Major changes are facing the NHS and the nursing profession. Frontline nurses could and should play a crucial role in how they are shaped but are they being engaged?
This is the message from a meeting of some of the profession’s key stakeholders.
Earlier this month, Nursing Times invited a dozen of the profession’s leaders to London to discuss issues raised at the NT Summit, held in Buckinghamshire during January.
Among those attending the meeting this month were senior nursing figures from the NHS, the Department of Health and academia. Top of the agenda were the proposed pathways outlined in the Modernising Nursing Careers programme, the move towards an all-graduate profession and the NHS Next Stage Review.
The pace of political change on the nursing careers issue has quickened in recent weeks, said RCN head of policy Howard Catton. For example, he noted that health secretary Alan Johnson had said he supported the case for an all-graduate profession in his speech at RCN Congress in Bournemouth last month.
But despite such step changes, the main problem still appears to be about getting nurses interested in the profession’s future and realising how they can influence it.
Eileen Sills, chief nurse at Guy’s and St Thomas’ NHS Foundation Trust in London, said: ‘Not a lot of nurses know or understand what Modernising Nursing Careers is. Yes, there’s been consultation but it’s not emerging as an issue for the profession.’
Delegates also noted the increasing influence that the NHS Next Stage Review could have on the profession, and the likelihood that the reforms already proposed for pre- and post-registration nursing would be overtaken by it.
The final results of the review, currently being developed by junior health minister Lord Darzi, are due to be made public at the end of June.
Deputy chief nursing office for England Janice Sigsworth said it had actually been helpful over the past six months in bringing attention to the ideas proposed in the other consultations, with doctors and other groups now taking note of the changes afoot in nursing and saying ‘it’s good stuff’.
But Ms Sigsworth noted that the review, although important, would not end work on other nurse careers programmes. ‘There’s work that’s gone on before it and there’s work that will go on after,’ she said.
However, Ms Sills highlighted that the real opportunity the review provided for nurses was to gain more influence. ‘Nursing has got a real opportunity to be where it should be – an important player within the care of the individual, often providing the glue in a multidisciplinary team,’ she said.
There is already evidence that ensuring nurses are involved in reforms early pays dividends. Mr Catton described research the RCN had previously carried out on private finance initiatives – some that had worked well and some that had been ‘horror stories’. ‘As simple as it sounds, one of the key differences that emerged was whether nurses had been involved early on,’ he said.
But, as has already been suggested, getting nurses on the ground to voice their views officially has proved tricky.
Deborah Sturdy, nurse adviser for older people at the Department of Health, said: ‘Consultations can influence things, they can contribute – it is an open door. But I’m not sure if there’s any evidence on how many nurses respond to consultations.’
Delegates suggested the problem was due to the way information was presented, either in its language or its lack of immediacy.
Mr Catton said it needed to be spelt out what the new models of care would look like. ‘What is the balance between numbers of GP practices, health centres, walk-in centres and polyclinics?’ he said. ‘Once you describe what those models look like it becomes easier to explain that nursing is going to be arguably the key profession to deliver all of that stuff.’
Rosemary Cook, director of the Queen’s Nursing Institute, agreed. ‘I think a lot of nurses aren’t engaged because they see it as policy stuff. Nurses are not daft they know that policies come and go as governments come and go. They think it’s not for them,’ she said.
‘If you can explain it so people understand what it’s about: “if you and your friends want to train as nurses, what experience are you going to have and what kind of job are you coming into?” If we can do that, first of all, it will engage more people and we’ll uncover what the big issues are,’ she said.
NT plans to hold another major summit on the future of nursing and the issues affecting it next year