Health ministers have thrown their support behind specialist nurses, in the face of concern about their falling numbers.
Charities and unions have been warning for several months about trusts cutting posts as they try to make savings, despite increasing numbers of patients requiring specialist nursing services.
Health minister Paul Burstow, speaking at a fringe event hosted by Health Hotel at the Liberal Democrat conference in Birmingham last week, was pressed on the issue. He said there was evidence specialist nurses represented “value for money”.
At an earlier event in London hosted by the Smith Institute health secretary Andrew Lansley had also supported the case for specialist nurses and said they would be increasingly needed in order to provide specialist care outside of hospitals.
Mr Lansley said the government was planning changes in the way the NHS pays for services to aid the cause of specialist nurses.
It wants to move away from paying hospitals for a particular procedure or “episode” of care, as is currently the case under the tariff system. Mr Lansley said the NHS should increasingly pay for an entire “pathway” of treatment and care in one sum, or a “year of care” - under which a payment would be paid for all services required for a patient in a year.
Asked about support for specialist nursing, Mr Lansley said: “What [will have] the biggest impact is the shift of tariff from episodes to a pathway basis.
“That is when you begin to move from a focus on what clinician is responsible for a particular episode.”
He said the new models would be better suited, for example, to “a specialist nurse [who] can take responsibility for a number of patients, regardless of the location”.
Mr Lansley said the increased flexibility “directly enables specialist nursing to be supported”.
“At the moment the tariff very often doesn’t give them the tools for the job – it pushes them into specific structures,” he added.
Analysis by Nursing Times in March found specialist nurses were playing a quickly growing role, leading the treatment of more patients. However, charities have warned posts are being cut, including Diabetes UK which in May said 218 diabetes specialist nurse posts had been left vacant by trusts.