wembley1

I agree, the role of NP's is a good thing for Australia. I think what is good to see is that education of NP's has properly being looked at, i.e., minimum of post grad diploma or masters in NP, with similar course content to the USA NP's. Gladly it is not a farce like the UK, regulation of NP's and qualifications over in the UK is a huge issue, and due to this, an introduction of physician assistants has come into place. I think in Australia we set higher standards of education and practice which is great, I spent a lot of time working in the UK, and whilst they have a lot of great NP's, ironically many of which are Australian!!!, the standard and knowledge of Australian nurses was greater the UK nurses. NP's in Australia will provide patient's with better access to healthcare, especially in rural areas.

I agree that NP's need to be regulated. I suggest the UK has a good look at Australia, NP's are gradually being introduced, despite reluctance of doctors, and minimun standards are a postgraduate diploma or masters of nurse practitioner. The course content is similar to the USA, advanced pathophysiology, pharmacology, diagnostics etc. As you mentioned a lot of NP's hold variable qualifications and roles in the UK. I think minimum qualification should be postgraduate diploma or masters, the UK needs to do away with the Bsc nurse practitioner, as this really suggests it is an undergraduate qualification not a postgraduate. I already hold a Bsc in nursing, an undergraduate degree. I guess it stems from the diploma/degree option for nursing in the UK. What is a concern is that these PA's can be health science graduates, have no previous exposure to patients, come and do this 2 year course and then be ordering nurses around and getting paid 40k plus. What is funny is that they are advertising in nursing magazines for nurses to undertake the course, to become a PA, kind of an insult to NP's. The truly qualified NP's are a great asset and it is a shame to see a new group of health professionals coming into the NHS, I think they are not needed, why not just advance nurses or increase the roles of NP's. I hope NP's sit up and take notice, but, I doubt they will do so, problem with UK is that nurses have no voice, are weak and fail to complain.. Be interesting to see what happens with the PA movement, a short-term ploy or long-term?

The AMA is a political group, aim is to protect their members, they don't care about patients, never have and never will. They are scared that there mighty wages will go down if NP's become widespread. It is good to finally see Australia recognise NP's and that courses set up for NP's have good content, similar to USA NP's. NP's have worked in the USA for years, and our health system is similar to the USA and Canada. I think we need to be careful about PA's coming into the system, like in the UK now. As nurses we need to protect patient's and push our credentials, but wouldn't surprise me if some Physician's pushed for PA's as they can control this group more than NP's. I would love to see the use of CRNA's in Australia, would love to see the AMA response to that!!!! Think NP's are good for Australia and for Nurses, some career options.

I agree, PA's have to prescribe under physician supervision, whereas NP's can prescribe independently. As has been shown in the USA, most jobs advertise for either a PA or NP. What irritates me about the UK is that they are advertising the PA course in nursing magazines and St Georges University is the latest to join in and will be offering a PA course. I think NP's need to be careful, protect their ground, but what I find interesting is as others mentioned, NP's only on bad 6, most would be band 7, 33-43k in London or similar, yet in Somerset, they are offering PA's with 2 years experience 40k plus benefits. I think the problem is the NP course, every few do an actual masters and a lot are termed a Bsc in nurse practitioner, I myself already have a bachelors so why would I do another? The education and protection of NP's needs to be looked at. In Australia, all NP course are at least PgD but most are masters level and the content is similar to the USA, fair amount of anatomy, pharmacology, diagnostic tests etc, whereas a lot of courses in the UK provide very basic levels of training. I think NP's as a group need to look at education and protection of their job roles, so PA's don't steal their ground. But I am still perplexed/confused, why use PA's in the UK why not just increase the scope of NP's. seems some NHS managers out their will always view nurses as just hand maidens, just good for basics. I hope NP's and nurses in general stand up....

I am now overseas, did a fair bit of agency in A&E and ICU throughout London until 2 years ago, I like many others left when the NHS brought in the absurd LAP3 project, just a way to reduce agency pay rates. Rates of pay went from approx 20 p/h to just over 16 p/h in central London and work became non-existant, hospitals would not use agency. Coming from Australia, we have strict patient-nurse ratios which mean that hospitals can't work without agency nurses, don't have the staff levels to work without, and they couldn't reduce agency pay rates as nurses would strike and complain. I find it interesting that nurses put up with this in the UK? So are your hospitals under staffed? Do you find that there is enough bank nurses to cover? Seems nurses don't have a voice in the UK, what I find funny is that the physician assistant movement is gaining pace, another healthcare group who will be telling nurses what to do!!! with pay rates of 40k in Somerset for a PA with 2 years experience, yet nurses can't get a decent pay rise??? My advice would be try agency but don't be surprised if you don't get work, so keep your options open, maybe sign up with 1 or 2 agencies and a nurse bank.

Hi guys, Just seen some jobs advertised for physician assistants (PA's) paying 40k in the Midlands. What do you guys think of PA's, has anyone worked with PA's here in the UK? Think that it is a bit insulting that PA's are payed 40K plus whilst NP's are around 30-38 K, any reason PA's are paid more? Funny as PA's have to work under a physician unlike NP's. Seems to be that the health system is overlooking RN's/NP's in favour of these new roles, seems same thing going on for anaesthetic PA's, overlooking RN's. Love to hear your views, I think RN's really need to be proactive and protective of our roles and our advanced roles, seems to be more roles being created that will tell RN's what to do, and these PA's can be life science graduates with no health care experience...

