfer of care across the sectors as
opposed to discharge from one to the other and providing care where
it is needed, closer to the home
• Doctors, nurses and other health professionals playing key
roles in decision making
• Increased focus on patient safety
• Building a sustainable workforce
• Shifting resources to the frontline and reducing
duplications of functions across the country
Recommendations
Closer to home: New models of care
The development of clinical networks, sharing electronic records,
and working together to share costs and resources, across the
sectors are all sound recommendations that we support.
Improving patient safety and quality of care
Rationalising the current quality improvement initiatives
and using new quality initiatives, such as QI4GP as a starting
point, has our support, as does the scaling back of the current PHO
Performance Programme. We would like to see Adverse Event Reporting
included in this new Quality Agency.
Enhancing clinical leadership
Recognition and support of health care leaders is vital, and the
measures suggested by the MRG are positive and tangible. Including
courses on leadership development at undergraduate level will help
to ensure excellent and effective leadership qualities are
developed within health education at all levels. We also agree with
supporting and encouraging productive cross-sectorial
partnerships.
Initiatives to increase elective surgery
Primary and hospital sector clinicians in partnership with
managers, sharing their specialist knowledge and making decisions
regarding appropriate allocation of services continues to build on
the cross-sectorial relationships.
Clinical leadership in primary care
The recommendation to reassess the funding models and allowing
primary care providers to choose an appropriate skill mix of
nurses, GPs, community pharmacists and nurse practitioners all
adding to the primary health care team is supported.
National Health Workforce Board
The recommendation of one pan professional workforce board is
supported and it is essential that primary care nursing be
represented on it.
Reducing waste and bureaucracy
We agree that GPs should have the choice of PHOs, and that new PHOs
should be permitted under the stated conditions. There is some
concern around reducing the management fee paid to smaller PHOs
without also looking at the cultural make up of these PHOs. We
would not support reducing management fees if it also resulted in
reducing services to smaller high need populations.
Ministerial and ministry committees
We support the rationalisation of the current committees and
advisory groups but are concerned that the demise of the Primary
Health Care Nursing Expert Advisory Group could results in Primary
Care Nursing having less of a voice. We would like to recommend
that the Nursing Reference Group have primary care representation
on it.
Omissions
We would have liked some recommendations around preventative health
care.
Conclusion
We have not commented on every recommendation, specifically not on
the restructuring and the formation of a National Health Board but
agree that this is necessary.
We applaud the huge amount of work that has resulted in this
thorough report, the clear format and recommendations.
We look forward to being involved in the further development and
implementation of these recommendations in the coming months.
Ros Rowarth
Chair General Practice Nursing Alliance