Gosport must be a tipping point for professional hierarchies in healthcare—an essay by Philip Darbyshire and David Thompson

Derbyshire and Thompson raise some critical points related to the fundamentals of the doctor-nurse relationship in the context of modern healthcare. Subservience of one group of clinicians to another has no place in the delivery of evidence based patient centred care and must rightly be consigned to the rubbish bins of medical and nursing history. However reflecting back on my past 30 years of working as a nurse I do observe that many changes have occurred for the better in the nature of professional relationships between doctors and nurses. For example, I remember being a young Student Nurse on my first surgical ward, where patients having the same procedure would either need to have their abdominal drain bags stands or on the floor in a blue plastic tray, each dependent on the preferences of the two Consultants on the ward. The drains being kept on the floors in plastic trays was only done like that because one of the Consultants had tripped over a drain bag on a stand during a ward round and had proclaimed all his patients' drain bags to be kept in trays thereafter, and all the nursing staff were all compliant with this whimsical decision.

However, coming back to the present day and my area of expertise in advanced clinical practice, I know that many of my colleagues working in roles such as Advanced Nurse Practitioners, Advanced Clinical Practitioners and Nurse Consultants have collegial and equatable working relationships with their medical colleagues, the frequency of which I hope will increase as advanced practice proliferates across care settings, which in turn will level out professional hierarchies in healthcare, and help eradicate the incidence of unquestioned medical decision-making such as tragically occurred at Gosport Memorial Hospital.