Interesting on how you work out your banding and applicable banding for nurses. I myself have spent a few years in the UK, worked agency in London. Coming from Australia, generally an RN from the UK coming to Australia will be assessed based on their overall experience, not based on their experience of the health system in Australia. I think it is quite interesting and quite biased how the UK system looks at NHS experience, how you can put a senior nurse, i.e., 5 years plus experience at a band 5, first pay point level alongside a newly qualified RN, is quite funny really!!! But I guess that explains why so many of us Australians actually do agency. I worked in a lot of A&E departments throughout London, and if it wasn't for us Aussie and Kiwi nurses, I would hate to think how these A&E departments would go, and this includes band 6 and band 7's. Generally the level of most of us was a very senior band 6 or 7, scary to think if we worked directly for the NHS we would only be band 5!!! But, I guess as some of you guys stated, can go for higher banded job.

Hi, Just be interested to hear what you guys think about the UK using physician assistants, PA's. Training courses at 3 universities, including the university of birmingham are being developed for PA's. These PA's will be able to work under Dr's and to see, assess, diagnose, order tests such as xrays, and prescribe for patients, similar to what PA's do in the USA, but not as advanced, will be working in A&E or with GP's. Just seems to me to be an insult to NP's out there. We all know how good a job NP's do, just look in A&E, what would waiting times be like without NP's and I have seen many NP's better at diagnosing minor injuries than SHO's. Obviously nurses are not powerful enough, or listened to enough, why not expand the roles of NP's along the lines of the USA, with acute care NP's etc! Just seems nurses are getting a raw deal from the Gov at the moment.

medical care practitioners are in line with the use of physician assistants in the usa.In some ways i see the introduction of MCP's as a waste of time,as from the job role they will perform in the uk,it is very similar to what a nurse practitioner already does.However,to become an NP you either have to self-fund or find an employer to sponsor you,not,to mention having an appropriate work environment,in comparison,these MCP positions will be new paid positions,around 30k whilst training,and training will take up to 2 years,depending on knowledge and skills.As mentioned,MCP's are already in practice in manchester,some of these are american trained PA's and trials are being conducted on them and there job role,but,they are being paid around 45k,most np's sit around 25-35k depending on location.I think more advanced job roles are needed that allow nurses to use and develop skills,however these need to be appropriately paid.I think it is a joke that a MCP can come along,the minimum requirement being a science degree or similar and they can earn more than a NP who has been working for 10+ years.I for one though,would consider becoming an MCP as the pay and conditions will be better than being an np,and training will be paid for.i personally think nurse have been short changed on AFC,you explain to me how 1 nurse can get a pay cut for doing the same job they have being doing for years,under AFC in 1 trust whilst another nurse doing the exact same job with the exact same skills and experience gets a pay rise in another trust.i think AFC stands for AGENDA FOR CHEATING,that is cheating nurses into thinking wage wise they are better off.maybe if nurses stood up more and pushed for better wages and conditions,there would be more nurses and more people interested in nursing and roles such as MCP's would not be required if NP's were paid more appropriately.I believe NP's,for the job they do,should be paid equivalent to nurse consultants,that is 45-60k.doubt that will happen.......

i myself work as an agency specialist rn in a&e throughout london and have noticed a decline in the amount of agency work,especially for november,when you expect work to pick up.also with the a4c,agency pay rates have dropped dramatically,i.e.,sunday rates i use to get 29.30 p/h now down to 19.30 p/h.Also,nurses with 5-10+ years experience,who don't have a postgraduate ENB course in emergency are now banded as band 5-equivalent to a d-grade,similar to someone with 6 months experience,but,even if you are in band 6,alot of hospitals are still being payed as band 5 only.Also,the NHS and PASA have developed new guidelines for agency nurses,1 stupid rule is that agency nurses need all blood tests done in a UK labatory,i.e.,hep B titre levels etc done overseas,in my case done in australia,are no longer valid!!!! As an australian RN i can vouch for the staff-pt ratios.They are in place in most states in australia to protect nursing staff,i.e.,provide a safe working environment and work load.In my view the UK will NEVER have staff-pt ratios as if they did,can you envisage the cost to trusts and the government!!!! it is just not viable financially for them.Also,it is now compulsory for nurses to have practical manual handling experience,another new rule,more than likely in place to reduce the ability of nurses to legally claim compensation against the NHS.In my view the Nursing Union in the UK is weak,do you see them actively see them in the news??? pushing for better wages and conditions for nurses??? when is the last time nurses went on strike for better pay and conditions in the uk??? In australia the australian nursing federation,the nurses union is constantly in newspapers and on television,and nurses as a general rule are alot more proactive about wages and conditions,hence staff-pt ratios,and as a result pt care is generally alot better.As mentioned by others,new roles such as medical care practitoners and physician assistants will be utilised in the NHS,many will be health science graduates,and will come in at band 6 and band 7,so will jump above junior nurses,even though they may be straight out of university.... just shows the value of nurses really.