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Will Jeremy Hunt's nursing policies solve the workforce crisis?

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This Wednesday saw such an explosion of nursing policy announcements that it was difficult to keep up with it all.

After the marked absence of nurses from the health secretary’s speech at the Conservative party conference in October, Jeremy Hunt chose to focus heavily on the profession during his address to this week’s NHS Providers meeting.

“They felt a bit like tinkering round the edges, a hotch-potch of bits and pieces on a theme”

He started by announcing plans to introduce the first degree-level nurse apprenticeships next year, which is expected to allow up to 1,000 apprentice nurses to join the NHS each year.

We already knew that NHS apprenticeships were coming – they had been trailed by previous government announcements – but the numbers, detail and particular focus on them as a route into nursing was shiny and new, and got the profession talking immediately. Was it a return to state-enrolled nursing etc?

Then, the health secretary turned to the new nursing associate role that is due to be piloted from next year as a “bridge” between healthcare assistants and registered nurses.

He confirmed that the Nursing and Midwifery Council had been asked by the government to regulate nursing associates – an announcement that took few people by surprise, except for those who had not realised regulation of the role was even a matter for discussion.

After that, Mr Hunt announced that proposals would be developed to make it easier for nurses to move into advanced practice roles, as career progression was important for staff morale and recruitment and retention.

Mr Hunt said he wanted to ensure there was a “clear progression path for nurses to reach advanced level practice and beyond”, he said.

And after that he said he would “set expectations” for trusts to boost their use of e-rostering technology in order to better manage ward staffing levels and improve flexible working opportunities.

And lastly, he called for more nurses and doctors to be occupying positions “at the most senior levels” of the NHS.

The proposals for advanced practice, e-rostering and leadership are probably no brainers, as far as I am concerned, but there is of course controversy about apprenticeships and nursing associates.

As readers of Nursing Times will have seen – hopefully – over the recent weeks and months, a raft of issues have been raised and discussed regarding the two ideas. They mostly fall into two camps, with those on one side arguing they risk a dumbing down of the profession and a risk to patients, while the other argue that the NHS is so chronically short of registered nurses that doing nothing is a risk in itself and any kind of nursing staff is better than none.

I am aware that I have grossly simplified the arguments here.

However, what struck me about the announcements from the secretary of state this week was that they felt a bit like tinkering round the edges, a hotch-potch of bits and pieces on a theme.

“The elephant(s) in the room for me were the more straightforward answers”

Admittedly, in their own different ways, they are all intended to boost recruitment and retention of the nursing workforce. But the numbers involved are quite small in relation to the total nursing workforce and they don’t feel like the whole answer to me, even when combined.

The elephant(s) in the room for me were the more straightforward answers to the nursing workforce problems faced by the NHS and care sectors that were absent from Mr Hunt’s speech.

Here are three that spring to mind: the lack of increased funding for educating more registered nurses – instead of axing the bursary, for example – a lack of pay rises above 1% – remuneration tends to be the key to attracting staff and keeping them happy – and the failure of any commitment so far from the government to secure the services post-Brexit of the many European nurses who are helping prop up the workforce.

Broaching these would go a long way further towards helping than the new policy announcements, I personally believe. But I have been around long enough to realise that they are a forlorn hope.

This week’s policy announcements from Mr Hunt were described in his speech as a “revolution in nursing” – it remains to be seen whether it will be a bloody one or a velvet one.


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