Senior nursing figures have raised questions about the status of the profession during the uncertain political period likely to follow the general election.
While nursing has featured heavily in party election pledges, strong leadership will be needed once the hunt for votes is replaced by the financial realities of the NHS, they warn.
Nursing Times has been told there will be a need for “high level” nursing advice to be provided to politicians at what it is a “tumultuous” time for nursing.
“It poses lots of questions about who is going to lead nursing in this tumultuous time of change and difficulty”
Baroness Audrey Emerton, a former nurse who sits in the House of Lords as a cross-bench peer, said nurse leaders faced a “time of change and difficulty – with finances and everything else, plus the growing population of elderly and all the healthcare needs to be met”.
She said that, following the election on 7 May, it was important to ensure nurses were “recognised” and equipped to be able to be effective leaders.
“You’ve got to be able to influence and persuade at all levels from the junior up to the most senior person… I think nurses for too long have not been in that position,” she warned.
Howard Catton, the Royal College of Nursing’s head of policy, told Nursing Times it was “imperative” that politicians received dedicated nursing advice following the general election.
“Look at the agenda the new political team are going to have to deal with – integration between health and social care, moving care out of hospitals, maintaining quality and safety in a really difficult financial climate, dealing with nursing shortage,” he said.
“There is a cast iron case for saying it is imperative that senior politicians have dedicated nursing advice to deal with the health agenda,” he added.
There has been criticism in recent months of the failure to include nurses in healthcare policy, with one academic claiming the workforce was often “invisible” in this area.
In March, Professor Alison Leary, chair of healthcare and workforce modelling at London Southbank University, said that nurses, particularly those in specialist posts, often “show up on a spreadsheet but don’t show up in policy”.
“We are using the opportunity created by staff turnover to further strengthen our team”
Speaking at the Florence Nightingale Foundation annual conference, she said this was a “real challenge” for the nursing profession, because it meant “their contribution isn’t always recognised” and made them vulnerable to job cuts when trusts looked to make financial savings.
The last election was followed by controversy when the coalition moved the chief nursing officer post out of the Department of Health to the newly-created arm’s length body NHS England. Meanwhile, a separate director of nursing role was appointed at the Department of Health.
The splitting of the CNO post from its traditional home at the DH was seen by some as a dilution of nursing influence at the highest political levels – a view supported in part by the Francis report.
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Mr Catton questioned why the medical profession had a chief medical officer based at the DH providing UK-wide advice, while the CNO was based at NHS England.
“There is a case for a very senior and prominent nursing advisory role directly into the DH to support decisions the DH makes,” he said.
Mr Catton’s comments follow a raft of high profile personnel changes over recent months, both at the DH and NHS England, which have raised questions about the future shape of nurse leadership.
Professor Viv Bennett – responsible for national leadership on public health nursing – moved solely to the arms-length body Public Health England, having previously being jointly based at the DH as its nursing director.
At the same time, the DH announced it was setting up a nursing and midwifery policy unit, which would be led by David Foster, a former deputy CNO and most recently Professor Bennett’s number two.
“It is imperative that senior politicians have dedicated nursing advice”
Meanwhile, since the start of the year, three members of CNO Jane Cumming’s team have left their positions at NHS England.
Ruth May, formerly chief nurse for the Midlands and East region, was appointed as a senior advisor to the health sector regulator Monitor last month and at the beginning of April, Gill Harris left her post as chief nurse for the North, to become chief nurse at Pennine Acute Hospitals Trust.
Meanwhile, Juliet Beal, NHS England’s director of nursing quality improvement and care, has just started a six-month secondment at the Care Quality Commission.
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There was uncertainty that these roles might disappear. However, it appears to have been quashed, as Nursing Times understands that interviews for Ms May’s replacement took place last week.
In addition, Margaret Kitching has been appointed as regional chief nurse for the North on an interim basis and a permanent replacement will be appointed after the election.
Similarly, Ms Beal’s role is also due to be recruited to after the election and is currently being covered by another member of the CNO’s team.
An NHS England spokeswoman said: “Having strong nurse leadership is a top priority for the chief nursing officer, and we are using the opportunity created by staff turnover to further strengthen our team.”