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Let nurses nurse. Let managers manage.

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We should free nursing staff to care for patients and open up management roles to people from other professions, says Klaudiusz Nowicki, a charge nurse at the Fulbrook Centre Oxford.  

For the past decade the NHS has emphasised the importance of change within the organisation.

klaudiusz nowicki

Klaudiusz Nowicki

Klaudiusz Nowicki

There have been several attempts to address staffing issues but staff numbers continue to drop.

Although there were 18,432 more NHS nurses in 2014 compared to 10 years earlier, the number has only increased by an annual average of 0.5% in that period.

Difficulty in recruiting and sustaining nurses are the main obstacles to overcome, and there are many dark clouds on the horizon.

One European survey suggests that 20% to 50% of nurses want to leave their jobs – that’s in the face of a 28% increase in admissions to hospitals in the past decade. This directly results in daily care being compromised due to staff shortages (Ball and Pike 2009).

On the other hand roughly 10% of managers in the NHS have a nursing background with an active PIN but do not necessarily have patient contact, often leaving frontline staff and patients in uncertain situations.

This raises the question of whether we really need 30,000 managers in the NHS? In Holland where there are no nursing management jobs patient satisfaction is the highest in Europe (European observatory 2016).

Based on the evidence, it would be better for all managers with active Nursing and Midwifery PINs to be temporarily redeployed – as part-time nursing staff – to any place in need on a short-term basis. By doing so, greater nursing care would be addressed by more experienced nurses.

In the long run, managers from other professions should be encouraged to enter NHS management.

All operational management roles in the NHS should be open to business school graduates only (no time to learn on the job – as that has not proved very effective thus far) to save time and money on educating nursing managers and preserve nursing staff in patient care.

There should be a clear career progression pathway for nurses from the beginning during their preceptorship, according to their specialities, to address recruitment and retention issues

“Managers from other professions should be encouraged to enter NHS management”

12-hour and six-hour shift patterns for inpatient wards could also address issues of staff shortage.

The introduction of 30-hour weeks for inpatient wards plus six hours a week compulsory training should address recruitment and retention issues too. In Sweden, after two years of piloting a six-hour project, researchers concluded that work satisfaction and productivity improved and absenteeism due to sickness fell. In the UK, the average days lost per case for stress, depression or anxiety – 24 days – was higher than for musculoskeletal disorders, which was 16 days (NHS Digital).

With Public Health England estimating the cost to the NHS of staff absences due to poor health at £2.4bn a year and an additional £4bn a year for the cost of agency staff to fill the gaps, this is a dire situation that must be addressed (NHS Improvement).

Klaudiusz Nowicki is a charge nurse at the Fulbrook Centre, Oxford

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Readers' comments (2)

  • I agree we don't need managers. Managers should spend time to patient's care if understaff rather than sitting inside their office and mostly they are on breaks smoking.

    Unsuitable or offensive? Report this comment

  • I agree we don't need managers. Managers should spend time to patient's care if understaff rather than sitting inside their office and mostly they are on breaks smoking.

    Unsuitable or offensive? Report this comment

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