Valuing the role of the non‐medical surgical assistant in Australia
An NMSA is a clinician who cares for the perioperative patient but is not a doctor. This role is well established, regulated and remunerated in the international setting.1 This role has existed in Australia for more than 20 years but is not professionally recognized or governed by the Australian Health Practitioner Regulation Agency (AHPRA) via either the Board of Nursing and Midwifery Australia or the Medical Board of Australia. An example of input by surgical groups in the international setting is the Royal College of Surgeons England who have been proactive with curricula input for the role in the UK,2 the Royal Australasian College of Surgeons (RACS) has had little input into formal recognition, curricula and governance of the role in Australia.
Meetings held in Canberra in 2015 between the Australian Association of Nurse Surgical Assistants and representatives from the Medicare Benefits Schedule (MBS) investigated how the NMSA could progress to a stage where the MBS would remunerate the NMSA for ‘Assisting at Operation’ as this does not currently occur.3 Lack of remuneration renders the NMSA role unsustainable to many clinicians. Currently, the most common payment method for the NMSA in Australia is an out‐of‐pocket expense paid by the surgeon or the patient versus the medical surgical assistant who is remunerated by the MBS.4
During these meetings, MBS representatives emphasized that the opinions of Australian surgeons regarding the role of the NMSA were highly relevant. This relevance regarding medical services is supported by a recent RACS publication noting that the Department of Health and the Medical Services Advisory Committee are actively seeking participation from surgeons on the ‘acceptability’ of medical services.5 Surgeons’ opinions are critical because they work closely with the NMSA, are the team leaders in the operating theatre and the primary carer of the patient. An online survey of Australian surgeons’ opinions on the role of the NMSA was distributed by RACS via ‘Fax Mentis’ during December 2015 to February 2016.