Surgical care practitioners in orthopaedics

The roles of surgical practitioner and the surgical care practitioner are conflated in this article. ¹ While the National Association of Assistants in Surgical Practice is the organisation that has made a major contribution to the standards of practice of nurses in the UK, it was not tasked, as stated in the article, to write a curriculum and establish standards for the surgical care practitioners. This was the responsibility of a multidisciplinary working party chaired by myself as representative of the Royal College of Surgeons of England in 2004/2005. Other advanced practitioner roles do not have nationally agreed curriculum frameworks. The role of the surgical care practitioner now has a very specific definition. ²

The Curriculum Framework for the Surgical Care Practitioner was first published in 2006 ³ and revised in 2014. ² It is the nationally agreed reference point for the development of such practitioners. It states that the development of this role:

will enhance the capability of the surgical team and will evolve together within the team;

will in the clinical environment be the responsibility of a named consultant surgeon (clinical supervisor) who has the time and resources to train surgical care practitioners;

will not compromise the training of future surgeons; and

will not replace surgeons.

It is my experience that where thoughtful and wise consultants supervise surgical care practitioners, the harmony between members of the team and their developmental needs can be beneficially achieved. The 21st century complexity of surgical practice requires many different talents and roles. It is our professional responsibility as surgeons to harness the team to provide the safest and most appropriate care for each of our patients now and in the future. An article repeating the rhetoric of the last decade does nothing to contribute to this ideal.