Shum 2000.

Methods	Randomised trial
Participants	1815 patients (total group), mean age 27.5 years, 40% male 5 nurses 19 doctors
Interventions	Intervention: patients allocated to nurse Control: patients allocated to doctor Detailed description of the intervention: Compared acceptability and effectiveness of a practice‐based minor illness service led by nurses versus routine care offered by general practitioners. Nurses managed patient care and took the history, performed a physical examination, offered advice and treatment, issued prescriptions (which required a doctor's signature), and referred the patient to the doctor when appropriate. Supervision, oversight: Patients seen by a nurse were referred to a general practitioner when appropriate.
Outcomes	Patient outcomes: Health status Satisfaction Provider preference Process of care: Provision of information Resource utilisation: Length of consultation Return visits Prescriptions Emergency department visits Use of out‐of‐hour services
Notes	Country: UK Study period: 2 weeks Nurse role: first contact care for patients with urgent problems Nurse title: practice nurse Nurse educational background: EQF level unknown Nurse years of experience: average of 8.4 (3.8) years of experience in practice nursing Nurse additional training: 3‐month academically accredited degree level course on managing minor illnesses. Nurses attended one half‐day a week of formal group teaching by a nurse practitioner and were taught twice a week by general practitioners during routine surgeries in the practice where the nurses worked.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Sequence was generated by non‐resealable opaque envelopes. "Allocation to being seen by a doctor or nurse was determined using random permuted blocks of four with sequentially numbered, non‐resealable opaque envelopes".
Allocation concealment (selection bias)	Low risk	Allocation was concealed by sequentially numbered, non‐resealable opaque envelopes. "Allocation to being seen by a doctor or nurse was determined using random permuted blocks of four with sequentially numbered, non‐resealable opaque envelopes".
Baseline characteristics	Low risk	Baseline characteristics were reported and were similar for both groups. "The two groups of patients were comparable in terms of age, sex, the number who usually preferred to see a female doctor rather than a male, and their reported rates of consultation in the previous 12 months (table 1)". Baseline outcome measures were not relevant.
Baseline outcome measurement	Unclear risk	Primary outcomes were not assessed before the intervention.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	It is unclear whether the outcome was influenced by lack of blinding of patients and care providers.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No information
Incomplete outcome data (attrition bias) All outcomes	Low risk	For most outcomes, follow‐up was > 80%. Follow‐up for satisfaction questionnaire was > 75%, for mailed questionnaire 76%.
Selective reporting (reporting bias)	Unclear risk	The protocol was not available.
Contamination	Unclear risk	No information
Bias due to lack of power	Low risk	Sufficient power "It was calculated that 1060 valid responses would be sufficient to detect an effect size of 0.2 SD at the 95% confidence level with a power of 90% using two tailed tests".