This week the Nuffield Trust published a new research report, Reshaping the workforce to deliver the care patients need. To coincide with the research, we will be unpicking the major themes from the report in a series of comment pieces from our researchers and expert guest contributors. In this blog, Lisa Bayliss-Pratt of Health Education England reflects on the changing nature of nursing and the opportunities offered by new roles.
Change can be daunting for some, while for others it’s a time to refresh ideas and grasp new opportunities. As many of us know, change is inevitable in our health care system, and is something we have learnt to anticipate and respond to with resilience.
The need for change underpins Reshaping the workforce – a new and thoughtful report from the Nuffield Trust. It says that the NHS workforce urgently needs to be reshaped if it is to evolve from being an illness-based, provider-led system to one that really puts patients’ needs at the centre of care.
The Trust’s report supports the work that we at Health Education England are doing to transform the education and training of nursing staff. It comes as we prepare to respond to Lord Willis's Shape of Caring review on the future education and training of registered nurses and care assistants. It also chimes with our consultation on the Government's proposed new nurse support role: the nursing associate.
Many of the recommendations in the report cite the blueprint for change – the NHS Five Year Forward View. This is a 'game changer' for everyone involved in delivering health services in England. The plan demands change and challenges all of us to deliver it.
So, what of the changing role and skills of nurses? How can they best respond to our patients' changing needs?
One of the key recommendations in the Shape of Caring review is to propose the creation of a new nursing role. The new role will help to bridge the gap between health and care support workers, who have a care certificate, and graduate registered nurses. It also offers opportunities for health care assistants to progress into nursing roles. However, this, as Lord Willis of Knaresborough made clear, is neither a panacea for future workforce supply, nor can it be a substitute for increasing the supply of graduate registered nurses.
If we take forward this new nursing role, what are the positive opportunities for graduate nurses? Would it help us to retain them for longer? Is the advanced practice of today going to become the standard practice of tomorrow, and is it therefore time that we encouraged more people to work at the edge of their scope of practice? If so, what should the content of future curricula look like? This is all food for thought and echoes the need for a more flexible, skill-based workforce to meet future patient needs.
What Reshaping the workforce shows us is that education and skill mix are inseparable. This is as true now as it will be in future, as we strive to build a truly valued nursing profession, equipped with the skills to lead on a wider range of roles. New career pathways and development opportunities will better enable them to lead rich and varied careers; clinical research will be an option that many will follow; and, increasingly, nurses will work hand-in-hand with other professions, including – and perhaps especially – those working in social care.
The nursing profession plays a fundamental role in care and has a profound effect upon our patients' experience. We now have a rare opportunity to challenge the status quo and to work together with the nursing professions, regulators, higher education institutions and commissioners to shape the nursing and care workforce around our patients. We must grasp this opportunity with compassion and conviction. We owe it to the people we serve now and in the future.
Bayliss-Pratt L (2016) ‘Embracing change for nurses’. Nuffield Trust comment, 20 May 2016. https://www.nuffieldtrust.org.uk/news-item/embracing-change-for-nurses