community nursing- health professional and public perceptions

ISSUES AND INNOVATIONS IN NURSING PRACTICE

Community nursing: health professional and public perceptions

Hugh McKenna BSc DPhil RGN RMN RNT

Dean, Faculty of Life and Health Sciences, University of Ulster, Newtownabbey, Ulster, UK

Sinead Keeney BA MRes

Research Fellow, School of Nursing, University of Ulster, Newtownabbey, Ulster, UK

Submitted for publication 12 March 2003

Accepted for publication 23 October 2003

Correspondence:

Sinead Keeney,

12JO5b,

School of Nursing,

University of Ulster,

Shore Road,

Newtownabbey,

Co. Antrim BT37 0QB,

UK.

E-mail: [email protected]

MM CC KENNA H. & KEENEY S. (2004)KENNA H. & KEENEY S. (2004) Journal of Advanced Nursing 48(1), 17–25

Community nursing: health professional and public perceptions

Background. Almost 10 years ago senior United Kingdom nurses met at Heathrow

Airport to discuss the challenges and opportunities facing nursing. One aspect of

this ‘Heathrow Debate’ was to encourage nurses to work closer with members of the

public. The resulting report stated that nurses have not been effective in working

outside their professional area and, in particular, they have not been adept at

working in partnership with the public.

Aim. The aim of this paper is to report a study to obtain the views of general

practitioners (GPs), community nurses and members of the public on how the public

perceive community nursing. A further aim was to explore the perceptions of senior

health care managers and policymakers about public involvement in primary care.

Methods. A two-stage Delphi investigation was undertaken with community nurses

(n ¼ 38), GPs (n ¼ 14) and members of the public (n ¼ 8). In addition, one-to-one

interviews were carried out with 34 senior health service managers and policy-

makers.

Findings. There was agreement on the following issues: community nurses must

work more closely with members of the public; there is a lack of public under-

standing on the roles of community nurses and specialist nurses; there is public

support for nurse prescribing; there is a preference for seeing the community nurse

as opposed to the GP; and people prefer one nurse to care for them rather than a

variety of nurses. Comments from managers and senior policymakers showed

agreement on the public being involved in primary care, but an acknowledgement

that this was problematic. A number of recommendations are outlined.

Keywords: primary care, community nurses, general practitioners, service users,

Delphi

Background

A core element of the United Kingdom (UK) government’s

health and social care strategy is involvement of the public in

decisions about the planning and delivery of services (DHSS

1990, 1996, DoH 1992, 1997). In 1994, UK nurses met at

Heathrow Airport to discuss the challenges and opportunities

facing nursing. They agreed that nurses have not been

effective in working closely with the public (DoH 1994a).

Furthermore, skills relating to community development,

community empowerment and public health perspectives

were weak and needed to be an integral part of education at

preregistration and postregistration levels (Jowett & Walton

1995).

Trnobranski (1994) emphasizes that the concept of service

user involvement in planning, delivering and evaluating care

is an essential component of health care philosophy. This has

been a matter of UK policy since the early 1990s (DoH 1990,

� 2004 Blackwell Publishing Ltd 17

1992, 1994b, 1997, 1999, DHSS 1996, 1999). Studies in

Britain (Robinson & Stalker 1993, Thornton & Tozer 1994)

and Scotland (Myers & MacDonald 1996) have explored

initiatives aimed at consulting with service users and their

carers. However, while such objectives continue to command

widespread support, practice has not always followed the

rhetoric (Myers & MacDonald 1996).

The 1996 DHSS report ‘Working together: a focus on

health and well-being’ states that:

The building of healthy alliances with service users and all involved in

the provision of health and social care is necessary for needs to be

addressed appropriately and equitably (p. 37).

It further asserts that all primary care professionals should

provide ‘person focused services which value the expecta-

tions, needs and views of patients/clients while protecting

their rights and dignity’ (p. 37).

Poulton (1997) outlines a model of user involvement

(Figure 1). It can be seen that the lowest level of user

involvement is information-giving. However, there is evi-

dence that community nurses have not even reached this

level. Most members of the public lack information on

what nurses do (Furlong & Glover 1998). There is also

much confusion about the plethora of specialist roles

currently making up community nursing (Adams et al.

2000). One way to address this is the introduction of a

generalist community nurse. A leading figure in the World

Health Organization has called for the introduction of ‘The

Family Nurse’ (Fawcett-Henesy 1999. This nurse would be

a generalist, a key professional to whom patients and their

families could relate.

