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EU nurses will need support during Brexit uncertainty, says CNO Jane Cummings

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NHS nurses from European Union countries will need the support of their colleagues in the coming months, the chief nursing officer for England told senior members of the profession today.

Professor Jane Cummings noted the “uncertain future” faced by nurses from other European countries working in the health service, as the debate continues over the UK’s exit from the EU and evidence suggests healthcare workers are increasingly considering their future in the UK.

“Colleagues from the EU face an uncertain future in coming months”

Jane Cummings

She highlighted that the NHS “will continue to make them feel welcome” during the coming months, reiterating that they currently comprise 4% of the nursing and midwifery workforce.

Prior to the EU referendum, nursing directors had increasingly turned to Europe to bolster their establishments at a time when the country faces a recruitment crisis due a shortage of nurses.

Latest figures from the Nursing and Midwifery Council have already indicated a significant slow-down in EU nurses applying to join the UK register, though it is unclear whether this is solely to do with Brexit or also the result of more stringent language testing.

Meanwhile, an investigation by the Channel 4’s Dispatches programme has found 25,000 – or 42% of – European NHS workers could leave within five years of Brexit. Around 66% of EU staff said they were worried about their career in the UK, according to a survey by the programme – screened on Monday.

Last week, the House of Lords voted in favour of an amendment to the Brexit bill calling for the UK to protect the long-term rights of EU citizens already in the UK to remain in the country.

It was one of two amendments to the bill that peers backed and that were subsequently rejected by MPs in the House of Commons on Monday.

As a result, prime minister Theresa May could trigger Article 50, which formally starts the Brexit process, as early as today though she expected to be waiting until the end of the month before she does so.

Today also marks the start of the CNO’s annual summit, at which Professor Cummings is due to address the challenges of Brexit in her keynote speech this morning.

She said: “For as long as there has been a National Health Service, there have been nurses from other countries and we have rightly celebrated the contribution of the 40,000 nurses who came from the Commonwealth to answer Aneurin Bevan’s call.

“Today, around 4% of nurses and midwives in the NHS are from European Union countries,” the CNO said.

She added: “Colleagues from the EU face an uncertain future in coming months. They will need our support. They help represent the communities we care for and we will continue to make them feel welcome.”

“Our standing as a profession should reflect this stratospheric level of public support”

Jane Cummings

Speaking to the country’s most senior nursing, midwifery and care leaders this morning, Professor Cummings outlined a range of challenges the profession will face over the next five years.

As well as Brexit, she discussed the image and pride of nursing and midwifery, saying she would be “championing” a piece of work that will focus on promoting the “image and pride of our profession, tackling misconceptions and stereotypes”.

“The way nursing and midwifery is seen, portrayed in the media and popular culture affects how we feel as individuals and as a collective. It affects how the public and other professions also see us,” said the CNO.

“It also has an influence on how successful we are at attracting the best, retaining the best and being the best we can be, at the top of our game,” she stated.

NHS England

CNO: EU nurses will need support during Brexit uncertainty

Jane Cummings

“I want to build on the fact that 93% of the population trust nurses, higher scores than any other profession. This is a testament to your dedication, your hard work,” she added.

“Our standing as a profession should reflect this stratospheric level of public support, and so should our status,” she told delegates at her fifth CNO summit, which is being held in Birmingham.

Professor Cummings also called on nursing and midwifery staff to take a leading role in helping the NHS to adapt to meet the needs of patients, at the same as they cope with increasing pressures.

As revealed to Nursing Times in an interview before the conference, the CNO is keen to encourage nurse involvement in service change, in the wake of concerns that the profession has not been sufficiently included in the development of England’s 44 sustainability and transformation plans (STPs).

“Demand is rising and budgets continue to be tight, every penny and resource has to count,” she told delegates.

“When it comes to commissioning and providing services, STPs are the best way for us to demonstrate real leadership and focus on doing the right things that deliver safety and the triple aim of good care, improved health, and lower cost,” she said.

She told summit delegates that by 2020 there will be a million more people over 65, 7000 people over 100 years old and two out of three babies born today will live until they are 100.

She said: “If we value our remarkable NHS, then we need to reshape it for a population size and age profile it wasn’t designed to deal with.”

On the challenge of resources, she said: “We can be proud of how the NHS has coped over the winter and in recent times.

“Working with tight resources has required tenacity and flexibility, which I have seen on the front line,” she said.

Professor Cummings said she recognised that the situation for staff was “punishingly tough right now”, being nearly 10 years since the global financial crash and, therefore, a decade of “tight budgets and real pressure”.

“I know that all nursing, midwifery and care staff feel battered, tired and often too busy to think,” she said. “The end of each day with feet or a head that aches, and a sense that there are not enough hours to do the job, whatever role they and we all have. When every bit of your resilience is strained, and every ounce of your leadership is put to the test. I know. I get it.”

But she added: “I do continue to be inspired by the leadership and innovation that continues despite the pressures – our profession focuses on the safety and experience of people like no other.”

Ten-point plan for practice nurse workforce

CNO for England outlined future plans to boost the nursing workforce in primary care and community settings.

Speaking at her annual summit, she highlighted that more care needed to be delivered in settings other than hospitals, with more focus on community and primary care services.

I am pleased to be leading the investment of £15m in the General Practice Nursing Workforce, recognising the evidence that shows us the pressure this vital group of our profession continue to be under in relation to recruitment, training and the image of primary care nursing. 

The CNO said the plan would cover the following areas:

  • Entry and recruitment – raising the profile of general practice nurses, increasing clinical placements in GP settings and ensuring standardised induction is in place, along with return-to-practice programmes focused on general practice
  • Establishing strong general practice nursing teams – increasing access to leadership programmes for general practice nurses, and working with GPs/CCGs/STPs to make sure these skills are utilised locally, defining what safe general practice nursing teams look like and giving general practice nurses the tools to assess cultural factors in the workplace that influence how care is delivered
  • Enhancing the role of the general practice nurse and retention of the general practice nurse workforce – more opportunities for professional development, accessible, fit-for-purpose training and clearly defined career progression
  • Expanding the workforce using widening participation schemes and apprenticeship routes – increasing healthcare support workers in general practice and supporting the emerging role of the nursing associate
  • Embedding ongoing support for general practice nurses workforce into the future – supporting skills development in a range of clinical priority areas such as frailty and multimorbidity and sharing examples of new ways of working

Professor Cummings said her team would be responding to the work Health Education England had already done and that, going forward, she and the Queen’s Nursing Institute would work with the royal colleges and government arm’s length bodies. “We will publish a 10-point plan in the next couple of months,” she said.

“In addition to this I will be working with my national colleagues and professional organisations to ensure we go further and develop a framework for community services, learning from our new models of care and vanguards so we have a common national plan for shifting more services into community settings,” she said. ”I will provide the clinical leadership for this programme and we will be shaping this in the coming months.”

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