The Nuffield Trust report, Reshaping the workforce to deliver the care patients need , is written for the “employers”. The response from the BMA (for doctors) and the Patients Association (For patients) shows the initial thoughts of the professionals. It will be interesting to hear the response from the Insurance Companies that cover the doctors and nurses. They will anticipate more claims, and premiums will inevitably reflect this. Nurses are untrained in differential diagnosis, efficient investigation requests, etc. etc. – so they are now asked to step in and probably without liability insurance cover…. Physiotherapists are efficient at musculoskeletal complaints and the experienced will recognise the “red flags” when cancer presents as (e.g) back pain, but expect delay and missed diagnosis. Demand for private health care may well rise, and a two tier system result. As NHSreality predicted (Dentistry now outside the Health Services for most of the nation ) General Practice could follow and become.. “two tier”.
…Expanding the skills of the non-medical workforce presents big organisational challenges and will not be easy in the current financial context. Reshaping the NHS workforce also carries risks. Evidence shows that without carefully redesigning how different staff work together, new and extended roles like these could increase patient demand, thereby costing money rather than saving it….
Thousands of nurses will be trained to fill in for doctors under plans to deal with chronic staff shortages.
Patients will be given drugs and tests by senior nurses, who will also be expected to take decisions on treatment usually made by junior doctors.
Details of the plan came the day before a deadline for a resolution of negotiations on a new contract for junior doctors. Tens of thousands refused to work even in A&E departments on two days last month in the first all-out strike in the NHS, and further strikes have been threatened.
Every hospital and many GP surgeries will be encouraged to develop advanced practice nurses under a blueprint drawn up for NHS Employers, the organisation that oversees staffing across the health service, to deal with a lack of junior doctors……
Katherine Murphy, chief executive of the Patients’ Association, said: “These proposals will not solve the shortage of skilled doctors and nurses across the health service.”
Mark Porter, chairman of the British Medical Association council, said that the plans were a sensible short-term solution, but added: “This should not be done at the expense of good quality training for doctors or, indeed, doctors themselves.”