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17. The financial impact of clinical task substitution between practice nurses and GPs in New Zealand primary care centres

Author

Hefford, Martin, Love, Tom, Cumming, Jacqueline, Finlayson, Mary P., Raymont, Antony, Hefford, Martin, Love, Tom, Cumming, Jacqueline, Finlayson, Mary P., and Raymont, Antony

Abstract

AimTo describe the financial impact on practice owners of increased clinical task substitution between practice nurses and GPs in New Zealand (NZ) primary care settings.MethodCase studies of 9 primary health care centres involving: interviews; collation of service and financial information; and nurse and GP diaries covering 1826 consultations. Results were compared with previous NZ large N survey results to develop a model predicting the financial impact of task substitution. ResultsThe proportion of general practice primary care consultations undertaken by nurses varied from 4% to 46% of total recorded consultations. The actual financial impact for a practice owner of substituting more nursing time for GP time is highly dependent on the following variables: nurse cost per minute relative to GP cost minute; nurse consult duration relative to GP consult duration; nurse consult revenue relative to GP consult revenue; and the proportion of nurse consults also requiring GP time.ConclusionPractice nurses can (and in some practices in NZ, do) provide a broad set of primary care services, including undifferentiated general consultations. For some practices, increasing the proportion of nurse consults and reducing GP consults, would result in significantly improved profitability—for others, the opposite applies. Clinical task substitution is one option to address the forecast increase in demand associated with population aging.

Published
2011

20. Letters.

Author

MacLean, Gavin, Dew, Simon, Keane, Christine, Raymont, Antony, Carapiet, Jon, Maxwell, Gabrielle, Slade, Colin, and Wood, Andrew Paul

Abstract

Several letters to the editor are presented commenting on articles in previous issues, including "Avoiding Armageddon" in the October 18, 2008 issue, "The Black Page" in the October 11, 2008 issue and "Milk Money" in the October 4, 2008 issue.

Published
2008

23. King’s Fund report on Canterbury, New Zealand.

Author

Gauld, Robin, Raymont, Antony, Bagshaw, Philip F., Nicholls, M. Gary, and Frampton, Christopher M.

Subjects
*MEETINGS, *ECONOMICS, *INCOME, *SERIAL publications, *DISCLOSURE
Abstract

A letter to the editor is presented in response to the King's Fund report on Canterbury, New Zealand and the related editorial "What Can England's NHS Learn From Canterbury, New Zealand" in the October 29, 2013 issue.

Published
2014

26. The financial impact of clinical task substitution between practice nurses and GPs in New Zealand primary care centres.

Author

Hefford M, Love T, Cumming J, Finlayson M, and Raymont A

Subjects
Humans, Interviews as Topic, New Zealand, Workload, Health Services Needs and Demand economics, Nurse Practitioners economics, Personnel Delegation organization & administration, Physicians, Family economics, Primary Health Care economics
Abstract

Aim: To describe the financial impact on practice owners of increased clinical task substitution between practice nurses and GPs in New Zealand (NZ) primary care settings., Method: Case studies of 9 primary health care centres involving: interviews; collation of service and financial information; and nurse and GP diaries covering 1826 consultations. Results were compared with previous NZ large N survey results to develop a model predicting the financial impact of task substitution., Results: The proportion of general practice primary care consultations undertaken by nurses varied from 4% to 46% of total recorded consultations. The actual financial impact for a practice owner of substituting more nursing time for GP time is highly dependent on the following variables: nurse cost per minute relative to GP cost minute; nurse consult duration relative to GP consult duration; nurse consult revenue relative to GP consult revenue; and the proportion of nurse consults also requiring GP time., Conclusion: Practice nurses can (and in some practices in NZ, do) provide a broad set of primary care services, including undifferentiated general consultations. For some practices, increasing the proportion of nurse consults and reducing GP consults, would result in significantly improved profitability--for others, the opposite applies. Clinical task substitution is one option to address the forecast increase in demand associated with population aging.

Published
2011

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