A question of balance: the extended surgical team
In April 2016, RCS England published 'A question of balance: The extended surgical team', a report exploring the experiences of staff working at hospitals that have introduced workforce models using the wider surgical team. The report highlights the benefits of a well-managed use of the extended surgical team.
We have since given careful consideration about how best to address the recommendations in the report, and working closely with surgical care team roles, surgeons and patients, have developed a series of resources and guidance, as well as opening RCS England membership to roles within the wider surgical team.
Following the report
'A question of balance: The extended surgical team' explores the experiences of staff working at hospitals that have introduced workforce models using the wider surgical team.
Read the report and accompanying case studies.
Following the report, we established a programme of work, collaborating with a wide range of roles, patients, surgeons, surgical trainees, employers and other organisations to:
- define RCS England's relationship with the surgical care team;
- set standards and produce guidance to support trusts, surgeons and other healthcare professionals to develop and work within a new model of care;
- produce clear information about roles within the wider team, what they do and what this means for patient care;
- further understand patients’ perspectives;
- promote the potential of the extended surgical team and increase support for this model of care.
Our aims are to:
- ensure high-quality continuous care for surgical patients through best use of the extended surgical team;
- support surgeons in the development, management and leadership of the extended surgical team;
- maintain high standards of training for trainees;
- develop the identity of these extended roles as part of the surgical team and the profession;
- support employers to maintain service delivery.
We are working with NHS England (formerly Health Education England), who are leading a piece of work that aims to develop a common education framework and training programme to support a route to statutory regulation for some extended roles in England.
FAQs about the surgical care team
Here you can find some common questions that trainees and surgeons ask about the surgical care team:
What are the benefits of the extended surgical team model of care?
As part of the Question of Balance report we visited NHS hospitals to explore new models for inpatient care using an extended surgical team. The experiences of the sites we saw were overwhelmingly positive. Managers, surgeons, trainees and practitioners themselves painted a picture of multi-professional teams working together effectively to provide better continuity of care for patients, greater efficiency of discharge and in theatres and smoother running clinics.
While the report highlighted potential benefits it also noted challenges around making this work including accountability, career progression, governance and sustainability. One of the biggest factors influencing the expansion of the extended workforce is the consultant in charge of the unit and their willingness to consider multi-professional working. Without the support and leadership of consultant surgeons, the extended surgical team will not thrive.
We recognise the need to address the challenges and will work with and support surgeons, employers, the wider surgical profession and other healthcare professionals to make change happen.
I am a surgical trainee. Will greater use of the extended surgical team reduce the training opportunities available to me?
Modelled in the right way, the extended surgical team should complement and enhance surgical training.
The Question of Balance report identified numerous ways in which use of the extended surgical team can enhance training. It found no basis for concern that greater use of other practitioners dilutes surgical training opportunities for junior doctors.
Where benefits were seen, roles had been properly planned in response to a specific need and established in departments with a clear vision and strong surgical leadership.
It appears evident that there is potential to share some of the tasks that doctors in training currently perform with a wide range of practitioners. Deploying the wider team effectively and avoiding potential drawbacks – including for doctors in training – comes down to striking the right balance. This means ensuring that doctors in training have sufficient exposure to tasks that inform their learning and development but are not drowned by tasks that do not hold good educational value (administrative tasks in particular).
In order for this to work it is important that consultant surgeons, in particular, take an active role in managing expectations in all members of the extended team, including doctors in training. We will support trainees, consultants, employers and healthcare professionals to develop and work within a new model of care.
The workforce isn’t available to take up the posts. How will this be addressed?
We recognise this is an issue. We are working with Health Education England who is responsible for planning the future of the wider NHS professional workforce.
How will the training and recruitment of the workforce and the creation of posts be funded?
This is clearly a challenge within the context of the current financial restraints. We will work with others to influence key stakeholders and raise the profile of the extended surgical team model of care.
Get involved:
Email Thomas Gale (Head of Support, tgale@rcseng.ac.uk / 020 7869 6092)
We will reply to you as soon as possible and aim to do this within a few days.
Telephone
Call 020 7869 6090 to speak to Jessica Cunliffe, Head of Support