What is the impact when nurses substitute for GPs ?

The conclusions of a systematic review examining the evidence around the impact of nurses working as substitutes for primary care doctors include:

• nurse-led primary care may lead to slightly fewer deaths among certain groups of patients, compared to doctor-led care
• patients probably have similar or better results in areas of health such as heart disease, diabetes, rheumatism, and high blood pressure
• patients are probably slightly more satisfied with their care and may have a slightly better quality of life when treated by nurses
• nurses probably have longer consultations, and their patients are slightly more likely to keep follow-up appointments
• there was little or no difference in the number of prescriptions, numbers of tests and investigations ordered, or in patients’ use of other services.

The level of evidence in the 18 studies was generally of  low to moderate certainty so all findings have to be taken with caution.

Laurant M et al. Nurses as substitutes for doctors in primary care. Cochrane Database of Systematic Reviews 2018, Issue 7. Art. No.: CD001271. DOI: 10.1002/14651858.CD001271.pub3.