The importance of developing ‘real’ partnerships between

service users and service providers has been highlighted by

Twigg and Atkins (1994). In addition, higher public expec-

tations are generally regarded as one of the key drivers of

change in public health care provision (see Harrison & Pollitt

1994), as service users tend to become more assertive as they

gain more knowledge. This can be seen as a power shift away

from the health professional towards the consumer that is

characterized by:

• choice as a fundamental political ideology;

• an increase in well-informed, assertive consumers;

• an increase in perceptive questions from the public about

provision of health and social care;

• increasing individual access to health information that was

previously held by professional gatekeepers;

• the challenging of professional autonomy and increasing

empowerment of consumers; and

• increased access to best evidence through the Internet and

other media.

However, there is very little published research on the

perceptions of health professionals about public involvement

in primary care or the perceptions of the public about

community nurses and their roles.

The study

Aim

This paper reports part of a large study that reviewed the role

and function of community nursing with reference to

developments in practice, education, research and policy.

The aims of this part of the study were:

• to obtain the views of general practitioners (GPs), com-

munity nurses and members of the public on how the

public perceive community nursing, and

• to explore the perceptions of senior health care managers

and policymakers about public involvement in primary

care.

Design

The Delphi technique and semi-structured interviews were

used in this study. The Delphi technique is a structured

process that uses a series of questionnaires, or rounds, to

gather information and continues until ‘group’ consensus is

reached (Beretta 1996, Green et al. 1999, Hasson et al.

2000). It is growing in popularity, especially for nurse

researchers and for health research in general (McKenna

1994, Keeney et al. 2001). This growth centres on the fact

that it allows the inclusion of a large number of individuals

Empowerment

Participation

Consumer satisfaction

Consultation

Health education

Information-giving

Figure 1 Levels of user involvement.

H. McKenna and S. Keeney

18 � 2004 Blackwell Publishing Ltd, Journal of Advanced Nursing, 48(1), 17–25

across diverse locations and with a variety of expertise, and

avoids a situation in which a specific expert might dominate

the consensus process (Jairath & Weinstein 1994).

We considered the level of consensus that would be judged

adequate during our use of the Delphi technique. A

universally agreed level does not exist as it depends on

sample numbers, the aim of the research and resources.

Loughlin and Moore’s (1979) work suggests that consensus

should constitute 51% agreement amongst participants;

Sumsion (1998) recommends 70%, while Green et al.

(1999) opt for 80%. Alternatively, Crisp et al. (1997)

question the value of using percentage measures, suggesting

that the stability of the response through a series of rounds is

a more reliable indicator of consensus. For the purpose of this

study, we used a consensus level of 55%.

Participants

The purposive sample for the Delphi survey consisted of 38

community nurses, 14 GPs and eight members of the public.

Purposive sampling means that participants were selected to

suit the purpose of the study, because it was felt that they

possessed the appropriate background to contribute to the

discussion (Parahoo 1997).

Thirty-seven community nurse participants were female

and one was male. Nine had been in practice for more than

20 years; seven for between 16 and 20 years; eight for

between 11 and 15 years; nine for between 6 and 10 years

and three for between 1 and 5 years. Two did not specify

their length of time in practice. Qualifications held by the

community nurse sample included Registered General Nurse,

Registered Mental Nurse, Registered Midwife, Registered

Health Visitor, in addition to diplomas in specialist areas

such as diabetic care and challenging behaviour, and certif-

icates in areas such as community nursing and mental health.

Several participants had primary degrees and Master’s

degrees. Several others held teaching qualifications. Their

specialties are shown in Table 1.

There are four Health and Social Services Boards in

Northern Ireland which are responsible for planning and

commissioning Northern Ireland’s health and social services.

The 14 GPs in the sample were accessed through Senior

Nurses at these Health and Social Services Boards. Twelve of

the GP participants were male and the remaining two were

female. Four GP participants had been in practice for over

20 years, four for between 16 and 20 years, three for

between 11 and 15 years and three for between 6 and

10 years.

Members of the public were recruited through the Health

and Social Services Councils, which are formal pressure

groups for service users. The participants were not Council

members but members of the public who agreed to take

part in the study. Seven were female and one was male.

They had been in contact with a range of primary care

services, including midwifery services, health visitor ser-

vices, social workers, occupational therapists and speech

therapists.

