Nurses are consistently being seen as an integral part of a team approach to primary care service delivery, with significant policy initiatives being directed towards their employment in Australian general practice. Furthermore they are being increasingly recognised to add a value to general practice that is more than simply the 'sum of its parts'. This recognition, for GPs and practices, has often occurred on the back of an experience that has been provided or illustrated by a Division of General Practice.
Divisions as the face of Organised general practice' in this country have been instrumental in providing a broad range of support strategies and development opportunities for practice nursing, especially over the last five to ten years.
Essentially, the role of Divisions has been about increasing connectivity, and acting as 'brokers' of information, opportunities, and in some cases even resources. Divisions have made a significant contribution to achievements in practice nurse development, but this has not been without challenges.
As the evolution of Australian practice nursing reaches a crucial stage, Divisions can play a pivotal role in advancing this development but must seek partnerships to be effective and should continue to broaden their scope.
Australia; divisions network; general practice; practice nurses; primary health care teams; professional development; workforce
Received 18 December 2006 Accepted 19 June 2007
Nurses have been working in general practices in Australia for several decades (ADGP 2006; Halcomb, Patterson & Davidson 2006). However there has been an increasing focus on this domain of nursing practice in recent years, especially since 2001 when Federal Government initiatives targeting nursing in general practice were introduced. During this period, the number of nurses working within general practice has increased substantially (ADGP 2006; AIHW 2005). Much of this expansion has been driven, resourced and supported by Divisions of General Practice, and their state and national support organisations, collectively known as the Divisions of General Practice Network.
DIVISIONS OF GENERAL PRACTICE IN AUSTRALIA
Divisions of General Practice have evolved in Australia since 1992, as a (primarily) government funded mechanism for providing the general practice profession with 'effective, resourced, regionally based organisations that could interact with other health care providers' (Weller & Dunbar 2005). In 2007, there are 118 Divisions of varying size and capacity distributed around Australia (ADGP 2006). The Divisions Network is supplemented by eight State Based Organisations (SBOs), whose role is to provide support to Divisions within their jurisdiction, and the Australian General Practice Network (AGPN, formerly ADGP), who are the peak national body.
Divisions arose from the provision of government funding to what were initially local collectives of general practitioners, and have evolved into a rich, diverse and strongly coupled network of organisations that provides infrastructure to support training, education, business development, information management, project implementation, research and innovation for the general practice profession. Weller and Dunbar (2005) suggest that Divisions have 'played a fundamental role in shaping contemporary Australian general practice'. The organisational structure they provide has created a mechanism for considering general practice as an Organised' entity within the health care system.
As they have evolved, there has been an increasing onus on Divisions to generate or contribute to the improvement of health outcomes at a population health level and in a demonstrable way (Divisions of General Practice Review Panel 2003).The Commonwealth Government has articulated a range of priorities (detailed in Table 1) for strengthening primary care through Divisions (Australian Government Department of Health & Ageing 2004). …