The crucial contribution specialist nurses can make to their organisations has been in the spotlight this week, hopefully acting as a bulwark against the continuing threats to their position.
As reported by Nursing Times on Tuesday, inspectors from the Care Quality Commission praised Barts Health Trust for its use of specialist nurses to improve patient care and staff training. On the back of the visit, the inspectors recommended that the trust – one of the biggest in the country – be removed from the special measures regime for failing trusts.
Inspectors commended the trust for having specialist nursing teams in place including in dementia, psychiatric liaison, pain management, critical care outreach, palliative care, and oncology.
In particular, they noted that since their last inspection a clinical nurse specialist in palliative medicine had been trained as a non-medical prescriber. They also found that a learning disabilities nurse specialist was helping consultants to communicate with and make reasonable adjustments for patients with learning disabilities.
“It would be good to see more of this kind of thinking spreading around the country, but unfortunately I suspect we have a way to go”
This is a great advert for not only using specialist nurses to their potential but actually recruiting more of them to improve care and reduce unnecessary admissions. Barts appears to be looking at the long-term gain over the short termism that often leads trusts to be tempted to reassign specialists to other roles or cut their posts to save money.
It would be good to see more of this kind of thinking spreading around the country, but unfortunately I suspect we have a way to go.
For example, a charity has revealed to Nursing Times that is having to fight to save seven Parkinson’s nurse specialist posts across England that are at risk of being axed.
Katherine French, who leads on nurse development work at Parkinson’s UK, told us the charity was in talks with commissioners to try and stop the positions from being lost but was prepared to take stronger action if agreements could not be met.
This is a familiar situation that has been happening ever since clinical nurse specialist roles were created. When money is tight or staffing is short, specialist posts are cut despite a growing body of evidence that these nurses save money, cut admissions and improve the patient experience.
However, while specialists in some areas are having to take up a defensive position, others are going on the public relations offensive. A team of diabetes specialist nurses who set up a social media network have been touring the UK in a bid to showcase the work they do and recruit other nurses into the specialty.
Bethany Kelly, who makes up one-fifth of the Diabetes Specialist Nurse Forum UK team, highlighted to Nursing Times the success the network has had in bringing together nursing professionals who specialise or have an interest in diabetes. Other team members include founder Amanda Epps, Sarah Gregory, Susan Mason-Cave and Rebecca Watt. Hats off to the forum for their proactive stance.
Of course, specialist nurses should not have to be fighting their corner at all. They should be lauded for what they are, excellent examples of experts in care who can make a real difference to patients and services.
The NHS Long Term Plan mentions them specifically a couple of times in relation to specific conditions, namely heart failure and cancer.
It states that, when admitted to hospital, the NHS in England will improve rapid access to heart failure nurses so more patients who are not on a cardiology ward will receive specialist care and advice.
Meanwhile, it promises that over the next three years every patient with cancer will get a full assessment of their needs, an individual care plan and information and support for their wider health and wellbeing. All patients, including those with secondary cancers, will have access to the “right expertise and support, including a clinical nurse specialist or other support worker”.
I hope specialist nurses around the country can take heart from their colleagues at Barts and, at the first sign of trouble, have a copy of the CQC report ready to show those who would try to dilute their role. As the plan rightly says, patients need more access to specialist nurses – and that’s a fact.