What’s in a name?

How time flies. Some 50 years ago now, I can remember sitting on buses in downtown Swansea confidently diagnosing my fellow passengers. Of course, then as now, I’m not qualified to diagnose any form of health or illness issue. But back then, with a modicum of nurse training and education, I thought I could. I was wrong on so many levels. That’s not to say that my nurse education was worthless. It wasn’t. It helped me on a journey from Nursing Assistant to a Professor, and Dean of a successful university School of Nursing.

I had a great student nurse experience. It wasn’t anything like today’s nurse education, but I loved the hands-on aspects of my programme. Theory was brought to life by some very wonderful nurse tutors. But it was far from a comprehensive course. I never worked in Urgent and Emergency Care (UEC), which I really wanted to do. I did just three months in a physical care hospital, and my placement was in the acute hospital dentistry department. As a young student nurse, it was a brutal and bloody place to spend time in.

Fast forward a few decades and as a Non-Executive Director, I have been fortunate to visit many UEC departments. UEC departments are often frenetic places. The numbers of folk walking through the front door or delivered by emergency ambulances can, at times, feel unremitting. That said in my experience, UCE departments are where you can see much compassionate care in action. I saw something very similar last week. I was able to visit our nationally renowned Addiction Services, well the inpatient side of the service at least.

It was a wonderful visit and a real pleasure to meet such a brilliant multi-professional team. They deal with some many complex and life-threatening health conditions and work closely with other healthcare providers in acute and mental health care across England. I even got to meet a tortoise, a very happy parakeet, a rabbit and guinea pig; all of whom were part of a pet therapy intervention. I was in my element, and it was clear, so were many of the service users taking part in the session.

A special delight for me was meeting Liz, one of our Nurse Associate's. She told me that back in 1988, I had interviewed her for a job, which she got. She has been working at our Trust since that time and told me she loved her job. I don’t know who had the broadest smile, Liz or me. Nursing Associates were first introduced in 2016. It is a role that bridges the gap between a Health Care Assistant and a Registered Nurse, and much needed.

We are likely to see many more new entrants to the once traditional and (undoubtedly) limited health care workforce, as the NHS 10 Year Plan: ‘Fit for the Future’ begins to gather momentum operationally. Of course, caution needs to be taken to ensure that as these new roles are developed, the scope of practice is carefully regulated. Something that was in the news last week following the publication of Professor Gillian Leng’s report into the role and practice of Physician Associates. Professor Leng is the current President of the Royal Society of Medicine. She had been asked to undertake the review by Wes Streeting (Secretary of State for Health and Social Care) following a number of high-profile deaths linked to the work of Physician Associates. One of which was that of Emily Chesterton. She died, aged just 30, from a pulmonary embolism having been misdiagnosed on two occasions by a Physician Associate.

I feel the need to add some context. I have no wish to defend those responsible for what might have been Emily’s avoidable death. However, according to NHS Resolution, in 2023/24 the cost to the UK of harm or death caused by medical or clinical negligence was some £5.1billion. The greatest number of claims arise from urgent and emergency care, with maternity claims’ costs being the most expensive.

Now every day, there are some 1.6 million individual patient contacts with the NHS (it includes people attending GP appointments, having an operation or those on a follow up outpatient appointments); the majority by far, being with GPs. Fortunately, there are over 1.3 million people working in the NHS who provide for those who need care. Sadly, mistakes will be made that might result in individuals being harmed rather than helped by the NHS. Hence the need to constantly look at ways of making health care safer and safe every time. I guess time will tell as to whether Professor Leng’s recommendations, which includes a change of title to Physician Assistant, will help keep patients safer. I hope so. I also hope her report does not leave us less confident in continuing to broaden further the traditional health care workforce.