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'We must bridge the gap between health and social care nursing'

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Nurses in the social care sector are facing many challenges: perceived cultural differences between nurses in different sectors and the NHS; dominance of NHS leadership in nursing; a falling supply of nurses, resulting in all sectors fishing in a rapidly reducing pond; poor utilisation of social care as a rich placement opportunity for students; and little understanding of enriched career opportunities for these nurses.

Trish Morris-Thompson

Trish Morris-Thompson

The gulf between hospital-based nursing and nursing homes can often feel broader than the Atlantic. Mutual incomprehension runs so deep as to occasionally break into feuds about safeguarding, care standards, information skills transfer and so on. The result puts many nurses off potential careers in the field of care work. It also causes tension between the two sectors.

Such complaints are almost always an unhelpful blame game but the perceived gap between the fields is largely illusory. Huge numbers of nurses choose careers in nursing and residential care: Barchester Healthcare alone employs 2,400 professionals to act as nurses in 200 care homes and many more have home and senior management positions. Similar needs apply across all homes in the 420,000-bed care sector - it provides exciting career options with satisfying roles for qualified nurses and offers rich placement experience for students.

The truth is health and social care services are interdependent - and increasingly so. An ageing population, pressures on hospital beds and the crushing financial squeeze on council funding mean care homes need nurses and nurse managers to support the older cohort that is entering care homes, with comorbidities that homes simply did not have to manage a decade ago. The care of these individuals demands skills and knowledge that social care training does not provide - and if care homes can’t cope, hospitals will collapse under unmanageable demand.

The recruitment crisis is a familiar theme to Nursing Times readers but its effects are disastrous in this sector, where vacancies are more than 2% above NHS figures (note: factoring in the roles for nurses in the community shows that 55% of UK nurses work outside the NHS). Thankfully, the Home Office has relaxed its immigration controls for nurse, but the proposed shift from bursary to loans for student nurses in training will be catastrophic.

The best practical strategy for dealing with this crisis is developing an intermediate role between nursing and social care - the care practitioner role. Health and social care chiefs are moving cautiously towards this conclusion and Barchester is working to put the idea into practice. This will radically change and enhance the role of nurses in care homes. They will retain a satisfying footing in care practice but their experience and supervisory skills will be far more called upon. Nursing and social care will be mutually enriched by the change but this role will need monitoring and evaluating. An added positive outcome is the career progression opportunity for carers who may then move to nurse training.

If nurses’ roles are increasingly located outside the NHS and changing rapidly, there is a clear need for changed representation. Most nurse leaders come from the NHS, and pointedly ignore nurses working in other fields. Given the realities of our unforgiving interdependent worlds and the sheer number of nurses in other sectors this is nonsensical. I’m sure others will come forward in time but for now I firmly believe it is a personal obligation to bang the drum in favour of that silent majority of nurses who are working on bridging exciting new frontiers.

Trish Morris Thompson is director of quality and clinical governance, Barchester Healthcare

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