The participation of nurses in primary care in six European countries, Ontario and Quebec

This study was commissioned and financed by the Directorate of Research, Analysis, Evaluation and Statistics (DREES). It forms part of IRDES programme of work on the organisation of health systems, specifically in the field of primary care, and follows a review of the literature on the effectiveness and efficiency of delegating procedures from general practitioners to nurses, which had shown that this is both feasible and effective (QES no. 65). This international comparison of skill-mix practice between general practitioners and nurses gives an insight into the context in which this is developing, as well as its form and content. A future publication will consider the implications of these developments for the organisation of primary care and the health professions, with specific regard to legal and regulatory considerations. In France, the forecast decline in the number of doctors and problems already evident in their distribution across the country has prompted debate on the division of labour among professionals, something which is already being put into practice in other countries facing similar problems.