The RCP has responded to a Cochrane review on the substitution of nurses for physicians in the hospital setting.
Professor Mumtaz Patel, RCP president, said:
‘Patients benefit most from high-functioning multidisciplinary teams, where every professional brings their skills and expertise to patient care. This should never be framed as a competition between professions.
‘Physicians undergo extensive medical training that equips them to manage clinical uncertainty based on complex and often incomplete information. They make nuanced diagnostic and treatment decisions for patients with multiple conditions followed many years of training that provides both breadth – understanding the whole patient across body systems – and depth through specialist expertise. This combination is essential for managing today’s increasingly complex patient population.
‘Nurses play a vital and highly valued role in delivering care, and nurse-led services can be extremely effective in clearly defined pathways. However, senior medical decision-making remains critical in particular for acutely unwell or medically complex patients. Physicians are trained to weigh risks, respond to rapidly changing circumstances, decide when to escalate, when not to intervene and when to stop treatment altogether. They hold ultimate responsibility and accountability for medical pathways and for leading multidisciplinary teams.
‘The right model of care is not about one profession replacing another. It is about ensuring patients have timely access to the right clinical expertise at the right time, with appropriate medical oversight where complexity and risk demand it.’