RCN steps in to defend ANPs again after more BMA concerns

The Royal College of Nursing (RCN) has once again stressed the ‘vital’ role of advanced nursing practitioners (ANPs) as the British Medical Association (BMA) has today criticised reported government plans to increase the use of the roles.

The latest criticisms from the BMA follow a string of concerns in recent weeks around the role of advanced practitioners (APs) and what it has described as ‘unsafe and dangerous substitution of doctors’.

This week, BMA members passed a motion calling for national scopes of practice to ensure APs ‘worked within their competence’.

The union has called for the government to ensure employers use APs to ‘complement’ rather than ‘substitute’ doctors.

And based on a new survey of more than 2,000 members of the public, the BMA suggested some 56% put increasing the number of doctors in the NHS as their ‘number one spending priority’, the union said.

Respondents also reported ‘wider confusion’ about NHS roles, with 7% of respondents placing APs as the most senior. Only 7% put GPs and resident doctors first.

Related Article: Action needed to close ‘dementia data gap’, warns report

The RCN has repeatedly stressed in recent weeks that ANPs are not a substitute for doctors and has today reiterated that same message.

RCN’s chief nursing officer Professor Lynn Woolsey said: ‘Advanced nursing practice is an integral part of the NHS workforce. These staff are highly trained experts and vital for the delivery of high quality, holistic patient care.

‘Staff in these roles work collaboratively and are not substitutes for any of their colleagues.

‘While it is important the public knows who is caring for them, the unique knowledge and experience of advanced nursing practitioners, working in multidisciplinary teams, are extremely valuable and there is robust evidence showing they enhance patient safety.’

She stressed that the highly anticipated NHS 10 Year Workforce Plan ‘must ensure growth in nursing, doctor and other safety-critical professions to properly deliver right across health and care’.

The BMA’s latest comments come amid reports that the workforce plan will include an increased use of APs and artificial intelligence.

BMA’s deputy chair of council Dr Emma Runswic said: ‘Multidisciplinary teams and our many non-doctor colleagues are essential to what we do, but this survey indicates the desire by the public to see greater investment in doctors.

‘Whatever the government’s long term health strategy might want to achieve, the public’s view is clear – invest in doctors.

‘By far the top spending priority for them is increasing the number of doctors in the NHS. That’s because they want to see their GP, or an A&E doctor, or one of many other doctors they know can help them in ways no one else can.

Related Article: Specialist nurse elected as new Unison president

‘However, the NHS clearly has a lot of work to do in making it much clearer to patients what advanced practitioners can do for them, but more importantly what they cannot and should not do.’

She suggested the government has ‘failed to educate people about the limitations of the role’.

This comes after the BMA wrote to the health secretary calling for ‘urgent action’ on its concerns over what it has called ‘unsafe and dangerous substitution of doctors’ by APs.

Following a separate survey of BMA members earlier this year on concerns around ‘inappropriate blurring of the distinction between doctors and non-medically qualified staff’, the association revealed doctors have ‘widespread fears for patient safety over the chaotic way employers use APs in the NHS’.

In the survey, the BMA states there have been ‘concerns’ about ANPs for ‘some time’, suggesting ‘employers use ANPs as doctor substitutes on medical rotas’.

Speaking recently at the RCN Congress in Liverpool last month, the RCN chief executive and general secretary urged ANPs to ‘be proud’ of their qualifications, expertise and years of experience.

Professor Nicola Ranger reiterated how ‘angry’ she was at comments made by the BMA.

Related Article: Health services urged to ‘be prepared’ as red heat-health alert issued

‘We are clear in this hall: you never elevate one profession by bringing down another,’ said Professor Ranger.

Nurses also voted at congress to ensure the RCN acts upon attempts to ‘undermine’ ANPs warning that without these vital roles, GP practices and accident and emergency departments ‘would drown’.

In the NHS England advanced practice strategy, plans to increase capacity of APs were revealed for between 2024 and 2027.