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November theme: Advancing Surgical Roles

Advancing Surgical Roles: Safe in Our Hands?

Our Association aims indicate that that we seek to deliver specialist care, in a safe environment which adapts to change? The extended consultant led surgical team remains the focus of surgical interventions, however since the times of Mary Seacole and Elizabeth Cadwaladr, “Custom and Practice” has enabled operating theatre scrub staff who pass surgical instruments to the operating surgeon to use, times, use retractors, suction and stitch scissors to “Assist” surgical outcomes.
Such practice continues to challenge professional boundaries, managers and individual practitioners!
In 2011 The Royal College of Surgeons of England (RCS) called for greater clarity in relation to the wide range of titles currently in use by practitioners assisting in surgery, stating that confusion as to their meaning could potentially be a safety risk for patients and clinical staff.  The college’s statement also expressed a significant challenge:
“The College expects surgical assistance to be carried out by surgeons-in-training wherever possible. If this cannot be a doctor we expect the role to be filled by a trained nurse or registered allied health professional.”
In recognition of this challenge and expectation, The Perioperative Care Collaborative (PCC) has over the last year reviewed the title, roles and responsibilities of the Advanced Scrub Practitioner (ASP), formerly known as the First Assistant and published a new position statement entitled:


SURGICAL FIRST ASSISTANT (formerly the ‘Advanced Scrub Practitioner’)


Introduction.
The PCC recommends that any perioperative practitioner who participates in the role of the Surgical First Assistant (SFA) must have demonstrable skills and an underpinning knowledge beyond the standard level of knowledge expected of a qualified perioperative practitioner.
The SFA role can be defined as the role undertaken by a registered practitioner who provides continuous competent and dedicated assistance under the direct supervision of the operating surgeon throughout the procedure, whilst not performing any form of surgical intervention.
This document recognises that the Scrub Practitioner, Surgical First Assistant and Surgical Care Practitioner as members of the extended “Surgical” team, can contribute to ensure a safe surgical outcome, guided by clear governance, mandatory education and active leadership.
The Perioperative Care Collaborative 2011 Position statement – Surgical first assistant (Formerly known as Advanced scrub practitioner) PCC Harrogate (AfPP currently chair PCC)                         

Now available - www.afpp.org.uk/careers/Standards-Guidance
Reference: Royal College of Surgeons of England 2011 Position statement – Surgical assistants London RCS (Eng)www.rcseng.ac.uk/publications/docs/rcs-position-statement-surgical-assistants

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