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Monday, 22 November, 1999, 03:54 GMT
Nurses' role set to expand
Nurses are keen to take on a bigger role

Plans to expand the role of nurses in the NHS have been be announced by Health Secretary Alan Milburn.

Mr Milburn says he wants to remove the rigid barriers that currently exist between the role of nurses, doctors and other health workers.

The expanding role of nurses
Running gastroenterology outpatient follow-up clinics and patient education programmes
Running diabetes outpatient clinics and controlling insulin doses
Managing the use of opiates in palliative care
Nurse practitioners
Nurse prescribing
The health secretary is keen to allow nurses to take greater responsibility for administering drugs, including powerful chemotherapy drugs for cancer patients.

He also wants to give nurses more responsibility in hospital wards and GP surgeries.

Addressing an audience at King's College in London, Mr Milburn said a far-reaching review of the roles of doctors, nurses and other health care professionals was under way to promote more flexible team working.

He said nurses were already at the forefront of pioneering schemes, including seeing diabetic patients in outpatient appointments and carrying out endoscopies.

He announced the establishment of a new training centre to teach the 250,000 nurses working in the NHS how to take on more clinical responsibilities.

Mr Milburn is also keen on reforming the pay structure to remove ceilings to promotion, and allowing higher pay for nurses.

Faster treatment

Alan Milburn wants a greater role for nurses
Mr Milburn said: "Where we want to get to is an NHS that offers people faster treatment

"We have to deliver care in a way that is unrecognisable in terms of 1948. It means revolutionising the heart of the NHS.

"If you look at somewhere like Leicester Royal Infirmary, they are re-engineering their outpatient service. They changed the demarcations between staff. They have speeded up treatment, improved levels of patient satisfaction.

"We can do that everywhere and that is precisely what I want to see."

The previous Health Secretary, Frank Dobson, floated the concept of blurring the lines of responsibility between doctors and nurses.

Monday's speech was the first occasion on which Mr Milburn has backed and fleshed out the idea.

Nurses were given more power to prescribe drugs under protocols set out by doctors several years ago.

Christine Hancock, General Secretary at the Royal College of Nursing, welcomed the proposals.

But she said: "The government must address nurse shortages because the experienced nurses needed to make this vision a reality are currently struggling just to keep the NHS afloat."

The British Medical Association also welcomed the possible extension of nurses' roles.

Dr Peter Hawker, chairman of the BMA's consultants' committee, said: "Hospital practice is changing fast. The last decade has seen major changes in the way we deliver care.

"Some of the most exciting areas of innovation have resulted from collaboration between nurses and doctors to improve access and follow up for patients.

"This is not an area of controversy for doctors. My only note of caution is that we must ensure we also retain experienced clinical nurses on the wards to deliver skilled nursing care to inpatients."

Dr John Chisholm, chairman of the BMA's GP commitee, said: "What is important as professionals' roles change and evolve is that all professionals including doctors and nurses are trained for those new roles, keep up to date and have the necessary competencies to deliver what is envisaged."

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See also:
21 Jan 99 |  Health
Nurses want larger role
10 Mar 99 |  Health
Nurses to get extended prescription powers
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Nurses: Reward experience
18 Jan 99 |  Health
Nurses: a degree of success

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