I know what a medical Consultant does. I've been trained to do the job over many years, I've ongoing appraisal and CPD and Job Planning and meetings that define my role iteratively.
Some roles are clearly medical and Consultant roles. In my corner, elliciting psychopathology and ascribing significance to this, to generate formal diagnosis, is seen as a Consultant Psychiatrist's job. Nurses (especially non-medical prescribers) have to be able to generate a sufficiently robust formulation, but formal diagnosis remains medical. DVLA work and fitness to drive is medical. Assessment of capacity is everyone's business but assessment of testamentary capacity or ability to undertake Lasting Powers of Attorney or fitness to stand trial is seen as medical work (because it's only accepted when done by a medic). Mental Health Act 1983 work is done by doctors (and even within the ammended Act, it's only doctors who can make Assessments and recommend compulsory admission).
We do more. Complex management plans. Case Conferences and Journal Clubs and Clinical Effectiveness. Taking a lead in safeguarding cases, saying How It Is. Expertise in medication, ECT and interventions. Being the one to speak up in court. Teaching of every discipline. Management meetings. We see a lot of patients out of hours (last weekend a Consultant Psychiatrist was called 16 times and drove out and undertook 12 assessments, and had worked 2 other nights in the month, for which she receives the princely sum of £183.50/month for being on-call, i.e. pay of £36.70/night for each night she had to be on-call). I like to know about and input in to every management plan (and at least everyone gets a Consultant Psychiatrist's input then, after a CPN sees them and discusses care with me when they're back in the office and we meet up each afternoon). Audit.
On top of that, we spend a lot of time seeing patients.
Senior clinicians, seeing patients, using their clinical expertise whilst also doing enough management stuff to develop their service as they'd wish. Life as a Consultant Psychiatrist is fairly clear.
In fact, mine is very clear. I share my Job Plan and Appraisal with anyone who's interested. Lots of folk have been curious. Nurses, OT, secretaries, managers. Why not? I'm busy, I do loads, I critique what other people do, it's only fair that we're transparent and folk can see what I do. My folder's a lever arch file full of stats so they can see how many patients I see, what my out-patient activity is, how many home visits I do, how many in-patients I look after, what their length of stay is, what comments (some) and complaints (none, yay!) there've been, what my sickness is (still at 0 days over the last year), everything.
I don't expect everyone to wish to be as open. But I'm surprised at how opaque non-medical Consultants can be.
So, without any rancor, could I pose the question more widely. Rather than existing senior posts, of the non-medical Consultant posts that are high profile (eg the SHA need to agree), what do these posts involve that the non-Consultant posts don't? What is the raison d'etre behind a Nurse Consultant, Physiotherapist Consultant, Occupational Therapist Consultant or Social Work Consultant?