Opinion  

However, the QNI's response warned that 'more of the same is not going to deliver changes.' We argued that the government's policies of the last 10 years have provided all the tools necessary to build a different kind of primary care.

PMS contracts, nurse prescribing, the 10 key roles for nurses, regulation of advanced practice and support for enterprise and independent practice have put nurses in a prime position to design, lead and deliver local services. It would be a missed opportunity if nurses were viewed only as back-up to GPs. We believe nurses should be central to any future developments.

Now, some PCTs are beginning to look for the extra nurses to staff these new primary care centres and there are two significant opportunities looming for nurses already working in this sector. The first is to be the leaders of the new services: we know from projects, pilots and nurse-led initiatives that the capacity and capability exists to do this. It is confidence and entry opportunities that are often missing. So this is the time to look out for training on business skills, project management and negotiation skills.

The other opportunity is to update the image of nursing outside hospitals. Recruitment strategies need to target nurses currently working in hospitals. These are people who still think 'the community' means only district nursing or health visiting; that it's about working 9am to 5pm, on minor ailments, and having an easier (if boring) life.

The QNI will shortly be launching a CD Rom called 'Careers in the Community' that will illustrate the diversity, complexity, challenge and excitement of modern nursing roles in primary care. But just as important is the example provided by nurses already working there. Perhaps every reader of Independent Nurse should pass on a copy to a hospital-based nurse: that would set the recruitment bandwagon rolling!

Rosemary Cook, director, Queen's Nursing Institute