There is little evidence that there are advantages to the increased use of skill-mix in primary care, both financially and in staff allocation, according to a report by the Department of Health's Medical Practices Committee. The report says that studies to date have not shown that skill-mix is simultaneously cost-effective, safe and satisfactory for both users and providers of healthcare. It says that an increase in skill-mix will rely on an increased number of nurses, of whom there is a shortage, but that there is further potential for practice nurses to delegate some of their workload to less qualified, or even unqualified, staff.

Skill-Mix in Primary Care: implications for the future. Medical Practices Committee. www. doh. gov. uk