Exactly who checks up on our practice nurses' work?
1: Our practice nurses have been told they will not be able to take smears using the new cytobrush technique unless they have been assessed by a PCT-nominated nurse trainer. They were told patients would be assigned to other practices if they did not agree to this. Our nurses audit their own work and we review their figures, which are excellent. Are we naive in thinking it is up to us to be satisfied they are competent and that we can choose the assessor if required?
The legal responsibility for taking smears for your patients rests with you. Any person you employ, and to whom you delegate duties, is responsible to you and not to the PCT. The patients are on your list and the PCT does not have the right to refer your patients to another clinician for treatment.
Paragraph 19 of the terms of service sets out that a doctor is under no obligation to give treatment personally, provided reasonable steps are taken to ensure the continuity of the patient's treatment. The doctor may delegate treatment to another doctor or, if it is reasonable to do so, to a person whom the doctor has authorised and who he is satisfied is competent to carry out such treatment.
Paragraph 28 of the terms of service stipulates you must take reasonable care to satisfy yourself that any employee to whom you delegate duties is suitably qualified and competent to discharge those duties and also that you must allow your employees to undertake appropriate training to maintain their competence.
The PCT has no right to interfere in this matter, but if you or your nurses feel they would benefit from any training programme or accreditation scheme offered by the PCT then it might be reasonable to take advantage of this.
If you do not choose to use any scheme that is offered then you must ensure your nurses are properly trained and are working to acceptable standards. Failure to do so could result in litigation.