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