Published 10 February 2009, doi:10.1136/bmj.a3049
Cite this as: BMJ 2009;338:a3049

Editorials

Nurse delivered endoscopy

Is as clinically effective as that delivered by doctors, but may cost more

The first 150 words of the full text of this article appear below.

The multicentre randomised controlled trial by Williams and colleagues (doi:10.1136/bmj.b231) compares the clinical effectiveness of doctors and nurses undertaking upper and lower gastrointestinal endoscopy. The study by Richardson and colleagues (doi:10.1136/bmj.b270) assesses the cost effectiveness of this approach. The studies found no significant difference in clinical outcomes, although doctors seemed to be more cost effective.^{1 2}

Nurse led services in the United Kingdom have been encouraged by government policy, a shortage of doctors, a willingness of nurses to adopt expanded roles, and a salaried NHS workforce where professionals are not in competition for income from patients. Evaluations of substituting doctors with nurses have consistently found little difference in performance. In primary care, no appreciable differences between doctors and nurses have been found in health outcomes for patients, process of care, or use and cost of resources, whereas nurse led care has resulted in higher patient satisfaction.³ These . . . [Full text of this article]

¹ King’s College London, London SE1 8WA, ² St Mark’s Hospital, Harrow HA1 3UJ

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This article has been cited by other articles:

• Aspinall, R. J (2009). Opportunity costs of endoscopy. BMJ 338: b1071-b1071 [Full text]  
• Williams, J., Richardson, G., Bloor, K. (2009). Study authors respond to editorial. BMJ 338: b1082-b1082 [Full text]  

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