Abstract
Fundamental changes over the last five years in the NHS, general practice and community care are influencing the shape of nursing in primary health care. This paper considers in particular the impact of general practitioner (GP) fundholding and discusses ways in which nursing in primary health care has responded in terms of changing skill mix in district nursing, health visiting and practice nursing and the growth of new nursing roles. The contribution of nursing to developing a needs-led and evidence-based service is discussed. This paper draws on exemplars from nursing practice in order to interpret policy and explain trends.
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