A systematic review and meta-synthesis: evaluating the effectiveness of nurse, midwife/allied health professional consultants


  • Ann Humphreys PhD, RN, MN, RM, Cert Ed,

  • Sarah Johnson MSc, PGCE, DipCOT,

  • Janet Richardson BSc, PhD, RN, RNT, PGCE, CPsychol,

  • Elizabeth Stenhouse MSc, PhD, RGN, RM, ADM, PGCEA,

  • Mary Watkins MSc, PhD, RN, RMN

Ann Humphreys
Faculty of Health and Social Work
Deputy Head School of Nursing and Community Studies
University of Plymouth
Drake Circus
Devon PL4 8AA
Telephone: +44 1752 233854
E-mail: ahumphreys@plymouth.ac.uk


Aim.  This paper presents the findings of a systematic review and meta-synthesis, which was undertaken to identify and assess studies that evaluated the nurse/midwife/allied health professional consultant role.

Background.  As part of the modernization agenda in the National Health Service the United Kingdom government proposed ‘Consultant’ posts for nurses/midwives and allied health professionals as an opportunity for experienced practitioners to extend their roles. Four key functions were identified as being significant to this role development: expert practice, leadership, education and research. Explicit within the proposal was a requirement of these new roles to be evaluated.

Method.  Inclusion criteria focussed on studies where an aspect of the role had been evaluated or where the consultant carried out the research. A total of 1931 citations was filtered to reveal 107 studies that possibly met the inclusion criteria. Of these 107, 14 studies were critically appraised and subjected to thematic analysis. Study methodology varied but of the 14 studies, 10 involved some form of measurement. The others adopted a literature review or descriptive approach.

Conclusions.  The extent to which consultants were involved in all aspects of the ‘four pillars’ was assessed in only a small number of studies. However, a number of studies implicitly implied active engagement in expert practice and leadership by focussing on specific service developments.

Relevance to clinical practice.  To date, a number of studies evaluating service developments, education, expert practice and leadership have been carried out. However although a number of studies have assessed perceived impact of the consultant role, no measure of actual benefit has been published to date. Studies that evaluate the cost benefit/outcomes of these roles in relation to both activity and quality of service are required.