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Letter: Specialist nurses matter - but we need to demonstrate how

NHS England and the Department of Health have failed to realise that specialist care for complex diseases requires experienced and knowledgeable support
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I completely agree with the Nursing Standard editorial highlighting the fact that NHS England and the Department of Health have failed to realise that specialist care for complex diseases requires experienced and knowledgeable support for the patient at many time points.

When patients have a complex disease managed by a specialist team, it will usually mean that primary care teams will refer the patient back to the specialist unit for a wide range of issues.

The nature of their condition combined with complex treatment regimes means that primary care teams want to get advice/or delay other aspects of care until their next appointment or refer patients back. So the cost and consequences will be to totally deskill the primary care teams (who would have a slightly closer relationship with their local unit) and disempower the patient and add burdensome travel.

Independent nursing consultant Alison Leary - and

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I completely agree with the Nursing Standard editorial highlighting the fact that NHS England and the Department of Health have failed to realise that specialist care for complex diseases requires experienced and knowledgeable support for the patient at many time points. 

When patients have a complex disease managed by a specialist team, it will usually mean that primary care teams will refer the patient back to the specialist unit for a wide range of issues.  

The nature of their condition combined with complex treatment regimes means that primary care teams want to get advice/or delay other aspects of care  until their next appointment or refer patients back.  So the cost and consequences will be to totally deskill the primary care teams (who would have a slightly closer relationship with their local unit) and disempower the patient and add burdensome travel.

Independent nursing consultant Alison Leary - and others - have spent a number of years now trying to highlight how we must demonstrate more clearly the immense complexity of specialist nurse roles and how they have a significant impact for patients while saving NHS costs.

For example, telephone advice lines give patients knowledgeable access, pro-active management by specialist nurses prevents A&E visits or requests for hospital or GP appointments at the same time as providing on-going tailored support.  Because the work we do crosses numerous areas of care - measuring the value is complex – but it is possible! 

Specialist nurses are cost effective (provided there is clarity about the role and level of competencies required) and patients value the continuity of care (something they do not see with junior doctors).  

When will NHS England and DoH start looking properly at collecting the right measures to evaluate the benefits of care for patients with complex disease?

 

Susan Oliver

Nurse Consultant Rheumatology (Retired)

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