PATIENTS are worried that nurses in Scotland are increasingly taking on GPs' work, with doctors also raising concerns they are suffering from stress and 'burnout.'
The fears emerged as new health service estimates suggest practice nurses now deal with one in three consultations with patients in Scotland. Ten years ago it was just over one in four.
The number of nursing consultations over the past 10 years has risen 31% from about 6.1 million to eight million as they take on more responsibility for work GPs used to do, including handling chronic disease management.
Practice nurses now account for almost half of all GP practice consultations (47%) in managing long term conditions affecting the elderly, allowing people to stay at home for treatment, says the Royal College Of Nursing (RCN).
It has emerged the amount of work handed to practice nurses in some key areas has more than tripled over the past seven years across a series of key work areas.
The Royal College Of General Practitioners has already warned that care is being put at risk due to a slump in the amount of NHS budget spent on general practice in Scotland, now the lowest on record.
BMA Scotland warned of "stress and burnout" as they deal with increased workloads as it emerged the number of GP practices has slumped to fewer than 1000 in Scotland for the first time since records began.
Meanwhile, the number of whole time equivalent nursing and midwifery staff in Scotland has dropped from more than 58,000 in 2009 to just over 57,000 in June.
Dr Jean Turner, executive director of the Scotland Patients Association raised concerns, saying there were "too many nurses doing doctors' work, because nurses are cheaper than doctors".She added: "I don't think this is a pathway we should have gone down."
NHS figures show that in the past two years providing prescriptions and giving medication reviews has become, for the first time in the past seven years, one of the practice nurse's top 10 most common jobs, accounting for 423,520 patient contacts last year.
Also figuring for the first time in the Scottish practice nurses' most common activities in the past two years is dealing with patients' psychological symptoms, with about 374,820 patient consultations last year.
The number of contacts for blood pressure monitoring and reading has more than tripled, from 606,720 in 2006/07 to 1,930,120 in 2012-13. Similarly, the number seeking general diagnostic tests and assessments rose from 434,930 to 1,449,450 over the seven years.
Patients' consultations related to dealing with circulatory and respiratory symptoms increased 44% from 409,700 to 590,720.
Meanwhile, appointments involving the practice nurse's most common job, taking blood tests, has risen 37% from 2,026,120 to 2,772,330 over the seven years.
The RCN said there was need to develop nursing roles, but this was not being matched with sufficient staff to deal with the workload.
Theresa Fyffe, RCN Scotland director, said: "We all want more care delivered safely in the community so fewer people are admitted to hospital and more patients are treated at or closer to home.
"All this is putting more pressure on practice nurses and other members of the nursing team in GP practices, many of whom are trying to meet this increased demand without a similar increase in the number of nursing staff employed or the resources available to them."
A Scottish Government spokesman said: "Under this Government the number of GPs have increased 5.7%, which is more than 250 additional GPs.
"Scotland has more GPs per head of population than the rest of the UK and is also leading the way with the world's first patient safety programme for primary care."