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Readers' panel: Should staff extend their roles to meet rising demand?

Our panellists comment on a report which argued the only way the NHS can meet future demand is to extend the skills of non-medical staff

"A report from the Nuffield Trust argues that extending the skills of nurses, healthcare assistants (HCAs) and other non-medical staff is the only way the NHS can meet the growing demand for patient care. Hasnt this been happening for years? Specialist nurses already lead clinics and prescribe, while HCAs learn to cannulate. Extending the roles of non-medical staff can be a positive step, allowing for upskilling and the creation of more diverse, motivating roles."

Mike Wallis, nursing student, University of York

"I have no issue with nursing staff and support workers extending their roles if it benefits patients and professionals, with increased job satisfaction and career progression. But this should not be a cheap option used simply because of a shortage of appropriately skilled staff. Demand in the NHS will continue to rise, and with it complexity, but this is a question

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Mike Wallis

"A report from the Nuffield Trust argues that extending the skills of nurses, healthcare assistants (HCAs) and other non-medical staff is the only way the NHS can meet the growing demand for patient care. Hasn’t this been happening for years? Specialist nurses already lead clinics and prescribe, while HCAs learn to cannulate. Extending the roles of non-medical staff can be a positive step, allowing for upskilling and the creation of more diverse, motivating roles."

Mike Wallis, nursing student, University of York


"I have no issue with nursing staff and support workers extending their roles if it benefits patients and professionals, with increased job satisfaction and career progression. But this should not be a cheap option used simply because of a shortage of appropriately skilled staff. Demand in the NHS will continue to rise, and with it complexity, but this is a question of appropriateness, not of plugging gaps."

Jane Scullion, respiratory nurse consultant, Glenfield Hospital, Leicester


Mark Pittman

"Nurses have been extending their roles for decades. Emergency and advanced nurse practitioners, for example, have demonstrated their cost effectiveness, even though trusts repeatedly fail to capitalise on their skills. The problem is finances – there is a bottomless money pit but only a trickle for nurses, who have to beg, borrow or steal for education and extended positions. I fear that, politically, we will be ignored."

Mark Pittman, emergency nurse practitioner, Southmead Hospital, Bristol


Liz Charalambous

"In the current political climate, extending the roles of nurses and support staff may be seen as an opportunity to deliver services ‘on the cheap’, without thinking about the long-term implications. We need to invest in education for health professionals to take on extra roles at all levels, and to ensure continued delivery of quality services. This opportunity needs to be managed intelligently to avoid a catastrophe."

Liz Charalambous, staff nurse, Nottingham University Hospitals NHS Trust @lizcharalambou

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