ABSTRACT
This chapter addresses the challenge of developing new roles for primary health care nurses within the context of purchasing, providing and contracting. The professional initiatives and policies that are enabling and influencing changes in role are examined, together with the tensions arising from the conflict between individual and community approaches. The effects of the changing role on practice are discussed, with particular reference to increasing autonomy through nursing development units and redefinition of roles, seen in moves towards nurse prescribing, development of nurse practitioners and the increase of practice nurses.
