Squeeze on UK health gives advanced nurses leading role

October 13, 2017 by Joe Jackson
Sara Dalby is an advanced nurse practitioner, one of thousands of professionals who are helping make up for the shortage of doct
Sara Dalby is an advanced nurse practitioner, one of thousands of professionals who are helping make up for the shortage of doctors in Britain

Sara Dalby never imagined she would one day operate on patients when she started studying nursing.

But with Britain facing a shortage of accentuated by Brexit, Dalby and fellow highly-skilled nurses have led the way in a reform already developed in North America.

"I didn't know these roles existed when I started; I didn't know I was going to go into (the operating) theatre either," the 35-year-old based at Aintree University Hospital in the northern city of Liverpool told AFP.

Advanced Nurse Practitioners (ANPs) like Dalby are considered increasingly important in Britain, where unprecedented pressure on the National Health Service (NHS) has seen a shortage of both doctors and funding.

The changing role of nurses "can potentially contribute towards that solution. I don't think they're the solution but they could potentially be used to help in some areas," Dalby said.

ANPs are also helping meet the changing needs of Britain's ageing population at a time when the prospect of Brexit is prompting European doctors working in the NHS to have doubts about staying.

The NHS in England last year already had a shortage of 6,500 family doctors and that shortfall is expected to rise to 12,100 by 2020, according to a recent estimate by Imperial College London.

A survey of some 2,000 European doctors in the NHS by the General Medical Council earlier this year found that 60 percent were considering leaving Britain.

'Real autonomy'

Dalby started out as a in 2003 and is now qualified to conduct facial skin cancer excisions and carpal tunnel surgery without a surgeon present.

ANPs can make independent diagnoses and care plans, as well as engage in more complex areas like surgery.

While they operate under varying levels of supervision, they have significant independence.

There are thousands of ANPs working in Britain
There are thousands of ANPs working in Britain

They typically earn more than nurses not in advanced practice but less than doctors and consultants.

ANPs began to proliferate in Britain following a 2006 change in the law.

No single organisation tracks their number, but Wendy Preston, head of nursing practice at the Royal College of Nursing (RCN), estimates thousands now operate in an array of fields.

"That change to legislation really opened out the ability for the nurse to be an independent practitioner and have real autonomy," Preston said.

Danny Mortimer, head of NHS Employers, a not-for-profit organisation, said the roles offer "a new opportunity for progression and career development for those who do not wish to move into management."

"And (they) have been shown to provide consistently high levels of patient care and outcomes," he added.

The trend has not received universal acclaim.

Some healthcare leaders expressing concern at the lack of regulation within the sector, citing cases of nurses unqualified for advanced roles still fulfilling such duties.

But as Dalby's case shows, becoming an ANP is far from easy. She embodies the time, persistence and patience required to reach this level, and the opportunities that can then open up.

Dalby acquired a Masters in advanced nursing practice and Masters-level qualifications in surgical care practice, all while working full time to build up clinical experience.

She now works in four specialities, as well as lecturing at Edge Hill University, co-authoring a textbook and working more administratively at the RCN and Royal College of Surgeons (RCS).

Ian Eardley, senior vice president of the RCS, said ANPs like Dalby are often "the glue that holds surgical teams together."

Explore further: Nurses' strike in Portugal cripples public health services

Related Stories

Nurses' strike in Portugal cripples public health services

September 11, 2017
Nurses in Portugal began a five-day strike over status, pay and working hours on Monday, crippling services at public hospitals, union leaders said.

Brexit puts EU lifeblood of British hospitals at risk

March 19, 2017
With British hospitals already struggling to fill their ranks, Brexit could make life even harder for the National Health Service as EU doctors and nurses either stay away or prepare to leave.

EU nurses registering in UK falls by 90% post-Brexit

January 27, 2017
The number of European nurses registering to work in Britain has fallen by more than 90 percent since last June's Brexit vote, the British Nursing and Midwifery Council (NMC) told AFP on Friday.

Nursing study investigates link between growth of retail-based clinics and nurse practitioner scope-of-practice reform

January 27, 2017
Just as primary care provider shortages are becoming acute, retail-based clinics in pharmacies and grocery stores are set to fill the gap in accessible patient care. Yet in some states, access to this convenient care is constrained ...

How different types of nurses impact the health of patients with diabetes

September 21, 2015
More than 28,000 nurses in the UK can prescribe the same medicines as doctors provided that it is in their level of experience and competence. A new study looks at whether there is added value of having nurse prescribers, ...

Recommended for you

One in 4 women and 1 in 6 men aged 65+ will be physically disabled in Europe by 2047

October 23, 2017
By 2047 one in four women and one in six men aged 65 and above is expected to be living with a physical disability that will severely restrict everyday activities, reveals an analysis published in the online journal BMJ Open.

Protein regulates vitamin A metabolic pathways, prevents inflammation

October 23, 2017
A team of researchers from Case Western Reserve University School of Medicine have discovered how uncontrolled vitamin A metabolism in the gut can cause harmful inflammation. The discovery links diet to inflammatory diseases, ...

New insights into controversial diagnosis of adolescent chronic fatigue

October 23, 2017
Crucial new research could provide some clarity around the controversy surrounding the diagnosis and treatment of chronic fatigue syndrome (CFS) in adolescents. The research by the Murdoch Children's Research Institute published ...

Do boys really have a testosterone spurt at age four?

October 23, 2017
The idea that four-year-old boys have a spurt of testosterone is often used to explain challenging behaviour at this age.

Our laws don't do enough to protect our health data

October 23, 2017
Have you ever wondered why your computer often shows you ads that seem tailor-made for your interests? The answer is big data. By combing through extremely large datasets, analysts can reveal patterns in your behavior.

New prevention exercise programme to reduce rugby injuries

October 23, 2017
A new dynamic 20-minute exercise programme, performed by rugby players before training and pre-match, could dramatically reduce injuries in the sport according to a benchmark study published today (Sunday 22 October).

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.