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PM’s Commission: What happens now?


It’s been five months since the Prime Minister’s Commission on the Future of Nursing and Midwifery produced its Frontline Care report. Much has changed during that time, not least the political party in office.

Since the change in government, myself and other commissioners have been asked by fellow professionals and the general public: “What happens now?”

It is perhaps worth reiterating that the commission and its report aimed to:

  • Identify the competencies, skills and support that frontline nurses and midwives need in order to take a central role in the design and delivery of 21st century services for those who are sick. This would involve promoting health and wellbeing and, in particular, identifying barriers that impede the pivotal role that wards sisters/charge nurses/community team leaders provide;
  • Identify the potential and benefits for nurses and midwives - particularly those in primary and community care - of leading and managing their own services;
  • Engage with the professions, patients and the public in an interactive and robust dialogue to identify challenges and opportunities for nurses and midwives.

These aims formed the foundations of the activities and discussions over the year it took to complete the report.
The initial actions that galvanised the commissioners to address the challenges and opportunities for nursing and midwifery over the next 20 years were initiated by the Labour government. However, the systems, processes and contributions of the commissioners was not underpinned or influenced by the priorities of a single party.

The commissioners’ main objective was to look critically at the nature of nursing and midwifery work and review what the professions did well and not so well, in an attempt to guarantee that, in future, they would provide high quality healthcare for all. This was as demanded by the general public, policymakers and, not least, by members of the nursing and midwifery professions themselves. Achieving the objective meant engaging in a level of detailed consultation with patients, families, practitioners and service providers about their experiences and expectations of nursing and midwifery care not seen since the Briggs report of 1972.

The consultation resulted in 20 recommendations, which aimed to frame the current and future direction of nursing and midwifery as high impact and highly skilled.

Frontline Care has been presented to the coalition government as a comprehensive report on the contributions that nursing and midwifery can make to improve the health and life chances of the British public. Moreover, the report reflects our awareness of ourselves as a profession and the key role we play in protecting and promoting the health and wellbeing of the public. What is articulated in Frontline Care and through the consultative processes used to gather the evidence is that it is not simply a record of the ideas of 20 people who made up the commission, but a record of the thoughts, feelings, hopes and experiences of all the users and providers of healthcare services.

So, what happens now? The change in government has understandably led to a delay in receiving the formal response to the report as the coalition determines its own strategies on health. The importance of it recognising and understanding that the report comes from the public and healthcare professionals cannot be underplayed. This is a central feature and one of the main strengths of the report, making it an important source of information for healthcare planning for all organisations, be that government or regional/local planning committees.

The white paper Equity and Excellence: Liberating the NHS supports many of the fundamental issues that were highlighted to the commissioners, such as the emphasis on services that are patient/user led and focused, as well as recognising the importance of addressing health inequalities and public health. It also aims to empower healthcare staff to determine what is required to best meet patients’ needs. Therefore, the new government’s views on health appear to be in tune with the recommendations of the Frontline Care report.

The purpose of the recommendations was not simply to inform national policy but also to offer suggestions as to where changes, reviews or future developments can be focused for all concerned. There are aspects of the recommendations that can be - and indeed have already been - actioned at local and regional level even before the formal response is received.

We are facing challenging times but what happens next is down to us. How do you plan to contribute to improving quality of care? What can you do now that will make a difference to achieving the goals we have set for ourselves?

How we contribute as practitioners, educationalists, researchers or policy advisers will have the greatest impact on how the recommendations for our profession will benefit both patients and healthcare professionals. Now is the time to engage and act.

About the author

Laura Serrant-Green is professor of community and public health nursing, school of health and social care, University of Lincoln


Readers' comments (5)

  • Well all I can say is ti every Nurse watch your Job as the managers will hang on to thiere's at the exspense of your's.