Data collection

Delphi technique

The literature and the views of an expert steering group

formed the basis for the formulation of the initial Delphi

questionnaire. Participants were asked to circle a response on

a five-point scale from ‘strongly agree’ to ‘strongly disagree’.

Space was also provided under each statement for partici-

pants to write qualitative comments if they wished; several

participants did take this opportunity. Round one secured a

response rate of 100%. Data were analysed using SPSS

(Version 10.0). The round 2 questionnaire, which included

written feedback from round 1, was mailed to the sample.

The response rate was 97% (n ¼ 58). One GP dropped out as

he had moved out of the country and one member of the

public did not return the second round. The reason for

this is unknown. While sample size overall was high for a

Delphi panel, the number of members of the public was

small (round 1: n ¼ 8; round 2: n ¼ 7).

Semi-structured interviews

Following the Delphi survey, individual interviews were

undertaken with senior health service managers and

policymakers. A purposive sample of 34 respondents was

Table 1 Community nursing specialties represented in the study

Community nursing specialty Number

Practice nurses 9

Health visitors 5

District nurses 4

Community midwives 4

Community psychiatric nurses 3

Public health nurses 3

Community learning disability nurses 2

Specialist community nurse

Palliative care 2

Diabetes 2

Child protection 1

Community paediatric nurse 1

Challenging behaviour 1

Macmillan nurse 1

Treatment room nurse 1

Nurse practitioner 1

Issues and innovations in nursing practice Community nursing

� 2004 Blackwell Publishing Ltd, Journal of Advanced Nursing, 48(1), 17–25 19

interviewed. This included chief executives of Health and

Social Services Boards, chief nurses, Department of Health

nursing officers, heads of university nursing departments

and other senior managers. A semi-structured interview

schedule was used for each interview, the questions for

which were formulated from the literature and the results of

the Delphi survey. Interview schedules were designed

according to the accepted rules of topic guide construction

(Rubin & Rubin 1995, Morgan & Krueger 1998). Inter-

views lasted between half an hour and one hour and were

audio-taped with the consent of the participant. Data were

transcribed and entered into the NUD*IST package for

qualitative data analysis.

Ethical considerations

Research ethics committee approval was not required at the

time of the study as patients were not being included.

Informed consent was obtained from all participants and

each was informed that they could leave the study at any

stage without prejudice. While true anonymity could not be

assured because we could link responses to specific partici-

pants, confidentiality was guaranteed. Participants were

informed that only we would have access to the data, that

tapes and transcripts would be destroyed after analysis, and

that no participant would be recognizable in any report or

publication derived from the study.

Findings

The findings are presented in four sections: perceptions of

GPs and community nurses; perceptions of members of the

public; overall Delphi findings; and perceptions of senior

health care managers and policymakers.

Perceptions of GPs and community nurses

In the Delphi study, GP and community nurses were asked to

agree or disagree with a number of statements about primary

care and the public. Table 2 shows round 2 Delphi responses

to these statements.

It is clear from Table 2 that the majority of both GPs and

community nurses agreed that community nurses of the

future have to work in close partnership with members of the

public. However, both GP and community nurse responses to

the statement ‘there is no clear understanding of the role of

the community nurse among members of the public’ varied..

Responses to the statement ‘members of the public feel

more comfortable dealing with the community nurse than

their GP’ were also split. It is interesting to note that, while a

high percentage of GPs and community nurses agreed with

the statement, sizeable proportions of GPs were either unsure

or disagreed, and many community nurses were unsure. Only

a small percentage of community nurse respondents disagreed

with the statement.

The majority of both GPs and community nurses agreed

with the statement ‘members of the public prefer one type of

nurse to visit them at home rather than a variety of different

nurses’ but, again, substantial proportions of each type of

respondent disagreed or were unsure.

The statement ‘members of the public feel more confident if

they are treated by a specialist nurse’ produced a departure

from the previous trend; many GPs were unsure about the

statement and most community nurses agreed with it. A

sizeable proportion of GPs disagreed with the statement

while disagreement was expressed by only a small percentage

of community nurses.

