The demands placed on practices mean that they may explore alternative methods of management for same day patients. However, the overall use of resources within the NHS must be considered before widespread changes are made. Nevertheless, the positive outcomes found here suggest that nurses provide a high standard of care to their patients, and this supports their extended role within primary care.We thank the patients, nurses, and doctors who took part in this study. Professors Debbie Sharp, Nigel Stott and Richard Baker provided additional valuable support and advice.Contributors: JC and AF initiated this study. PT, LA, and AS developed the methods. PK and EA further developed the methods and undertook data collection. CR and KP undertook the analysis. Eileen O'Donnell was responsible for data processing. All authors were involved in the interpretation of the results and writing the report. PK and CR act as guarantors for this study.Funding (Accepted 17 February 2000)Randomised controlled trial comparing cost effectiveness of general practitioners and nurse practitioners in primary care P Venning, A Durie, M Roland, C Roberts, B Leese AbstractObjective To compare the cost effectiveness of general practitioners and nurse practitioners as first point of contact in primary care.

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This article examines the ‘Delivering the Workforce’ project in Greater Manchester, which aims to provide over 2000 assistant practitioners in a major attempt to contribute to the redesign of the health and social care workforce. target groups it is intended to benefit.

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