NURSE-LED clinics — do they lengthen lives or risk shortening them? In the blue corner, Nursing Standard (Sept 13) reports on research which found that survival rates for people with coronary heart disease across the European Union improved when patients were cared for by nurse-managed teams. Patients whose treatment was given by a GP alone fared worse.

Nurse-led “rapid chest pain clinics” are also more successful than other settings in diagnosing illness and treating people, another study reported in Nursing Standard suggests.

But across the ring, Dr Anila Reddy, a GP, has a different view of nurses’ ability to diagnose and treat.

Dr Reddy has resigned from his post in a privately run primary care walk-in treatment centre because of concerns over potentially unsafe nursing practice.

“Walk-in centres attract undifferentiated patients,” he tells Doctor (Sept 12). “But basic nurse training does not equip the nurse to make a diagnosis.”

Nurses are taught to monitor patients, perform basic operations and administer treatment, but most would fail a clinical exam designed to assess fourth-year medical students, Dr Reddy says. “So why are (nurses) suddenly being expected to have the diagnostic skills and experience needed to cope with the wide range of patients who attend these new walk-in centres?”

His concern seems to be shared by other doctors. Nursing Times (Sept 12) reports on a survey of nurse practitioners by the Royal College of Nursing. More than half of the surgery-based respondents say that GPs have refused their referrals of patients to other services.

The RCN says that the problem is caused by prejudice among the medics.

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