A large percentage of GPs disagreed with the statement ‘the

concept of the nurse being able to prescribe medication within

Table 2 Perceptions of general practitioners and community nurses (round 2 responses)

Statement

General practitioner responses Community nurse responses

Agree (%) Unsure (%) Disagree (%) Agree (%) Unsure (%) Disagree (%)

Community nurses of the future have to work closely in

partnership with members of the public

14 (100) 0 0 37 (97Æ4) 0 1 (2Æ6)

There is no clear understanding of the role of the community

nurse among members of the public

2 (15Æ4) 4 (30Æ8) 7 (53Æ8) 21 (55Æ3) 6 (15Æ8) 11 (28Æ9)

Members of the public feel more comfortable dealing with the

community nurse than their GP

6 (46Æ2) 3 (23Æ1) 4 (30Æ8) 20 (52Æ6) 15 (39Æ6) 3 (7Æ8)

Members of the public prefer one type of nurse to visit them

at home rather than a variety of different nurses

8 (61Æ5) 3 (23Æ1) 2 (15Æ4) 21 (55Æ3) 12 (31Æ6) 5 (13Æ1)

Members of the public feel more confident if they are being

treated by a specialist nurse

2 (15Æ4) 7 (53Æ8) 4 (30Æ8) 23 (60Æ6) 12 (31Æ6) 3 (7Æ8)

The concept of the nurse being able to prescribe medication

within a GP practice is very appealing to members of the public

4 (30Æ8) 9 (69Æ2) 0 20 (52Æ6) 16 (42Æ1) 2 (5Æ3)



a GP practice is very appealing to members of the public’,

while most community nurses agreed with it. However, many

community nurses were unsure, as were most GPs.

Perceptions of members of the public

Members of the public were asked to agree or disagree with

the same statements about primary care and the public.

Table 3 shows their round 2 responses to these statements.

It is clear from Table 3 that all members of the public

agreed that community nurses of the future would have to

work in close partnership with members of the public. While

four of them agreed that there is no clear understanding of

the role of the community nurse, it is interesting to note that

two were unsure and one disagreed. Three agreed with the

statement ‘members of the public feel more comfortable

dealing with the community nurse than their GP’, two were

unsure and a further two disagreed.

As Table 3 illustrates, most members of the public agreed

with the statements ‘members of the public prefer one type of

nurse to visit them at home rather than a variety of different

nurses’, ‘members of the public feel more confident if they are

being treated by a specialist nurse’ and ‘the concept of the

nurse being able to prescribe medication within a GP practice

is very appealing to members of the public’.

Overall Delphi findings

Table 4 outlines which statements gained consensus and

which did not. It also shows the level of consensus gained

overall for all statements.

Consensus was gained on the statement ‘community nurses

of the future have to work closely in partnership with

members of the public’. The vast majority of respondents

agreed with the statement, giving an overall sample consensus

of 98Æ3% agreement.

Participants were asked to consider the statement ‘There is

no clear understanding of the role of the community nurse

among members of the public’. No overall consensus was

gained after two rounds of the Delphi questionnaire.

Table 3 Perceptions of members of the public (round 2 responses)

Statement

Responses

Agree (%) Unsure (%) Disagree (%)

Community nurses of the future have to work closely in partnership with members

of the public

7 (100) 0 0

There is no clear understanding of the role of the community nurse among members

of the public

4 (57Æ1) 2 (28Æ6) 1 (14Æ3)

Members of the public feel more comfortable dealing with the community nurse than

their GP

3 (42Æ8) 2 (28Æ6) 2 (28Æ6)

Members of the public prefer one type of nurse to visit them at home rather than a

variety of different nurses

5 (71Æ4) 1 (14Æ3) 1 (14Æ3)

Members of the public feel more confident if they are being treated by a specialist nurse 6 (85Æ7) 0 1 (14Æ3)

The concept of the nurse being able to prescribe medication within a GP practice is very

appealing to members of the public

6 (85Æ7) 1 (14Æ3) 0

Table 4. Overall levels of consensus

Statement Consensus gained Level of consensus

Community nurses of the future have to work closely in partnership with

members of the public

Yes 98Æ3% agreed with statement

There is no clear understanding of the role of the community nurse among

members of the public

No 46Æ6% agreed with statement

Members of the public feel more comfortable dealing with the community

nurse than their GP


Members of the public prefer one type of nurse to visit them at home rather

than a variety of different nurses

Yes 58Æ7% agreed with statement

Members of the public feel more confident if they are being treated by a

specialist nurse


The concept of the nurse being able to prescribe medication within a GP

practice is very appealing to members of the public




Overall, 53Æ5% (n ¼ 31) of the sample agreed that mem-

bers of the public feel more comfortable dealing with the

community nurse than their GP. As it is over half the sample,

this percentage could be considered to represent consensus on

the issue. However, in our study it did not constitute

consensus as it did not reach the level of 55%. It is interesting

that six (46Æ2%) of the GP respondents agreed with the

statement as did 20 (52Æ6%) of the community nurses.

