Hundreds of unregistered care staff are working in NHS roles that hold advanced or specialist nursing titles, posing a “real risk” to patient safety, a new study has concluded.
Among the 8,064 posts looked at that were labelled as being advanced roles, 323 – around 4% – were held by staff with no qualification recorded with the Nursing and Midwifery Council.
“What the results of this study clearly show is that advanced nursing practice needs regulation to help protect the public”
Professor Alison Leary
This group of unregistered nursing support workers with dubious titles were found to be most prevalent in London and the North East of England, according to researchers at London South Bank University who carried out the study.
They were working at NHS band 3 or 4 level, earning between £17,000 to £22,000, mainly in emergency care, pre-assessment, theatres and cancer care services. The majority used titles including “advanced practitioner”, “specialist practitioner” and “advanced nurse practitioner”.
There is currently no system of regulation for UK nurses working at an advanced level, but global body the International Council of Nurses recommends that advanced nurses who often prescribe drugs and manage a caseload should have obtained at least a master’s degree-level qualification.
“As there is no regulation of specialist advanced practice in the UK, employers and postholders drive the labelling of posts,” said the new research paper, called Variation in job titles within the nursing workforce.
The lead nursing professor behind the study, Alison Leary, said the findings “clearly show” that advanced nursing practice must be regulated.
“If the current system is allowed to continue unhindered, then there is a real risk posed to patient safety”
The study also found that many registered nurses were using specialist or advanced titles when they in some cases had no additional qualifications – while others had master’s or PhDs.
This meant that among the 8,064 advanced jobs for which an educational level of those in the job was known, postholders ranged from unregistered support workers – with no nurse qualification – to registered nurses with doctorates.
Overall, the researchers looked at a total of 17,960 specialist nursing posts between 2006 and 2016 within NHS trusts across the whole of the UK and found 585 different job titles were in use.
The findings, due to be published tomorrow in the Journal of Clinical Nursing, warned of a resulting risk to patient safety and undermining of public confidence in the nursing profession.
“What the results of this study clearly show is that advanced nursing practice needs regulation to help protect the public,” said Professor Leary, chair of healthcare and workforce modelling at the London university.
“Lack of consistency has implications for the wider perception of advanced specialist practice in the worldwide community and the workforce more generally,” she said.
“If the current system is allowed to continue unhindered, then there is a real risk posed to patient safety. Public trust also risks being undermined by NHS trusts applying professional job titles to low-paid carers who are not fully qualified nurses,” said Professor Leary.
“In some instances, there is evidence that these post holders are being expected to treat members of the public and are missing diagnoses altogether, which could lead to patients becoming seriously ill or worse,” she warned.