Specialist nurses provide expert care
Some of the most experienced and highly skilled nurses in the NHS fear for their jobs despite a budget surplus in the health service, a survey indicates.
A fifth of the 330 specialist nurses polled by the Royal College of Nursing said they were at risk of redundancy or being downgraded.
The nurses specialise in conditions such as diabetes and Parkinson's.
Nurse leaders said it "beggars belief" that nurses were worrying about their jobs in the current climate.
The health service is expected to post a large surplus when the accounts for 2007-8 are released later this year. The figure could be as high as £1.8bn.
But the Royal College of Nursing said the job threats were a hangover from the round of cuts made in earlier years when deficits were being posted.
The nurses' union said any cuts to the 40,000-strong workforce would represent a colossal waste of money - it takes three years and as much as 20,000 pounds to train up many specialist nurses.
The survey also revealed that half of the nurses did not feel their work was valued.
Specialist nurses mainly work in the community, helping to manage a range of long-term conditions.
But they can also be employed by hospitals, covering conditions such as breast cancer and cardiac problems.
Their remit goes beyond the role of a traditional nurse with many getting involved in the assessing, treating, diagnosing and referring of patients.
RCN general secretary Peter Carter said: "Specialist nurses are our gold-plated resources who make a huge difference to the lives of their patients.
"The loss of just one of these highly-trained experts will have a disproportionate impact on patients.
"These are the very nurses who will be at the centre of the government's plans to deliver care closer to home and yet these same nurses are being treated as soft targets.
"We should be looking at ways to recruit more specialist nurses and keep those already working in the profession."
Shane Keenan, a specialist nurse who works for a GP out-of-hours service, added: "It makes no sense at all, especially when you consider we take a long time and a lot of money to train."
Douglas Smallwood, of the charity Diabetes UK, said: "It is absolutely ridiculous that the jobs of specialist nurses could be at risk at a time when the NHS is on track for a £1.8bn surplus.
"People with diabetes need specialist care. Diabetes specialist nurses are an integral part of the local diabetes service and play a fundamental role in providing education and support for general practice diabetes care teams.
"It would be appalling if people with diabetes lost access to their advice, support and skills."
Ann Keen, Minister for Health Services, said: "Nurses caring for people with conditions such as multiple sclerosis, epilepsy, strokes, diabetes, breast cancer and Parkinson's disease are vital to vulnerable groups of patients.
"The Department is working closely with the charities associated with these conditions to develop guidance for the NHS to ensure they can commission effectively and make best use of the skills of specialist nurses.
"I meet regularly with the charities associated with these conditions and the Department is working with them closely."