Unions have welcomed elements of NHS England’s plans for “radical” new care delivery options, which could see primary care nurses and midwives take on a stronger leadership role.
The Royal College of Nursing said proposals to identify non-medical leaders for new models of care, invest in staff and a focus on prevention and care closer to home were all positive suggestions.
It said the five-year plan – written by six NHS leading bodies, including the Care Quality Commission and Health Education England – provided a “rigorous and realistic” assessment of the scale of the challenge facing the country’s health service.
However, the union warned that nurses, midwives and healthcare assistants would be “sceptical, if not a little cynical”, that without a clear commitment to increase funding, the NHS workforce would still face similar problems to those it has now.
Peter Carter, RCN chief executive and general secretary, said: “None of these changes will be possible without the hearts and minds of NHS staff.
“The reality is that, over the years, they have seen policy initiative after policy initiative come and go, whilst they have cared for record numbers of patients through the most disruptive reorganisation in the health service’s history and in the face of huge workforce cuts and pay freezes,” he said.
“The NHS bodies have set out the direction of travel but they can’t do this by themselves”
But the RCN noted that nurses would be “delighted” with the report’s acknowledgement that nurses should be paid competitive salaries to avoid staff shortages.
“The NHS bodies have set out the direction of travel, but they can’t do this by themselves. They will need the support of an engaged and motivated staff, organisations like the RCN and a firm commitment on the necessary finances. The next government must listen and act,” said Mr Carter.
Meanwhile, the Royal College of Midwives welcomed proposals to review how maternity services were organised and delivered.
It noted, in particular, that the five-year plan included an assessment of how funding was allocated to support maternity services.
RCM chief executive Cathy Warwick said moves to review the maternity services section of the NHS tariff system – which sets national prices for service commissioners – was a “positive step”.
“Our research shows that in the postnatal area in particular the tariff is often not enough to pay for the actual costs of the services,” she said. “We want to see these services funded appropriately so that women and babies receive care based on their needs.”
Professor Warwick added that to “really transform” maternity service, the NHS needed to receive the “right levels of funding,” which the plan recognised.
However, the union Unite, which represents many health visitors and mental health nurses, was less positive.
Unite head of health Rachael Maskell said: “Simon Stevens, the new chief executive of NHS England, makes precious little mention of the plummeting morale of the 1.3 million workforce which is becoming a worrying pattern for this government with its continued failure to invest in skills, retention and development.
“It is clear that the plan will not plug the predicted £30 billion financial black hole by 2020-21,” she said.
“This will be impossible to deliver in five years – if you are talking about a real improvement in health prevention, retraining and realigning the roles of NHS staff, together with integration of health and social care,” said Ms Maskell.
She added: “One positive to take from this plan is that it will focus the minds of politicians of all parties for the need to provide a suitable financial framework to underpin the NHS going forward.”