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'Government proposals could reverse the progress we’ve made'

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In the past six months, there have been three major government announcements that will have a profound effect on the nursing profession in England for years to come.

janet davies

janet davies

First, the chancellor announced in the Spending Review that he was removing funding for student nurse university places, including the bursary. Then the health minister said he was creating a new nursing associate role. Now we are awaiting a further consultation on plans for a system of nursing apprenticeship leading to registration. Each of these announcements will have real implications for the development of the future nursing workforce.

The government’s proposals seem to hark back to how nursing education was delivered in the past rather than acknow-ledging that modern nursing is complex and requires high-level skills and know-ledge, as well as compassion and caring.

Nurses working today know the reality of care means knowledge is just as important as skills. Nurses don’t just need to know what to do, they also need to know why they’re doing it and to be able to critically assess the best options for their patients. A university education, with its emphasis on questioning as well as learning, is the best way for nurses of the future to learn and develop the critical thinking skills that will enable them to deliver safe and effective care in a range of settings and situations.

It’s taken the profession a long time to get things to where they are now – we can’t stand by and allow a return to an outdated notion of what nursing is. We should be educating and training a nursing workforce for the 2020s not the 1970s. And that nursing workforce should consist of registered, graduate nurses working with support worker colleagues – a modern nursing family working to provide the best care for patients.

 Plans for the associate role could be a step in the right direction. The Royal College of Nursing has long been concerned about the unacceptable variations in

preparation for those in support roles working with sick and vulnerable people. We would welcome something that brought consistency and quality. If the role also offered opportunities for better training, regulation and career progression – including a route into nursing – all the better. But new nursing support roles cannot be a replacement for future registered nurses and should not be used as a way of artificially increasing nursing numbers and of providing a nursing workforce ‘on the cheap’. The evidence against this is too strong.

The future direction of the NHS, signalled by the Five Year Forward View, the development of vanguards and new plans for primary care shows how we will need to work differently, with more cross-organisation nursing roles based outside hospitals and requiring greater flexibility.

That’s why there are still questions about the government’s proposals for nursing apprenticeships and, most crucially, how these roles will support the future vision of healthcare.

It is vital that future nursing apprentices are able to develop degree-level knowledge, the ability to think and act differently, and challenge the status quo as well as experiencing supported placements in a variety of clinical settings.

The future of nurse training currently hangs in the balance. The government and nursing leaders must consider the implications of these changes. Putting into reverse the great progress the nursing profession has made over the last few decades is not the way to secure its future or the future of the nation’s healthcare. And if it’s bad for nursing, then it’s bad for patients.

Janet Davies is chief executive and general secretary of the Royal College of Nursing


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