Collaboration

The Focus column by David Jewell1 and the editorial by Rosamunde Bryar2 touch on the topic of shared responsibilities for care and the importance of responsiveness and good communication. This should be strengthened and facilitated by practice-based education and interprofessional adult learning, starting from the organisational and/or employer end of primary care.

It is important to get reciprocal collaboration, and focus on the initial preparation of doctors and nurses.

In Italy, for the last few years we have had a compulsory bachelor's degree for specialist nurses, opening up real opportunities for more joint learning and programmes at undergraduate level.

Sadly, the new bachelors don't seem to be getting better at communication and team-working and conflicts are arising in teams and departments. They regard themselves to be less considered than previous ‘normal nurses’ and at the same time they claim more autonomy, and do not follow, as before, doctors' therapeutic and decisional directives. This can have disastrous consequences on collaboration and healthcare development for patients.

• © British Journal of General Practice, 2008.