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Speaking at the Primary Care Live conference in London last week, independent primary care consultant Sue Crossman stressed that nurses who had an idea for a new service, or wanted to undertake additional training, needed to justify it in terms of patient benefit.

'It's no good saying "I want to develop this service or I want to do a training course because it's something I really want to do". GPs don't respond to that,' she said. 'You need to support your proposal with impartial standards, something GPs cannot argue with.'

Nurses should search out standardised frameworks and recommendations to support their cases, so that they can show what they can offer and how it will benefit the practice.

'Can you demonstrate that there's a framework or that there's a NICE standard or some guidance that your practice is not meeting at the moment that your proposal would help it achieve?' she asked.

'Can you put your case and say that practice income is going to be generated, or QOF points won?'

Nurses also need to leave themselves room to manoeuvre when discussing new services with GPs, she added, and they should have decided a best alternative to the desired outcome before negotiations start.

'Be seen to have some flexibility,' she said. 'Recognise that you might make some progress or get agreement on some things. Work that out before you start negotiating so that you're not losing sight of what you actually want to get to,' she said.

Supporting proposals with evidence, as well as being willing to negotiate and being confident in discussions, would increase the likelihood of services being adopted and improve the support provided for any changes, she added.

tom.moberly@haymarket.com

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