Overall, 58Æ7% (n ¼ 34) of the total sample agreed that

members of the public prefer one type of nurse to visit them

at home rather than a variety of different nurses. This

percentage was just over the consensus level.

In relation to the statement ‘members of the public feel more

confident if they are being treated by a specialist nurse’, only

two (15Æ4%) GPs agreed, but 23 (60Æ6%) community nurses

and six (85Æ7%) members of the public agreed. While the

majority of community nurses and members of the public

agreed with this statement, the very low percentage of GPs who

agreed resulted inagreement by just overhalf the overall sample

(53Æ4%). This is not high enough to be considered a consensus.

‘The concept of nurses being able to prescribe medication

within a GP practice is very appealing to members of the

public’ was the next statement that the sample were asked to

consider. Six (85Æ7%) members of the public agreed with the

statement; one was undecided and none disagreed. Over half

the community nurses (52Æ6%, n ¼ 20) agreed with the

statement and four (30Æ8%) of the GPs agreed, with the

remainder undecided. No GPs disagreed with the statement.

Overall, over half the sample (51Æ7%, n ¼ 30) agreed with

the statement but no consensus was gained.

Perceptions of health care managers and policymakers

The involvement of members of the public in primary care was

explored in the interviews with 34 senior health managers and

policymakers. They were asked what role they believed that the

public should play in the development of primary care services.

Responses were categorized and three clear themes emerged:

• There is no role for the public at present,

• There is a role but it is not clearly defined,

• There is a clear role for the public at present.

The second theme was by far the most predominant.

Examples of interviewees’ comments follow.

There is no role for the public at present

[I am] not sure that they have any role at present. They could have a

big role, but not at present. I think we should be seeking the view of

the public on this. Efforts should be made independently to assess

what is thought of community nursing in Northern Ireland. (Director

of Nursing)

There is a role but it is not clearly defined

It is very important that we have government policy to engage the

public and seek their views on how the service should be provided.

We always said we knew what the public need and wanted, but

I don’t know that we ever actually asked them. (Director of

Nursing)

We are not innovative enough or creative enough to organize

ourselves in a way that makes our service amenable and accessible

to the most vulnerable in our community. The only way to engage

these communities is to make them active partners in these

processes, and so community development is a concept, which is

easy to say but very difficult to do. (Chief Executive, Health &

Social Services Board)

The answer, of course, is that they should be involved, but the real

question is: How do we involve them? (Director of Nursing)

What we really have to do is ensure that the public’s voice is heard.

This hasn’t really been worked out yet. There are issues to do with

public representation, community representation, PCGs in primary

care, the Health and Social Care partnerships. But there is a

commitment to ensuring that the public voice is heard. (Senior

Nurse Manager)

There is a clear role for the public at present

There is a clear role for the public in primary care at present and it is

beginning to work very well. It has to be a partnership, and we have

begun that process. (Director of Nursing)

Limitations

This study was confined to purposive samples in Northern

Ireland and a small sample of members of the public was

used. While every effort was made to ensure a rigorous and

systematic study, the findings are not generalizable to similar

groups of participants outside this setting. Nonetheless, the

findings do mirror those of other international research

studies on this topic. In addition, there are many critiques of

the Delphi technique as a research method (see Keeney et al.

2001). However, it remains one of the most popular methods

of achieving consensus on difficult issues.

Discussion

One of the main findings suggests that community nurses

must work more in partnership with the public. This is

something which has been policy-driven for the last decade

(DoH 1992, 1994b, 1997, 1999) and it is interesting to see

that GPs, community nurses and members of the public were

all in agreement.



The findings show no overall consensus among participants

on there being a misunderstanding of community nurses’

roles among members of the public. However, closer exam-

ination indicates that the views of GPs and the other

participants were polarized. Most nurses agreed that there

was misunderstanding among members of the public about

their role. This suggests that, unlike GPs, nurses recognize

that there is a problem. This would support the views of

Furlong and Glover (1998).

Further to this, it is interesting that 58% of all participants

agreed that members of the public prefer one type of nurse to

visit them at home rather than a variety of different nurses.

