Nurses will be offered express training to qualify as doctors under a plan to break down professional boundaries in the NHS that is due to be agreed today by the action teams preparing the government's overhaul of the health service. According to the confidential final report of the team investigating reform of the professions, the NHS will have to scrap traditional demarcation lines if it is to correct aserious skills shortage.
In the long term, it recommends a single regulatory body for all the health professions, merging the powers of the General Medical Council and parallel bodies for nurses, therapists and social care workers. In the short term it wants to give greater responsibility for nurses, midwives and therapists to take decisions about patient care.
"They should be empowered to carry out functions such as taking the patient history, physical examination, diagnostic tests, diagnosis, development and implementation of a treatment plan including prescription and clinical interventions, and discharge decisions," the report says.
There should be a "skills escalator" allowing staff at every level to progress on the career ladder. Nurses who had established competence in relevant training modules, could use them as credits to qualification as a doctor, shortening the training period.
The report was drawn up by a team including Sir George Alberti, president of the Royal College of Physicians. Ministers are understood to be convinced by the arguments and will almost certainly include them in the national plan for health later this month.
The report tells the government to offer lifelong learning to all NHS staff. There should be "routes into health care roles for support workers such as porters, administrative and secretarial staff", and scope for extending the health expertise of other staff.
Andrew Foster, speaking for the NHS Confederation of health authorities and trusts, said: "The logical conclusion is that a hospital porter could become a consultant.
"We have a long way to go towards unjamming the regulatory systems that would allow that to happen, but it is an exciting message."
