At a time when the NHS is struggling with a perfect storm of workforce challenges, Dr Crystal Oldman CBE hopes Health Education England’s forthcoming workforce strategy will be one that attracts people back into nursing.
It is a simple fact that the nursing workforce is facing a crisis. Recruitment and retention are both at a critical low. This has led to a perfect storm where many of the nurses that remain are dealing with an unsustainable level of pressure, trying to do far too much to compensate for the vacancy rate to ensure that patients, families and carers continue to be well cared for.
It has been clear for some time that a coherent nursing workforce strategy is required. The General Practice Nursing Plan
launched earlier this year was a crucial step, but covered only one component of the workforce.
The announcement by the Secretary of State for Health that Health Education England (HEE) has been charged with producing a ten-year plan for the entire NHS workforce
, with a draft due by the end of the year, is very welcome. While I believe we really need a plan covering at least 20 years, this will hopefully be a good – and much needed – start.
It is much needed because there are so many workforce challenges facing us. These are of concern to me both as chief executive of the Queen’s Nursing Institute and as the registered nurse on the governing bodies of Aylesbury Vale and Chiltern clinical commissioning groups (CCGs). As part of the NHS Clinical Commissioners’ Nurses Forum, which provides a voice for executive and governing body nurses on CCGs, I know many of my concerns are widely shared across the country.
As a clinical commissioner, it is very difficult to plan the right healthcare for your population without the right workforce being available. We have a growing ageing population (which is a cause for celebration) and a vision of delivering care for people closer to home. Logically then, more resource needs to be put into district nursing – increasing staff numbers and training people to deal with the highly complex needs of people being cared for at home.
Currently, however, it is hospital vacancies that dominate the conversation – possibly for the simple reason that the vacancy rate is easier to quantify than it is within the district nursing workforce, for which we have very little reliable data.
Connected to this is the shortage of social care carers: the district nursing service is only one critical provider of the package of care that people will need. The NHS workforce cannot be considered in isolation.
Then there’s the matter of training. With HEE no longer funding qualifications beyond the point of registration, it’s a challenge for clinical commissioning groups looking to work in creative ways with providers. How can we contract with providers to work in new ways when there isn’t the funding to develop the skills, knowledge and competence of staff to lead, manage and deliver the care in these new ways?
I hope that the anticipated workforce strategy will help address these challenges, along with others, being faced by nursing. Nurses are an integral part of the workforce and when they are stretched beyond capacity, everyone loses out. That’s a tragedy for the NHS and for nurses – because what often gets lost in these circumstances is the fabulously rewarding career that nursing offers.
Caring for people when they are at their most vulnerable – at times being entrusted to care for them in the last days of their life – is challenging, but also such a privilege. My hope is that the new workforce strategy will be one that attracts talented, compassionate people into nursing and supports them to thrive throughout their career.
Dr Crystal Oldman CBE is chief executive of The Queen’s Nursing Institute and the registered nurse of Aylesbury Vale and Chiltern CCGs. She is also a member of NHS Clinical Commissioners’ Nurses Forum. Follow her on Twitter @CrystalOldman
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