This is not a surprising finding, but it does show a lack of

understanding about the contemporary role of community

nursing. It intimates that there is a preference for generalism

rather than specialism and that one community nurse, rather

like one GP, can deal with all their community nursing needs.

This is coherent with Fawcett-Henesy’s (1999) family nurse

initiative.

In contradiction to the previous finding, over 85% of the

members of the public agreed that they felt more confident

when being treated by a specialist nurse. This suggests

confusion about the community nurse’s role. It is inconsistent

to be a supporter of specialist nursing practice and yet wish to

be visited by a generalist nurse. What is most surprising is

that community nurses themselves appear to be torn between

desiring specialization and realizing that clients can best

interact with one key visiting nurse. Perhaps the best way to

interpret this is that nurses and members of the public want a

balance between high quality expertise and as few visiting

nurses as possible. This seems to echo the conclusions of the

National Public Health Nursing Committee (1995), which

state that, while increased specialization is inevitable, there is

no agreement on how all-embracing it should be.

Over half of the participants agreed that members of the

public would feel more comfortable dealing with a commu-

nity nurse than their GP. Interestingly, just under half of GPs

and members of the public, and over 50% of community

nurses agreed with this statement. This reflects the contem-

porary expansion of nurse practitioner and practice nurse

roles (Hicks & Hennessy 1999). It suggests that nurses can

take on roles that were previously the remit of doctors, and

that many of them have the expertise and time to give to

patients who present with a variety of problems, as Adams

et al. (2000) also concluded.

This expansion of the community nurse role is also

supported by the responses of members of the public to

community nurse prescribing. Interestingly, GPs seemed less

convinced that this was a good idea. This could be a form of

territorialism, and of GPs seeing their independent role being

eroded by community nurses. Over 40% of the community

nurses also disagreed with nurses being allowed to prescribe.

This seems to be a rejection of a key recommendation of the

Crown Report (1999): extension of the scope of nurse

prescribing in the UK to a wide range of medicines which at

present require a doctor’s prescription.

Almost all of the 34 senior managers and policymakers

gave responses supportive of a greater involvement of

members of the public in health care planning and provision.

This is in line with a large number of UK government reports

(DHSS 1990, 1996, DoH 1992, 1997). However, there was a

distinct impression from the participants that they were

unclear as to how this wish could be turned into meaningful

reality, a perspective echoing that of Myers and MacDonald

(1996).

Conclusions

The study highlights the views of a sample of GPs, commu-

nity nurses and members of the public on public perceptions

of community nursing, and senior managers’ and policy-

makers’ views on user involvement in primary care planning

and delivery. Findings indicate agreement on community

nurses working in partnership with the public, but also a lack

of clear understanding of the roles of community nurses and

specialist nurses. There were positive views on nurse prescri-

bing and it was thought that members of the public often

prefer to see a community nurse rather than the GP. Members

of the public highlighted their preference for having one nurse

care for them, as opposed to a variety of nurses. Comments

from senior policymakers suggest that the public should be

involved in primary care but acknowledge that this is

problematic.

In light of this, the following recommendations are

proposed:

• Nurses should promote and encourage the public to be

involved in the planning and delivering of services.

• Community nurses must also involve consumers of health

and social services in ways that increase their resources,

promote their capacity and power to influence factors

affecting their health and well-being, and enhance their

understanding of community nurse services.

• Nurses have a special relationship with the public and this

demands a readiness to ask people about their experiences

of health and how they want their care needs met.

• Commissioners and trusts must create a climate and culture

that is responsive to public involvement, and this must be

reflected in the resources, timescales, information exchange

and willingness to support individual practitioners in their

public engagement.



• Senior nurses at management, planning and commissioning

level should invest in developing strategies for involving

the public in service planning and provision.

Acknowledgements

The study was funded by the Southern Health and Social

Services Board and the Western Health and Social Services

Board in Northern Ireland, and Co-operation and Working

Together (CAWT).

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What is already known about this topic

• The importance of developing partnerships between

service users and service providers has been highlighted.

• Nurses have not been effective in working closely with

the public.

• There has been very little research on the public’s view

of community nursing.

What this paper adds

• The views of general practitioners and community

nurses on public perceptions of community nursing.

• The views of members of the public on issues in com-

munity nursing and primary care.

• The views of senior health managers and policymakers

on public involvement in primary care.



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community nursing- health professional and public perceptions

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