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Specialist nurses trained to take over surgical service from doctors


Specialist nurses at an NHS trust in the South of England are now performing a minor surgical procedure formerly led by senior doctors. 

Cardiac rhythm specialist nurses at University Hospital Southampton NHS Trust have undergone extensive training to implant devices in patients with heart rhythm problems.

The operation is traditionally carried out by consultant cardiologists.

“This is a significant development in the roles and responsibilities of our nurses”

Dr Waqas Ullah

The new nurse-led service is based at Southampton General Hospital and launched in December.

The procedure is used for patients with heart rhythm problems, such as the heart beating too fast, too slowly or irregularly

Specialist nurses implant a paperclip-sized device, called Reveal LINQ, under the patient’s collarbone while they are under local anaesthetic.

The device helps to identify changes in the patient’s condition and sends information remotely to their clinician. 

The Reveal LINQ device

The Reveal LINQ device

Source: University Hospital Southampton NHS Foundation Trust

The Reveal LINQ device

Following an extensive training programme, the service is being provided by nurses supported by the cardiac physiology team.

Paul Thirlwell, clinical nurse specialist in cardiac rhythm management, played a crucial part in setting up the initiative and is now running the new service at the hospital.

He said the training and governance trial was the longest point in developing the service and explained how cases were undertaken in the trust’s cardiac catheter labs in this period.

“The first formal independent nurse-led list with support from our physiologists was in December 2018 with the aim of a monthly list depending on referral rates going forward, January is already booked up,” he added.

Mr Thirlwell added that the initiative was a good example of the trust demonstrating its values: “working together, patients first and always improving”.

Dr Waqas Ullah, a consultant cardiologist at University Hospital Southampton NHS Foundation Trust, said: “Our cardiac rhythm nurses have undergone extensive training to implant these devices independently as part of an ongoing expansion of their roles and our leading cardiac services.

“This is a significant development in the roles and responsibilities of our nurses as these devices remain in place for around three years and are used to diagnose potentially life-threatening changes in heart rhythm,” he said.

He added: “Importantly, in addition to developing the skills of our clinical team, this nurse-led service will ensure we can speed up clinic access for patients and free up consultant time.”

In a separate development for the service, Dr Ullah was recently invited to represent University Hospital Southampton NHS Foundation Trust in Pakistan where he demonstrated the use of a new piece of 3D mapping equipment.

Used widely in Southampton, it is required to help clinicians perform complex ablation procedures to scar or destroy tissue responsible for causing abnormal heart rhythm.


Readers' comments (4)

  • Congratulations on developing this patient centred service. Nurses lead the way in new medical associate professions, whilst highlighting nursing care as our primary aim!

    Adrian Jones RN
    Orthopaedic Surgical Care Practitioner
    Immediate Past President
    Association for Perioperative Practice

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  • I have been doing skin surgery as a band 5 staff nurse for over three years without any recognition.

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  • Well said Anonymous 12:29

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  • Well this should be recognised. You should be banded higher and given a specialist role.

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