Tools for defending specialist nurse posts

Practical tools for defending specialist nurse posts
This page is based on a resource originally co-developed by the MS Trust, Parkinson’s UK, Epilepsy Action and Epilepsy Society in 2014. We hope this key information and helpful tools will be useful to MS specialists who are facing threats to their service.
5 minute read
Common challenges to specialist services (more information on each below):
- Downbanding – changing the pay structure of a role to a lower grade
- Redundancy or a reduction in team size
- Despecialisation – moving a condition-specific service to covering a range of conditions for example altering a job title from MS Specialist to Neurology nurse
- Redeployment – asking specialist nurses to take on additional duties
- Impending vacancy – when there are no plans to fill a role that a nurse is leaving
- Change of employer – another provider taking over from your existing employer
For further support, please do not hesitate to contact our Health Professionals Programme team.
Making your case
- prepare brief factual evidence that supports your case including your caseload, key responsibilities etc.
- avoid personal terms such as I, we, me, us or our and steer clear of emotional statements or responses, always refer to 'the service'.
- paint a realistic picture of the new service, ensure patients and service users are aware of the potential for a reduced service in future and that you will be unable to continue to provide everything as you do now.
- remember the 'bigger picture' and the risks for your employer, because it will help shape your response appropriately. Consider NICE guidance and key NHS documents, such as the 10 Year Long Term Plan (2019). Consider the wider financial implications of the proposed changes.
- think about making joint submissions e.g. with other condition-specific neurology nurses.
- ensure your submission stands out. Management may be receiving lots of reports from specialist nurses – what makes yours different?
- offer an alternative scenario only if this is suitable for the service and the team e.g. reduced hours in condition specific nursing and some hours offering a general neurology nurse specialist service.
- talk to your national patient organisation (e.g. MS Trust) at all stages of the process.
Gathering and presenting evidence
Gathering evidence
1. Describe the threat
2. Describe your service in 500 words or less (here’s a generic description which you can amend)
3. Describe the risk (here’s a sample risk assessment)
4. Describe the consequences (here are some examples). The risk assessment at step 3 should help here.
5. Summarise the arguments. List what you have found in key bullet points. Include any direct financial consequences you know will result (our cost saving table may come in handy here).
6. Write an executive summary in 200 words or less (here are some examples) It helps to keep your document short and concise to make sure that your Managers are able to read it and absorb the key points easily and quickly.
Presenting evidence
Using the evidence you’ve collected using the steps above, write a business case structured as follows:
1. Executive summary
2. Describe the threat
3. Summary of arguments
4. Description of service
5. Description of risks
6. Description of consequences
Then finally… submit your document!
Ensure you know who should receive this, eg local management, senior management, commissioners etc. The MS Trust can help you identify your key stakeholders if you aren’t sure.
Top Tip! Ask an external party to read your case. Ask a colleague in another service, or a member of the team at the MS Trust to read through the final document. Sometimes a fresh pair of eyes can spot things you've missed that can help support your case.
