The sub-groups, made up of clinical experts, were set up by the government to investigate the feasibility of shifting orthopaedics, urology, dermatology, ENT, general surgery and gynaecology out of hospitals as outlined in the White Paper, ‘Our Health, Our Care, Our Say’.
All the groups identified the current plethora of specialist nursing titles, qualifications and variable Agenda for Change bandings for similar roles as a barrier to the successful transfer of services out of hospitals.
The recommendations have clear implications for Modernising Nursing Careers, which is currently investigating the future of specialist nursing.
The gynaecology sub-group also said it expected specialist nurses to be registered on the NMC’s sub-part of the nursing register for advanced practice, which is currently still awaiting government approval.
Meanwhile the dermatology sub-group called for wider dermatology training for all nurses, arguing that primary care nurses lacked confidence in the area despite often prescribing.
The specialty sub-group reports also identified workforce planning as an issue. Current services often depended on the enthusiasm and experience of individual nurses, they said. In the future, commissioners would need to ensure enough nurses were trained to a high level to ensure sustainability of services.
All the groups have made clear that protected time for doctor and nurse training and CPD should be part of any service level agreement.
The report has also called for Payment by Results to be altered to ensure hospital consultants can lead the shift of care into the community without foundation trusts regarding it as a threat to income.
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