FAQs

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.

Read the report.

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. 

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.

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.