Since the introduction of the reduction in hours for junior doctors in 1991, nurse led clinics (NLC) have increasingly become embedded into specialist practice. Whilst some NLC such as Diabetes and Respiratory have been established for many years, in the area of Endocrinology they are a newer evolving concept.
Currently there is limited research in this area. An online survey was distributed to 98 nurse members of the Society for Endocrinology. The questionnaire consisted of 35 multiple-choice questions, and also allowed an open response for additional comments. Questions sought to investigate if nurses were involved in nurse led clinics, types of clinic, knowledge and skills required, medico legal considerations and barriers and drivers of these services.
Initial responses have been received from 29% (n=28) nurse members (teaching and general hospitals and the independent sector). 85.7% of respondents ran nurse led clinics in a wide range of endocrine specialisms. Although 53.9% had worked in the speciality for 10 years or less, 67.8% had studied at a degree level standard or higher. NLC are developed for a number of reasons including organisational and medical colleague support, experience of the endocrine specialist nurse (ESN), service need and financial savings/income generation. 100% of those responding worked with some, significant or full autonomy in clinics. In these clinics a large number of patients are seen per month with 84% reviewing 11150 patients. ESNs use a combination of verbal and written consent in NLC for dynamic function testing, clinical examination, radiological procedures, treatments and research. Whilst 84% stated they optimised or changed medications only 52% were non-medical prescribers. All respondents felt that their service was valued.
In conclusion; ESN are extensively involved in providing a valuable service, working with a significant level of autonomy, although further work is required to establish the extent of formalisation of the knowledge and skills required.