Advanced clinical practitioners have hit back at claims that their increasing use in the NHS poses a risk to patient safety, arguing that the real issue is poor governance rather than their professional background.
In response to a recent British Medical Association (BMA) warning that the use of 'non-doctors' in medical roles is unsafe, one advanced clinical practitioner in acute respiratory medicine said the characterisation was unfair. They noted that their role involves managing patients with severe conditions such as chronic obstructive pulmonary disease and pneumonia, underpinned by a master's-level qualification and over a decade of specialist experience. They described advanced practice as a distinct, evidence-based role that enhances care, not a substitute for doctors.
Another respondent pointed out that the BMA, as a trade union for doctors, has a financial and professional interest in limiting the expansion of advanced practitioner roles. They cited a Cochrane systematic review of 82 randomised studies involving over 28,000 patients, which found little to no difference between nurse-led and doctor-led care on critical outcomes, including mortality and patient safety events.
The respondents also highlighted that missed diagnoses by doctors are common but often go unnoticed, while errors by advanced practitioners attract disproportionate scrutiny. They argued that the real problem is inadequate supervision and governance, not the professional group itself. One patient shared their positive experience with advanced nurse practitioners in stroke services, praising the collaborative teamwork that the NHS relies on.
The BMA has been urged to focus on workforce and management failures rather than engaging in what critics describe as a professional boundary dispute.
