Nurses will require more advanced specialist training under a reformed NHS in which patients are increasingly treated outside of hospital, according to two key expert bodies.
Both the Centre for Workforce Intelligence - tasked with helping the NHS to plan its workforce – and the advisory National Quality Board have made the recommendation.
A Centre for Workforce Intelligence report last week found caring for patients across organisational boundaries required “upskilling” nurses, particularly those in the community.
The report, Integrated Care for Older People, said this would “allow a shift in the delivery of care from acute and nursing homes to the community, also reducing admissions”.
It endorsed training in advanced prescribing and intravenous therapies. Parts of the country that were already successfully caring for patients in an integrated setting had required additional nurses with specialist skills in geriatrics, dementia, COPD and falls, the report said.
The need for extra training was identified in seven of the eight integrated care models the researchers looked at in detail.
The report also found that two of the nurse-led models demonstrated only “weak/ambiguous evidence of economic benefit”. However, there were benefits to patients of having a more seamless NHS service.
Integrated care was supported last week by prime minister David Cameron, who said regulator Monitor would have “a new duty to support the integration of services”.
Meanwhile, the national quality board - whose members include NHS chief executive Sir David Nicholson and chief nursing officer Christine Beasley – has called for better specialist training in specific long term conditions for nurses.
It has published a list of 11 recommendations for “aligning” the NHS to improve quality.
One of the recommendations was that all nurses and other staff “whose work routinely brings them into contact with patients with a particular long term condition, such as dementia, should have received basic education and training in that condition”. It also said the Care Quality Commission should “consider” whether such training has taken place.
Jan Procter-King, a primary care cardiovascular nurse lead in Leeds and formerly Department of Health cardiovascular adviser, said long-term conditions training in primary and community care was often insufficient.
She said: “I have personally seen standards falling because of structured education not being seen as a priority and not being offered. There are differences around the country, often reflecting how well the primary care trust has commissioned and organised education.”
Ms Procter-King also warned the problem was being exacerbated because PCTs were losing staff in advance of their planned abolition.
You can discuss this further on our Nursing Times forum, connect with your peers!