New guidance has been issued to help nurses and GPs take on extra roles that will expand primary care services.

The guidance aims to build on the fact that some GPs and nurses already have special interests and that these can help relieve some of the burden of hospitals and frontline staff.

Services that can already be shifted from a secondary to primary care setting include ear, nose and throat, dermatology and ophthalmology procedures. Around 600,000 such procedures took place by primary care staff the end of 2001.

"Developing these new, specialist roles for GPs and nurses working in primary care will help the NHS provide a more convenient and efficient service to the public", said Health Minister John Hutton. "It will help ease the pressure on secondary care services and cut waiting times. And it will help make better use of the skills and talents of key frontline staff".

'A Framework for Nurses with Special Interest' will help nurses expand their clinical practice in areas such as heart failure, diabetes and stroke care.

"Practitioners with special interests" published by the NHS Modernisation Agency, expands on current guidelines for GPs with special interests (GPwSI) to cover topics such as child protection, epilepsy, mental health, palliative care and respiratory disease.

The NHS plan set a target of 1,000 GPwSI to be working by 2004. Initial framework and guidelines were published last year.

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