Endocrine Abstracts (2017) 50 P312 | DOI: 10.1530/endoabs.50.P312

Endocrine clinical nurse specialist nurse led clinics - Legal considerations of practice.

Lisa Shepherd1, Anne Marland2, Rachel Austin3 & Helen Turner2


1Heart of England NHS Foundation Trust, Birmingham, UK; 2Oxford University NHS Foundation Trust, Oxford, UK; 3Society for Endocrinology, Bristol, UK.


Introduction: In 2015, a service evaluation of endocrine clinical nurse specialist (CNS) nurse led clinics (NLC) demonstrated they took on a variety of formats to meet local service and patient population requirements. Continuing professional development (CPD) is a fundamental and legal requirement of nursing practice. However, because of the introduction of NMC revalidation in 2016 and recent medicolegal developments such as confidentiality, duty of candour, consent and freedom to speak up (NMC, 2015, DOH, 2009) we sought to establish how this currently impacts on endocrine CNS NLC.

Method: An online questionnaire, consisting of 13 multiple choice and open-ended questions, was distributed to 119 nurse members of the Society for Endocrinology (SfE).

Questions focused on the legal framework and knowledge surrounding NLCs. We aimed to capture a larger cohort of clinics and assess developments within this important aspect of endocrine care.

Results: Preliminary findings demonstrated that 82.6% of endocrine CNS who responded currently run NLC, of which 95% worked autonomously. Clinical responsibility fell to the endocrine CNS, consultant in charge of the patients care or both. Informed consent was obtained for a variety of procedures, with dynamic function testing being the most frequently consented (94.1%). 70% personally took consent, while 22.2% relied on consent obtained by another healthcare professional (HCP). Consent was predominately verbal (76.9%), but only around half of CNSs were trained to obtain consent. Over half (65%) were independent non-medical prescribers with 43.5% undertaking relevant annual CPD. Complaints mainly involved communication issues. 66.7% of nurses audited their practice with 27.3% resulting in a change in practice.

Conclusions: There is disparity in the training and process of obtaining consent by endocrine CNS. Establishment of guidance would be useful and would address legal implications. CPD should form an integral part of the prescribing process and incorporation of audit should be standardised into endocrine CNS practice.

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