Radical changes in the make up and responsibilities of hospital staff are needed if the challenges of the new NHS agenda are to be met, according to a report from the Royal College of Physicians.
Consultants, junior doctors, and nurses all need to be more flexible and to work together more as a team to serve patients better, recommends the interim report. A full report will be published at a later date.
Among the key recommendations is the creation of a new post of healthcare practitioner, to support the work of doctors and nurses. It is envisaged that after a two to three year training programme healthcare practitioners would be responsible for tasks such as assessing emergency treatment of patients according to agreed protocols and ordering and perhaps undertaking diagnostic tests.
The report quotes the example of a former used car salesman in the Midlands who was trained to record and analyse electrocardiograms and who became so proficient that he was able to set up a cardiac arrhythmia service for the NHS.
The recommendations have been developed to tackle current staffing arrangements, which are failing to meet the needs of patients adequately. Patients who need acute care are still waiting too long to be seen, and there are too few staff to run services properly.
Hospital Doctors Under Pressure: New Roles for the Health Care Workforce can be seen on the Royal College of Physicians' website at www.rcplondon.ac.uk/pubs/wp.
Summary of recommendations of Royal College of Physicians
• New consultants should be involved in acute care of patients; established consultants should have a greater role in teaching, auditing, and management
• Healthcare practitioners should be introduced to work alongside doctors and nurses
• Senior house officers should be taught more general skills
• The role of medical secretaries should be expanded
• Better links should be established between accident and emergency clinical staff and the admitting medical team
• Nurse led intermediate care beds in the community should be developed
• Trusts should introduce better information systems for healthcare professionals, including telemedicine
• There should be more shared learning among healthcare professionals and more hands-on training for medical students