Opinion  

Not everything is perfect. There are still problems around funding for, and access to, CPD. Grumbles from some quarters of the medical profession continue and there is also some difficulty embedding nurse prescribing in settings outside primary care, particularly mental health.

These issues must be addressed, but it is clear that nurse prescribing is a real success story. It demonstrates the value of extended nursing roles and shows what can be achieved with a national approach and government support.

Unfortunately, it seems that the DoH is no longer as committed to community matrons. It has abandoned its target in favour of a flexible approach, allowing other professions to take on the case manager role (Community matron target axed amid claims of PCT cost-cutting).

It is right that the DoH is allowing PCTs to devise solutions best suited to local populations. But this overlooks the unique contribution nursing brings to the role. If, for example, an advanced nurse practitioner were a community matron, along with co-ordinating services they would be able to monitor and prescribe for existing conditions and diagnose further medical problems.

The real worry is the long-term sustainability of the role if it is not widely adopted across the NHS. How many times have new roles been abandoned because there was not enough support from PCTs and government? It is unlikely in this case, but it is a concern.

The government is very supportive of nurses expanding their roles and this is vital if new initiatives are to get off the ground. However, as this situation demonstrates, implementation happens locally. This is why it is so important that those nurses wishing to take on extended responsibilities know what is happening in their area and how their role could fit with local objectives.

The success of nurse prescribing shows how far nursing has come nationally. But, for most nurses who have taken on new responsibilities, the challenge has always been local - ensuring local clinicians and managers support what they do.

emma.bower@haymarket.com

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