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Researcher calls for investment in ‘pivotal’ specialist nurses


The NHS must consider investment in nurses with specialist training in advanced practice to ultimately reduce costs and increase efficiency, according to a UK healthcare academic.

Alison Leary, professor of healthcare modelling at London South Bank University, argues that misconceptions about the use of specialist nurses have hampering their perceived value and impact.

“With just small investments in education and administrative support, we could grow and develop this workforce”

Alison Leary

Professor Leary, who has researched the work done by specialist nurses, said: “There is a perception that these nurses are expensive, but actually they are a very good return on investment and there are a lot of studies that show that.

“Together with colleagues, I have looked at the work of 12,000 specialist nurses in advanced practice, around 50 million hours of work, and they are a cost effective, high-quality option in terms of delivering care, she added.

“With just small investments in education and administrative support, we could grow and develop this workforce. It is a solution, not a cost and problem,” said Professor Leary.

Specialist nurses were now “pivotal to running services in long-term conditions and managing very complex caseloads”, she argued.

Professor Leary made the points in a special supplement on specialist nurses published by Nursing Times’ sister title Health Service Journal.

The supplement – titled Time for some advanced thinking?: The benefits of specialist nurses – pulled together the opinions of nurses, patients, academics and others on the differences specialist nurses can make.


Readers' comments (10)

  • Advanced on top of specialist?? We don't have any educated generalist nurses in the UK. Get that right first!!

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  • I agree! Get the terminology correct. Specialist Nurses and Advanced Practitioners are different entities altogether. I've just completed a module on this very subject as part of my MSc in Advanced Practice. Is the author describing 'Advanced' or 'Specialist' practice?

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  • too many hierarchical layers. nurses are nurses and should be involved, at the same level, in the common interest of front line patient care as in the rest of Europe. all of these layers, typical of any british establishment, are an illusion of better care and to detriment of good care by destroying the fabric and moral of staffing through power struggles, competition and bullying of which none of these have a place in caring for the sick, injured and dying. time for fundamental attitude changes in the NHS fit for the 21st century and the application of modern medicine.

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  • Anonymous | 3-Mar-2015 11:10 am

    Would you apply the same argument to other health care workers, for example medical staff - that we should no longer have junior doctors, registrars and consultants but only a single unified level of doctors?

    Many nurses tale on specialised or advanced roles because it gives them an opportunity to work in areas that they particularly enjoy. They also do it in order to step up the career ladder and to earn more pay in return for developing new skills and taking on more responsibility. If you were to take this away then far fewer nurses would take this route, to the great detriment of patient care.

    Specialist and advanced roles are common throughout Europe, the USA, etc. with these nurses typically being employed at a higher level than more junior staff.

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  • Laha78

    I just wish to become a specialist nurse there would be more opportunity to do 'on the job' training!
    As a band 6 already working in acute care, it's my dream to become a health visitor. I can't however afford the dramatic drop in wages for the year it would take to qualify but with on the job training I could bring experience and a dedication to learn whilst attending uni 1 or 2 days a week if supported!

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  • michael stone

    I grasp the difference between 'advanced' and 'specialist' but remember that we are talking about 'day jobs' here.

    In the same way that a surgeon who performs 100 hip replacements a year should be better at it than one who does 5 a year, 'simply through 'on-the-job learning'', most nurses who specialise in a particular area of practice, should 'become better at it' (which equates to 'become 'advanced'').

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  • having worked in the NHS, briefly in the UK private sector and the bulk of my career in a European university hospital I find the flatter system for nurses s I describe as far superior to the UK system. all nurses and the nurse floor manager (= 2 layers) have a common goal which is the best care possible of their patients. they are fully professionally autonomous and on a ward each manages their own case load. they are also part of an interdiscplinary team and all work together with the patient as central focus. communications are open and transparent and it is an excellent and highly stimulating learning environment. In a hospital with around 5000 staff, in our department and those we worked with did not have stories of whistleblowing, bullying and stabbing others behind their backs. if there was any issues these were addressed directly with those concerned which prevented them developing from molehills into mountains and people were not afraid of reporting and discussing their errors which, with any necessary support, were easier to rectify and rarely did they become so serious they had to go to higher management levels and if they did there was also opportunities for open dialogue and the relevant support. it made a pleasant, respectful and highly motivating and well resources environment to working in providing the very highest standards of care and where the left and right hands knew what the others were doing instead of all of the divisiveness and intrigue found in the NHS which is highly detrimental to adequate care.

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    you should get a proper job instead of demonstrating your persistent trolling and voyeuristic behaviour on the websites of journals of the professions of which you are not a member.

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  • Advanced is a level of practice not a job title. Specialist nurses particularly nurse consultants practice at advanced levels but are also specialists. Its about the complexity of care.
    Why does nursing have to be so adversarial to other nurses? This is why it doesn't have a voice.

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  • by definition generalist nurses with many years of experience and proven skills are also specialist nurses and advanced practitioners in some of the areas of the work they do. what is in a title other than further divisiveness in the profession?

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