I would be interested in hearing your comment on delegation of tasks that are considered "medical tasks" to nurses. The role of the Nurse in the UK over the last 10 years has expanded and advanced greatly to the extent that we have highly trained individuals who form part of the MDT within clinics

Within my organisation advanced nurse practitioners who in routine practice carry caseloads of patients , consent , examine , assess blood results order tests etc . Within a number of research clinics the nurses form part of the research team and undertake GCP and study specific training and are delegated to take written informed consent and review patients by the relevant PI. Even though within the context of a clinical trial such assessments are only being conducted because the patient is on a trial surely the actual way of conducting and appraising assessments etc is no different so long as the person conducting them is aware of and understands all the relevant info, trained etc ....
Recently there have been a number of issues whereby sponsors have questioned this practice and believe is it not in accordance with legislation or GCP as " medical care given to, and medical decisions made on behalf of, subjects shall always be the responsibility of an appropriately qualified doctor or, when appropriate, of a qualified dentist"
Surely given the additional training in assessments etc that such individuals receive and the relevant research related training they can be deemed as "suitably experienced and qualified" in order to undertake the tasks delegated so they are accountable but the PI would remain responsible and would need to demonstrate oversight.

Demonstrating the oversight /personal supervision is where the difficulty lies. What would be deemed as adequate?... or do we need to , as some may suggest having an attending physician "sign off " on the nurses assessments before each patient leaves the clinic... which to my mind would surely be duplicating effort and provide a much less operationally efficient service for both the organisation and patient.

All your views greatly appreciated.