1. New contracts in primary care: implications for nursing Kate Billingham

2. Areas of change for nursing team based contract payment based on services provided and not the person providing them global budget will prompt greater skill mix new or modified roles for nurses delivering the QOF (applies to all team) better employment conditions and safer patient care

3. Nurse entrepreneurs nurses can become partners in both GMS and PMS nurses can set up their own limited companies providing enhanced/additional services greater diversity of employers

4. What the contract says: supporting new roles Nurses will be given more freedom and support to work with GPs in new ways and to take forward more advanced and specialist roles [Para 4.20] support nurses to participate in clinical supervision, appraisal, access to CPD, professional advice

5. What the contract says: involving nurses When making changes to the working practices of nurses and other health care professionals the practice will be expected to involve them in decision making and to seek advice from relevant professional lead in the PCO. [ Para 4.20]

6. What the contract says: employment of nurses Appropriately registered with relevant professional body (para 52) Two clinical references checked (para 57) Agenda for Change not mandatory but employers expected to implement its principles ( p 102)

7. The contractor shall ensure that for any health professional performing clinical services under the contract there are in place arrangements for the purpose of maintaining and updating his skills and knowledge in relation to the services he is performing (para 59) The contractor shall afford to each employee reasonable opportunities to undertake appropriate training with a view to maintaining competence (para 60)

8. The risks Nurses not competent for their new roles Workforce supply Poor engagement by nurses PCT lead nurse not involved Agenda for Change not implemented

9. What needs to be done Practice contracts not GP contracts PCT lead nurse to be involved Keep an overview of nursing services across PCT (workforce planning, clinical governance, service development) Monitor HR requirements of the contract Encourage nurses to become entrepreneurs

10. Programme of support Two conferences to be held for all nurses on nGMS and nPMS A network of SHA and PCT lead nurses to advise on implementation Regular updates on nGMS/nPMS on CNO and NatPaCT websites Nine regional workshops to be held later in the year Support for nurses interested in partnerships

11. Just a new way of paying GPs or really improving care for patients? Time to change the culture This is a practice not a GP contract General practice is one part of primary care services Liberating the Talents of nurses in general practice Secure improved employment and career opportunities