Another review found that appropriately trained nurses can produce high quality care and good health outcomes for patients, equivalent to that achieved by doctors, with higher levels of patient satisfaction.13 Nurse led care is attractive as it has been associated with stricter adherence to protocols, improved prescribing in concordance with guidelines, more regular follow up, and potentially lower healthcare costs. Without associated changes in models of prescribing, however, there seems to be little effect on blood pressure level.14 At present the usual model of care is shared between general practitioners and practice nurses, with general practitioners prescribing. Our local survey of Devon and Somerset found that of 79 responding practices (n=182; response rate 43%) 53 were using this model, with only four using nurse led care, including nurse prescribing (unpublished observation).
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