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Perioperative Practitioners – Driving Forward their Scope of Practice?

26 October 2018 1:34pm

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Are there limits to the scope of the perioperative practitioner’s professional practice in today’s surgical teams? That’s the key question for debate at this year’s annual Faculty of Perioperative Care conference taking place in Birmingham on 3 November, where over 80 delegates have already signed up and one of the two courses on offer is already full.

The Faculty of Perioperative Care (FPC) Lead Charlie Auld and Royal College of Surgeons of Edinburgh (RCSEd) Council Member says that with the Government decision to regulate physician associates and assistants in anaesthesia “there will be further development in legislation for surgical care practitioners that is likely to lead to statutory regulation in the near future, so it is important for perioperative practitioners to push the boundaries of their scope of practice.

“A surgical care practitioner (SCP), for example, can lead ward rounds and undertake advanced roles in surgery. Perioperative practitioners are developing the skills and knowledge that will ensure they can work alongside junior doctors in clinics and theatres,” Charlie Auld explained.

“That’s why this year’s annual conference is focused on their scope of practice, how we can build on that, work better as a team and progress levels of competency. How good medical practice applies to the extended surgical team is key because perioperative practitioners are working towards a medical model of care, and the General Medical Council (GMC) is likely to be their regulator in the future,” he added.

This is echoed by session chair John Stirling, a senior nurse and Lead for the NORS Workforce Transformation Project and first MFPCEd: “Increasingly, surgical teams in the operating theatres, clinics and wards do not adhere to the traditional medical model with more and more highly specialised clinical practitioners from a nursing or allied health professional (AHP) background augmenting the medical workforce.”

He stressed the importance of “maintaining a safe environment for staff and patients that all team members are aware of each other’s competencies and limitations to practice. We should all embrace the drive towards statutory regulation and engage with the debate so we can all be involved in shaping the surgical teams of the future”.

Central to the effectiveness of surgical teams is the impact that bullying and harassment can have not only on the NHS workforce but on patient care. As John Stirling says “many of us who have worked within surgical teams over the years will have witnessed the consequences of negative behaviours on both staff and patients, which takes many forms and can affect all members of the multidisciplinary surgical team”.

Speaker Alice Hartley, senior trainee in urology and chair of the RCSEd campaign to tackle undermining and bullying #LetsRemoveIt, agreed: “As a surgeon you have to lead, but as the surgical team changes all members have to take responsibility to challenge bullying and harassment. That’s why we must have a multidisciplinary approach to remove this from the working environment and promote the development and maintenance of teams that foster a supportive and respectful culture.”

The FPC, set up by the RCSEd in 2016, provides the education, training and support for advanced perioperative practitioners who are key members of today’s surgical team. Perioperative practitioners are a flexible but permanent part of the surgical team, while junior doctors move between training jobs. Research shows that this continuity and more holistic approach has improved patient care.

For the first time the Faculty is offering delegates the opportunity to attend professional development courses the day before the annual conference takes place (2 November 2018): “I am delighted we are able to offer bespoke courses in cardiothoracic surgery and leadership and development for perioperative practitioners to attend - free as a conference delegate or at a discounted rate. And, I am even more delighted to say that the leadership and development course is already full!” Charlie Auld said.

“RCSEd supports the whole surgical team and the role of perioperative practitioners because it is increasingly a key element in the health service providing safe patient care, working in partnership with the surgical team,” Charlie Auld explained.