The current state of the surgical care team in the United Kingdom: Shall we 'do a time out'?

Abstract

The reduction of junior doctors' working hours over the last two decades paved the way to non-medical practitioners providing care traditionally discharged by surgeons and other medics. These registered practitioners play a vital role in the care of patients in surgery and work within multi-disciplinary teams comprising surgical care practitioners, advanced clinical practitioners in surgery, and physician associates, with significant experience in nursing or allied health care professional practice. Health Education England and the Royal Colleges of Surgeons have invested considerably in developing the relevant educational frameworks to support and quality assure the training of non-medical practitioners. Notwithstanding, to ascertain whether advanced and extended practice have been developed appropriately, a wide critical stance is needed. This article aims to begin to analyse the status quo of the extended surgical team and of the associated pitfalls and challenges, making conservative comparisons between the roles with the international scene. The objective is to help students, trainees and all involved in surgical care to adopt an informed and critical viewpoint about the extended surgical team in the United Kingdom, in the hope that this can lead to improvement and forward planning in workforce design for the benefit of patients and their communities.