Specialist nurses are the type of health professional in most short supply in Scottish rheumatology clinics, according to a survey of those working in the field.
Overall, 92% of Scottish health professionals working in rheumatology units considered their service to not be sufficiently staffed.
The most understaffed roles included specialist nurses, rheumatology trainees and allied health professionals.
The finding comes from the Rheumatology in Scotland: State of Play report, based on a survey of around 50 members of the Scottish Society for Rheumatology and the British Society for Rheumatology.
When asked to indicate which roles are most understaffed, the most popular response was specialist nurses, which was chosen by 30% of respondents.
The next popular were medical trainees and allied health professionals, chosen by 20% of respondents. Meanwhile, 6% said they were most short of general nurses.
“A number of issues have emerged, which if ignored, could result in poorer outcomes for patients”
The report highlighted that rheumatology nurses could assist in self-management and help provide patient education, helpline services, outpatient clinics, vocational rehabilitation, fatigue management groups and joint protection programmes.
Specialist nurses could also undertake the function of a care co-ordinator, it said, adding that there were cost benefits from employing nurse and other non-medical roles.
For example, it said outpatient work done by a specialist nurse cost £72,128 per annum per nurse but delivered savings of £175,168.
“In light of this, it is concerning the nurse and AHP roles continue to be understaffed,” stated the report.
In addition, survey participants noted patients’ ability to access treatment was limited by staffing numbers.
For example, access to the drug rituximab was cited as “problematic” due to lack of nurse support to deliver the therapy, resulting in waiting lists.
The report noted that the Scottish Public Health Network had previously highlighted that there were few training programmes for rheumatology specialist nurses and AHPs in Scotland.
As a positive example of what could be achieved, it highlighted that NHS Greater Glasgow and Clyde had developed an associate rheumatology nurse specialist training post.
The 10-month training post rotated through three rheumatology units, with the academic element supported by Glasgow Caledonian University.
The initiative was found to be cost effective and a second 12-month training post had now been developed, noted the report.
“The report provides a real insight into the pressures facing rheumatology services”
Among its recommendations, it called on the Scottish Government to “ring fence” a proportion of the £2.5m it had previously announced for investment in specialist nursing and care from 2015-16 for specialised rheumatology nurses.
Scottish Society f Rheumatology president Dr Elizabeth Murphy said: “This report helps shine a light on the key challenges facing rheumatology services in delivering care to patients across Scotland.
“The last decade has seen enormous advances in the drug treatments available for our patients and we need to ensure that our services are set up to deliver these treatments to the maximum benefit of patients,” she said.
“A number of issues have emerged, which if ignored, could result in poorer outcomes for patients,” she warned.
Professor Simon Bowman, president of the British Society of Rheumatology, added that the report provided “a real insight into the pressures facing rheumatology services”.