PRACTICE NURSES AND THE EFFECTS OF THE NEW GENERAL-PRACTITIONER CONTRACT IN THE BRITISH NHS - THE ADVENT OF A PROFESSIONAL PROJECT

In the light of changes to the GP Contract in the U.K. which were impl emented in April 1990, health promotion was introduced into General Pr actice and was encouraged through the financial elements of the contra ct. This paper seeks to illustrate some of the outcomes of the changes , in particular the extent to which activity in relation to health pro motion has been passed to practice nurses. The paper explores the perc eptions of the practice nurses to their new activity and examines the implications of that change. The argument is presented that health pro motion activity has provided an impetus for the attempts to develop a professional project on the part of practice nurses. The outcome of th at professional project and the possibility of more development of the terms of the GP Contract could lead to unintended consequences of cha nge in General Practice and the paper argues the need for more evaluat ion and debate of the developments. (C) 1998 Elsevier Science Ltd. All rights reserved.