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Mark Radcliffe

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‘Giving good care isn’t just about nurses and doctors’

You may know Japan likes to hunt whales. It defends this largely unpopular activity by saying ‘we are doing it for scientific research purposes’. So the scientific community said ‘show us your research’ – and the most cutting-edge paper was on attempts to cross a cow with a whale.

You’ll be pleased to hear the Japanese scientists did not put a cow and a whale in a really damp field, feed them oysters and play soft music. That would have been stupid. Instead they injected some whale sperm into some cow’s eggs to see what happened. It is unclear what they got. My guess is a legless cow with a big fishy tail that desperately wanted to swim but needed a snorkel. Still, hybrids can have their uses – particularly in healthcare.

Last week, figures were released stating that the number of doctors and nurses in the NHS had risen by 6,000 since 2006. The total workforce dropped by 0.6% and there were 11,000 fewer clinical support staff, including nursing assistants and administrators, but the increase in trained clinical staff should be acknowledged.

But, sacrilegious as this may sound, it isn’t just about nurses and doctors any more. A number of new roles are emerging in the NHS that offer the opportunity to work in new ways to develop dynamic and responsive services alongside nursing and medical colleagues.

These are often thought of as hybrid professions, combining some of the core skills of nursing with, say, social work or psychology or, in the case of sports therapists, basketball. And, unlike the hapless whale-cow, they are creative and purposeful developments to be welcomed.

But will the dominant professions – nursing and medicine – embrace ongoing development of these roles? Indeed, what is the response to the significant reduction in clinical support staff if the money saved on nursing assistants and administrators is what has funded the additional nurses?

It seems to me that this is a moral dilemma for nursing. Over the last 25 years nursing has been forced to develop something of siege mentality to protect itself from assaults faced under the Tories and ideological confusion under New Labour. Nursing leaders have had to base strategy on defending nursing and nurses from what has amounted to, at best, carelessness and, at worst, stupidity.

But what happens when patient or service need would benefit from something other than a nurse? Can we even entertain such a thing, let alone facilitate it? How easy is it, for ward managers, say, to use their budget to hire a part-time ward clerk and support worker instead of a band 5 nurse? And will nursing leaders welcome these new roles? Or will they treat them as the NHS equivalent of the unwanted offspring of Moby Dick and Daisy?

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