    I know because I was told last week that my job is going to save money and a nurse in another hospital,
    The reason to save money!!! as I'm frontline staff and most of the other staff members in my directorate are band 7 and upwards, they are clinging on to thier jobs, and they don't have much patient face to face contact.

    The whole trust has been told it has to save 3 million a month!!! As they had overspent Last year, I'm only band 5 and not a budget holder!!!

    Don't rely on the RCN to help they have said to look around for another Job within the trust,( no jobs for band 5) or they will do a deal for a early retirement ( I love my Job)

    The job loss are is only at the consulation stage!!
    I Have paid for over 10yrs subs to the RCN

    I will try and fight it because patients safety is involved, but I've been told that's not my problem, well registered with NMC and its my duty of care to report my concerns,

    So just be aware as nursing is now not a job for life,
    I completed a survey on whether I would take strike action if it meant I could keep my Job I would.

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  • agree with the above comments. This government (nor any other for that matter) do not give a toss about nurses or nursing so get it through your heads that no white/green/yellow or any other colour 'papers'/thinktanks/exploratory investigations/reports/consultations will do none of us any good, apart from those in higher echelons who will use all these 'research' ploys to obtain/keep a job and justify their existence. What a sorry profession nursing is-I've met some great nurses, but you know what? as long as it is predominantly a female occupation the predominantly males in power will use you as a doormat and it will NEVER change. And I am male and the majority of great nurses I have met WERE female but the world is still a patriarchal place so just remember that when you hear all this rhetorical b***s**t

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  • I'll tell you exactly what will happen now; cuts need to be made, that is inevitable, but instead of being concentrated on management/executives/non job idiots (like it should be), they will execute a slash and burn approach to the weakest profession, the Nurses, in order to save money and save their own pathetic arses. They don't give a crap about the effect this will have on patient care.

    Secondly the GP's WILL get control of the purse strings. They will use this to reallocate the budget, increase their own pot and feather their own nests more, whilst they will take money away from Nursing and Nurse led services, because they consider us to be not as important and disposable.

    Now I will tell you what SHOULD happen.

    Nurses should get up off their arses, get their heads out of the sand and pull the collective sticks from where they shouldn't be. Nurses should band together, stick together, and fight for our profession. We should start DEMANDING job security, better pay, status and working conditions. There are better ways to save money than targeting Nurses, and by securing and increasing our roles the short sighted idiots will save money in the long run! We should go on strike if we need to, we should show these pathetic nomarks in charge that without us, there will be no NHS for them to leech off and that we are the most powerful group within it, and we should demand the voice, the say, and the respect accordingly!

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  • We need to chuck all this rhetoric out the window and demand actual genuine increases in funding that is clinically based.
    No doubt this report is based on what others say about us rather than a true self analysis across the nursing spectrum.

    Furthermore many figures will simply acknowledge the apparent frsutration and pledge to try and improve the improbable.

    After all i'm quite sure that simply because stories make the middle pages of the Daily Mail does not equate to public distrust at the profession, largely because erm.... the vast majority of the general populous has virtually no contact with us.

    We need to make clear our demands which are more resources as in actual equipment, more pay and an end to the reduction of any physical beds based purely of the fanciful notion that we don't need to put the ill in one place - morons!

    This government are utterly corrupt and bereft on any integrity but they are no doubt in a similar position to our union and professional body. With their hands in the sand and our cash in the bank, why should they want to raise their head into the harsh light of day????

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  • Yes JJJez. you are right. I tried to provide appropriate resources for my client group,starting in 1999.

    My nurse manager immediately turned it into gang warfare (divide & rule policy).

    Never mind I'm a member of an excellent professional organization.

    What I did not know at the time was that my RCN senior officer who claimed to be representing me was in fact colluding with corrupt managers and so called Human Resource staff.
    Sadly a decade later nothing has changed. Why? Because most nurses despise each other even more than the poor conditions they choose to endure. The NHS is not a Learning Organization.
    Kathleen White. Edinburgh

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