Jeremy Hunt has said he would be surprised if any sustainability and transformation plan (STP) areas managed to reduce their numbers of registered nurses.
The health secretary said he was clear on the lesson from the Mid Staffordshire scandal that hospitals needed to have safely staffed wards.
“The lesson of Mid Staffs is that you need to have properly staffed, safely staffed wards”
He also said there was scope for new roles that could complement and support trained nurses but these should not substitute nurses.
His comments follow emerging evidence of regional attempts to reduce registered nurse levels, as part of NHS England’s sustainability and transformation plan drive.
NHS organisations in 44 parts of the country have been asked to come together to develop “place-based plans” for the future of health and care services in their area. Draft plans were submitted in June 2016, and final plans are expected to be completed in October.
However, the plans have recently attracted controversy, with claims they have been drawn up in secret and that they are a means of reducing services.
In recent weeks, two STPs have been published that refer to skill mix changes to save millions of pounds, including reducing registered nursing posts.
The final draft of the Buckingham, Oxfordshire and Berkshire West STP revealed plans to save £34m through a “reduction of nursing grade input” and greater use of “more generic support workers”.
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The Nottinghamshire plan included an appendix that featured an indicative proposal to save £12m, including a 12% cut in “core” staff groups such as band five nurses, social workers and therapists.
“The lesson of Mid Staffs is that you need to have properly staffed, safely staffed wards,” he told Nursing Times’ sister title Health Service Journal after announcing a raft of nursing policy at a conference in Birmingham.
“I don’t want to be rigid or inflexible about new roles, but if you ask me whether it is likely that local areas are going to be able to reduce the number of trained nurses, I would be very surprised if any actually managed that. That is why we are looking to train an extra 40,000 nurses [during this parliament].”
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But he added: “With the pressures on the NHS, we will need to ask ourselves whether there are current roles that could be done by staff who are not trained nurses.”
He cited one example of staff used to deliver training for talking therapy services, which in the past would have been delivered by mental health nurses.
Meanwhile, earlier on, Mr Hunt announced that he had asked the Nursing and Midwifery Council to regulate the nursing associate role.
Jeremy Hunt 2
In a keynote speech to the NHS Providers conference, he said that because those in the new role will be able to administer medicines, a “stronger regime of assurance” will be necessary to ensure safe and effective clinical practice.
He also repeated previous pledges that the new role – designed to bridge the gap between healthcare assistants and nurses in England – would not replace nurses, but will support them.