Non-medical surgical assistants: a review

The healthcare system and workforce of Great Britain have undergone significant change over the past two and a half decades, with non-medically qualified practitioners crossing traditional boundaries between medicine, nursing and the allied health professions in many areas. In surgery a number of advanced roles have emerged to support both service provision and specialist medical training, ensuring continuity within surgical teams and high standards of patient care.1

Younger2 outlined drivers for such roles nearly a decade ago and raised issues over regulation, the future of, and the infrastructure required to support such roles. It is now 25 years since the introduction of the first formally trained non-medically qualified surgical assistant (NMQSA) in cardiac surgery to the United Kingdom (UK). A historical review of NMQSAs detailing catalysts and constraints together with an evaluation of the progress made since that time is now timely.

Major conflicts of the late 19th and 20th Centuries saw the emergence of the nurse as a valued and experienced surgical assistant. They replaced the male attendants who received limited training and were primarily used for their physical strength in restraining patients. American nurses working as non-medically qualified surgical assistants became increasingly valued, leading to the establishment of robust educational courses for Registered Nurse First Assistants.3