I couldn't help but notice some of the figures given in a recent BMJ ad for
a Consultant at Southend, which has one of the longest-established ENP
programmes in the UK.
There are 8 middle-grade doctors, 8 SHOs, and 11 G grade ENPs, all of whom
are under the supervision of the two or three consultants. The advert
states that the 11 ENPs see and treat 21% of the total patients attending,
which means that each ENP sees about 2%, while each doctor sees about 5% of
the patients. Given that a G grade nurse is not much cheaper (if at all)
than your average A&E medic, and given that the vast majority of the
patients seen by the ENPs will be at the minor end of Minors, can it really
make sound economic sense to pursue this course?
Don't get me wrong - our ENPs do a great job, and are a great help, but
only when they are in addition to, and not instead of, junior and
middle-grade doctors.
Southend's figures confirm my long-held suspicion that the loss of an SHO
would need to be made up by the recruitment of 3 ENPs. Somebody should be
telling Tony!!
Lawrence Jaffey
Liverpool
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