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Nurse specialists take initiative to show their value to NHS


Nurse specialists are developing a tool to demonstrate their clinical and financial value to trusts in order to ward off the erosion of their role as the NHS seeks to make massive savings.

As Nursing Times revealed last month, trusts across the country are requiring clinical nurse specialists to undertake general ward duties away from the specialist work in order to save money on expensive agency staff. Click here to see the Nursing Times article.

The concerns have prompted colorectal and stoma care nurse specialists at Homerton University Hospital Foundation Trust to develop an online tool that reveals their value along the care pathway, which they say can be shown to managers and trust boards.

Nurses use an online template to plot the pathway of their patient – from referral to discharge and follow up care – and then add in the specialist nurse input at every stage. They are currently working on refining the tool so that it will show their positive financial impact as well as their clinical input.

Trust nurse consultant in coloproctology Terri Porrett, who designed the model, told Nursing Times it supported specialist nurses by describing what they do and “ticks the boxes” to demonstrate their worth to managers.

She said: “It is not just about the senior nurse or director of nursing understanding what you do, clinical nurse specialists have a wider audience that they have to get their message across to.

 “The directors on the board of your trust need to know and value what you do, and the finance manager has to know you are cost effective. This tool shows managers that you can’t take the nurse specialist out of the patient pathway without it having a significant impact on patient care,” she added.

Ms Porrett was speaking to Nursing Times at the launch of a set of “high impact” actions for stoma care last week in London.

Chief nursing officer for England Dame Christine Beasley unveiled eight high impact actions in November last year, which if fully implemented, could save the NHS an estimated £9bn a year. Click here to see the Nursing Times Article.

A steering group of 12 stoma care specialist nurses, including Ms Porrett, have tailored the high impact actions to their area of care – the first specialist group to do so – with the endorsement of the Department of Health and the Royal College of Nursing. They have also developed three new actions specific to stoma and colorectal care.

The document “High Impact Actions for Stoma Care” can be downloaded at


Readers' comments (2)

  • Marjorie Lloyd

    We may also need to define what the difference is between a specialist nurse, a qualified nurse and an unqualified nurse - given that most of the trusts are aiming to replace qualified nurses with unqualified.
    This will be our road to destruction not the specialist nurses working on the wards.

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  • It is imperative that all nurse specialists across the country look at their value in the patient journey and look at ways ijn which we can prove our worth. The current financial climate means all avenues of cost cutting will be looked into by trusts looking to save money. This means no specialist post is exempt from a change to their working practices.
    We are valuable and do an excellent job, lets prove it!

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