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Emergency nurse practitioners needed to avert A&E 'crisis'


The NHS is “desperately short” of emergency nurse practitioners, which is exacerbating a “crisis” in medical cover, the College of Emergency Medicine has warned.

College registrar Clifford Mann spoke to Nursing Times following a “crisis summit” called by the medical body to discuss the chronic shortage of emergency consultants and middle grade doctors.

Many hospital trusts are reporting problems filling medical posts in accident and emergency departments. Recruitment problems were partly behind recent decisions to close A&E departments overnight at Mid Staffordshire Foundation Trust and Mid Yorkshire Hospitals Trust.

Mid Yorkshire was only able to begin operating a 24 hour service again in September after bringing in GPs with emergency medicine skills to man the service overnight while Mid Staffordshire is still closed between 10pm and 8am.

Dr Mann said staff shortages often meant medical shifts were being filled by poor quality locums or not at all. This put pressure on other staff in A&E, including nurses, and led to potentially unsafe care.

He told Nursing Times more emergency nurse practitioners could help alleviate the problem, as they were often able to work more autonomously than junior doctors. But he said trusts were reluctant to fund the posts, as emergency nurse practitioners were on a higher pay band than most A&E nurses and cost more than trainee doctors – much of whose salary is paid by the deanery.

Dr Mann said: “The college is very keen to encourage multidisciplinary working. We are desperately short of emergency nurse practitioners; if we had more of them that would free up medical staff.”


Readers' comments (4)

  • Many A&E Depts. are small, offering a limited range of clinical experience and lacking in support such as 24 hour on site CT scanning. These departments will never be attractive to prospective Consultants.

    Increasing the number of Nurse Practitioners will not alter the status of these small and professionally unattractive units but will ensure patients with minor illness/injury are seen and treated sooner.

    Keeping these small and badly staffed units open and continuing to call them A&E departments is irresponsible and potentially criminally negligent.

    "Out of hours" services do require urgent consideration. Many patients feel they have no options other than to attend A&E as they find accessing "emergency" GP care almost impossible.

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  • If they stopped cutting back on training, and introduced more moduler and e-learning, more staff would be able to step up to the additional challenges.

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  • we are the victims of our own success us nurse practitioners! We can do what doctors do and what nurses do and at half the price. The WIC where I work cannot recruit any more NPs and has to pay for more expensive GPs with inferior skills to NPs-and where is the recognition for our work?Dont get me started

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  • Kirsty Armstrong; inferior skills to NP?
    Please explain how a doctor with 10 years of medical education provides inferior MEDICAL skills than a nurse practitioner, you people really, really think you are something for a group that have no organised standardised training, no standardised exams. Having seen the content of these 'advanced practice' courses it is madness that you people are allowed to practice autonomously.

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