I NOTE with interest your report on practice nurses ("Patients fear nurses taking on work of GPs", The Herald, November 19).

You state that "patients are worried that nurses in Scotland are increasingly taking on GPs' work". I would be interested to see the evidence on which you base this statement. Nursing consulta­tions have risen in the past 10 years, as your article shows, yet as far as I am aware, there is little to back up the claim.

Indeed, the Scottish Patient Experience Survey of GP and Local NHS Services found that the vast majority of patients felt confident in the practice nurse's ability to treat them and that the nurse had all the information needed to treat them. Similarly, when it was first proposed that appropriately trained nurses could safely prescribe medicines, many voices were raised against this. Yet a review carried out by the University of Stirling a number of years later found that the public has considerable confidence in nurse prescribing and nurses are regarded as "safe prescribers" by both patients and professionals.

The Royal College of Nursing is certainly not arguing that nurses can replace doctors. What we are saying is that doctors, nurses and other members of health care teams need to work together effectively to deliver healthcare in a way that meets the needs of their local population - and that everyone in a multi-disciplinary team should be treated equally, with respect for what they each bring to the team.

At a time when the NHS is under increasing pressure and we know that changes are needed to the way health care is delivered, surely, as long as patients are treated by healthcare professionals with the right skills and qualifications, job titles are not important.

Theresa Fyffe,

RCN Scotland director,

42 South Oswald Road,

Edinburgh.

AS an occasional patient of the NHS in Scotland I do not find the fact that nurses are taking on the work of GPs a cause for alarm.

Recently I had to wait a week for an appointment with my GP in order to be referred to a hospital consultant when the referral could easily have been done by a qualified nurse.

There are many occasions when GPs are burdened with appointments for minor matters that could have easily been handled competently by experienced nurses. This method of dealing with appointments should be a cause of satisfaction and the increase in this process should be welcomed and encouraged. If this process leads to a reduction in cost of consultations we can be glad of the opportunity of expanding the service. We should be encouraging the use of nurses to relieve GPs of their stressful burdens.

Ed Cardiff,

1 Levanne Place, Gourock.

YOUR report on practice nurses quotes a Government spokesperson as saying that the number of GPs has increased by 5.7%, or by 250 additional GPs since 2007. However, these figures are not in line with those published in official statistics (Information Services Division Scotland) on the primary care workforce in 2013 which state that in the last four years there has only been an increase in the number of full-time equivalent GPs of less than 1%, or 35 GPs.

The issues raised in the article are symptomatic of the falling investment in general practice. In real terms this is the equivalent of a £30m drop over the past four years as revealed by our new campaign, Put Patients First: Back General Practice, which calls for an increase in funding for general practice to 11% of the NHS budget by 2017. Practice nurses are vital members of Scotland's highly skilled general practice teams. However, they are paid for by general practice budgets and without an increase in funding there will be increasing pressure on them and on GPs to maintain and deliver excellent standards of patient care.

Dr John Gillies,

Chairman, Royal College of General Practitioners (Scotland),

25 Queen Street, Edinburgh.