IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v68y2009i7p1206-1212.html
   My bibliography  Save this article

Practice nurses and the effects of the new general practitioner contract in the English National Health Service: The extension of a professional project?

Author

Listed:
  • McDonald, Ruth
  • Campbell, Stephen
  • Lester, Helen

Abstract

This paper reports the impact on nurses working in primary health care settings of changes to the general practitioner (GP) contract in England implemented in 2004. Previous changes to the GP contract in 1990, which gave financial rewards for health promotion activities, were seen as enabling nurses to take on work that GPs did not want and providing an impetus for the development of a professional project (Broadbent, J. (1998). Practice nurses and the effects of the new general practitioner contract in the British NHS: the advent of a professional project? Social Science & Medicine, 47(4), 497-506). Our study, which involved interviews with nurses from 20 practices, finds that nurses are taking on work which has previously been the exclusive preserve of medical professionals. An increasing emphasis in nurses' accounts on technical skills and knowledge may help decouple nursing from a narrative of caring, which has been seen as detracting from professional advancement. Our research suggests that practice nurse work is changing to reflect a more medical (and masculine) orientation to service delivery. At the same time, nursing work is described as routine and template driven, which may limit claims to 'professional' status. The reaction of some practice nurses to Health Care Assistants encroaching on what was previously practice nurse territory suggests a policing of boundaries, rather than an inclusive approach to colleagues within the nursing team. This resonates with Davies' (Davies, C. (1995). Gender and the professional predicament in nursing. Bucks: Open University Press) suggestion that professionalisation as a process involves compliance with a masculine notion of professionalism (autonomous, elite, individual, divisive, detached) which marginalises feminine attributes and devalues the work done by women. The study also raises questions about the role of caring in general practice settings where nurses choose to prioritise other concerns.

Suggested Citation

  • McDonald, Ruth & Campbell, Stephen & Lester, Helen, 2009. "Practice nurses and the effects of the new general practitioner contract in the English National Health Service: The extension of a professional project?," Social Science & Medicine, Elsevier, vol. 68(7), pages 1206-1212, April.
  • Handle: RePEc:eee:socmed:v:68:y:2009:i:7:p:1206-1212
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(09)00065-3
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Broadbent, Jane, 1998. "Practice nurses and the effects of the new general practitioner contract in the British NHS: The advent of a professional project?," Social Science & Medicine, Elsevier, vol. 47(4), pages 497-506, August.
    2. Hannah Cooke, 2006. "Seagull management and the control of nursing work," Work, Employment & Society, British Sociological Association, vol. 20(2), pages 223-243, June.
    3. Sharon Bolton & Daniel Muzio, 2008. "The paradoxical processes of feminization in the professions: the case of established, aspiring and semi-professions," Work, Employment & Society, British Sociological Association, vol. 22(2), pages 281-299, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. McDonald, Ruth & Cheraghi-Sohi, Sudeh & Bayes, Sara & Morriss, Richard & Kai, Joe, 2013. "Competing and coexisting logics in the changing field of English general medical practice," Social Science & Medicine, Elsevier, vol. 93(C), pages 47-54.
    2. Cant, Sarah & Watts, Peter & Ruston, Annmarie, 2011. "Negotiating competency, professionalism and risk: The integration of complementary and alternative medicine by nurses and midwives in NHS hospitals," Social Science & Medicine, Elsevier, vol. 72(4), pages 529-536, February.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. McGovern, Patrick, 2014. "Contradictions at work: a critical review," LSE Research Online Documents on Economics 45188, London School of Economics and Political Science, LSE Library.
    2. Haynes, Kathryn, 2017. "Accounting as gendering and gendered: A review of 25 years of critical accounting research on gender," CRITICAL PERSPECTIVES ON ACCOUNTING, Elsevier, vol. 43(C), pages 110-124.
    3. Bosch, Maria José & Heras, Mireia Las & Russo, Marcello & Rofcanin, Yasin & Grau i Grau, Marc, 2018. "How context matters: The relationship between family supportive supervisor behaviours and motivation to work moderated by gender inequality," Journal of Business Research, Elsevier, vol. 82(C), pages 46-55.
    4. Ozbilgin, Mustafa F. & Tsouroufli, Maria & Smith, Merryn, 2011. "Understanding the interplay of time, gender and professionalism in hospital medicine in the UK," Social Science & Medicine, Elsevier, vol. 72(10), pages 1588-1594, May.
    5. McDonald, Ruth & Checkland, Kath & Harrison, Stephen & Coleman, Anna, 2009. "Rethinking collegiality: Restratification in English general medical practice 2004-2008," Social Science & Medicine, Elsevier, vol. 68(7), pages 1199-1205, April.
    6. Edgley, Carla & Sharma, Nina & Anderson-Gough, Fiona, 2016. "Diversity and professionalism in the Big Four firms: Expectation, celebration and weapon in the battle for talent," CRITICAL PERSPECTIVES ON ACCOUNTING, Elsevier, vol. 35(C), pages 13-34.
    7. Charlotta Stern, 2016. "Undoing Insularity: A Small Study of Gender Sociology’s Big Problem," Econ Journal Watch, Econ Journal Watch, vol. 13(3), pages 452–466-4, September.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:68:y:2009:i:7:p:1206-1212. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.