In an exclusive opinion piece for Nursing Times, health secretary Jeremy Hunt explains how plans to train more nursing associates and nurses will tackle the workforce shortage.
Happy staff means happy patients. This is the perhaps rather over-simplified expression of what we know to be true, namely that patients are more likely to be given high quality care if staff are motivated and supported. But how can staff do that if there are not enough of them?
Whatever your views on Brexit, the decision to leave the EU last year was a wakeup call for an NHS that has grown too comfortable assuming it can forever plug workforce gaps by fishing in the EU pond.
This was already starting to unravel before the Brexit vote for the very simple reason that we are not the only country with an ageing population.
Italy, Spain and Portugal also need doctors and nurses, and as their economies start to expand again after repeated financial and Euro crises, NHS recruiters have been finding it harder to recruit irrespective of our status in the EU.
We want the NHS to be the safest, highest quality healthcare system - and that means actually training the number of doctors and nurses we need.
“Today I announced that we will permanently increase nurse training places by at least 25%”
So last year I announced an unprecedented 25% expansion of doctor training places in England - an extra 1,500 training places a year on top of the 6,000 places already in the system. 500 of those places will be available for September 2018 and the bidding process for the remaining thousand places started today on 3rd October 2017.
This year we are announcing a similar package for nurses. We have already seen the NHS nurse workforce increase by more than 2,000 over the last five years, but we need to go further. So today I announced that we will permanently increase nurse training places by at least 25%, a vital investment for sustained growth in the nurse workforce that we will need over the next five years and beyond.
But I want this increase to do something more. The NHS, since its inception, has been an engine of social mobility in our society, providing opportunities for people from all walks of life to train, to serve and to build a career regardless of their background.
I want the growth in the nursing profession we will see over the coming years to serve as an accelerator of social mobility, so that people who in the past might have written off their chances of ever becoming a registered nurse have realistic and achievable routes to do so.
For healthcare assistants, many of whom would make brilliant nurses, the first step is to become a nursing associate and today’s announcement will see 12,500 training places created over the next two years.
“The final part of today’s package is designed to make the NHS much better at retaining the qualified staff it has.”
As the next step, I have asked Health Education England to work with the nurse regulator, universities and employers to create a shortened nurse degree apprenticeship so that, following a further two years of study, those nursing associates that are registered with the Nursing Midwifery Council can become fully qualified nurses.
Delivering and expanding nursing education needs innovative delivery.
Already, I know that some universities, such as the University of Bradford, are setting up nursing schools on NHS hospital sites to meet local workforce needs. I want to see more of this innovative practice and have asked HEE to work with interested employers, universities and the regulator to do more of this.
HEE will be working with the NMC and the sector to explore opportunities for employers to deliver some taught elements of the nurse apprenticeships in their own facilities.
”An at times archaic way of working enshrines a view of working life perhaps more suited to the 1960s and 1970s than the realities of people’s lives today.”
Derby, Wolverhampton and Coventry Universities have already offered to run apprenticeship nursing courses on hospital and community sites and others will follow, always making sure we maintain the high standards required by the nursing regulator.
The final part of today’s package is designed to make the NHS much better at retaining the qualified staff it has. At the moment we lose too many staff as they struggle to balance their working responsibilities and their family commitments.
An at times archaic way of working - partly culture, partly contract – enshrines a view of working life perhaps more suited to the 1960s and 1970s than the realities of people’s lives today. As a result too many people end up working for agencies - not just because of higher rates of pay but because of the greater flexibility offered.
It is lose-lose: inflexible contracts for NHS staff leading to exorbitant rates paid for the extra hours we need.
So today I announced that by the end of the parliament all NHS staff will be offered new, flexible working arrangements for additional hours they choose to work, to sit alongside their standard contract.
“To deliver the safest possible care we need to recognise the pressures of ageing population are only going to increase.”
It will cut out the agency middle-men, allowing staff to work extra hours with a tap on an app. It will offer rapid payment - at least weekly - for additional hours with potentially greater flexibility over pension contributions.
In discussion with staff and employers, we will start next year by piloting the approach in a dozen trusts in three clusters, with the aim of a comprehensive system in place by the end of this parliament.
NHS staff say in the most recent staff survey that levels of engagement are at record levels, with record numbers satisfied with their training and the way they are treated.
But to deliver the safest possible care we need to recognise the pressures of ageing population are only going to increase, which is why additional nurse training places, new routes into nursing and new ways to make it easier for staff to work extra hours, will be essential if we are to maintain the highest standards.