Would be effective in selected surgical settings and can offer benefits

New professional roles in surgery are a controversial issue. Recent publicity surrounding surgical care practitioners has illustrated the extent of hostility in parts of the surgical community.1^–3 Yet the landscape of the NHS is changing radically. External forces such as the European Working Time Directive are having a profound effect on the United Kingdom's healthcare workforce, and maintaining the current situation is not an option.4 5

The unavoidable reality is that we do not have enough doctors to sustain traditional working patterns. Therefore, developing new professional roles seems a logical response. Moreover, role redesign fits with the government's commitment to widen career opportunities in health care and to develop a flexible training structure based on individual competences rather than traditional pigeonholes such as doctor or nurse.6 7

Increasing numbers of medically unqualified practitioners are now being trained in surgery related practice, and this is a good time to examine the pros and cons. We write from the …