... holding, the practice nurse role has rapidly grown (Carey, 2000). This combined with the establishment of integrated nursing teams in community health provision (DOH, 2005), has lead to the vast evolvement of the practice nurse and their contribution made to the health of the practice population. The National Health Service (NHS) plan (DOH, 2000) outlined the development of "clinical leaders" to deliver organisational change and quality to service users. A further Department of Health (DoH) white paper, Liberating the Talents (2002) took this further, placing great importance to improve leadership and change within the roles of primary care nurses. Practice nurses' are now encouraged to take responsibility for assessment, planning, care and management of patients that were previously the domain of medical staff. The advent of nurse led clinics and advanced nursing roles have led to the inevitable evolution of nursing leadership roles (Norman, 2005). The general practice surgery in question ...

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