Research shows also that nurses are highly effective in managing
chronic diseases. The key element of effective care is service
organisation. If care is well structured (ie, there is a patient register
and recall system, with clinical reviews conducted in accordance
with evidence-based guidelines), then health outcomes for patients
are good. General practice diabetes clinics have been shown to
provide as high quality care as hospital outpatient clinics when
they are well structured.16 In coronary care, nurse-led specialist
clinics appear to be as effective as doctor-led specialist clinics, and
more effective than care provided by doctors in routine consultations.
In other words, the evidence suggests that nurse-led
chronic disease clinics offer higher quality clinical care than can be
achieved by GPs in conventional practice.