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A view on the future nursing and care workforce

NHS Improvement’s Director of Nursing shares his thoughts on best practice for staff experience and retention ahead of a session at the 2018 CNO Summit he is co-leading with Niall Dickson, Chief Executive of the NHS Confederation:

The global demand for the skills and expertise of nurses is growing.

It has been recognised by the International Council of Nurses that this creates a worldwide issue requiring a coordinated and collaborative effort to resolve. That issue is to ensure that the health of nations can continue to improve through access to expert support of nurses.

England and the NHS are not immune from such challenges. Recent reports from the Kings Fund and Health Foundation have reiterated the current and long term workforce challenges we need to tackle, and the critical role that nursing plays in the health of our nation.

The recent publication of the draft Health Education England (HEE) workforce strategy and Health Select Committee report has clearly articulated this, providing a compelling narrative and opportunity for nurses to contribute to the long term plan.

Alongside reports such as this, we recognise there are personal stories of the pressure our staff face on the frontline. For many nurses, they joined the service to deliver outstanding care, support families and communities, develop themselves and their profession and have huge pride in the role they do. However, individual testimony through many publications highlight that they are increasingly frustrated, have low morale and in some cases are leaving the profession.

As a nurse, this is something that we all need to address in the short term, and that is better retention.

NHS Improvement launched the national nurse retention program in July 2017.   Since the start of the programme a great deal has been achieved, including the publication of a Retention Improvement Resource based upon best practice identified in the NHS.  In addition to this, NHS Improvement will be working with over 100 trusts with an aim to improve retention, by providing trusts with the knowledge and tools to improve retention, and reducing variation in retention rates.

The vast majority of trusts have committed to focussing on culture and organisation development, developing career pathways , early years career support supporting new starters, improving work-life balance through flexible working arrangements, improving benefits offers and a focus on health and well-being, as well as improvements to flexibility for those wishing to retire and continue working.

An important part of the retention programme is sharing learning between trusts on what improves retention. There are many great examples out there – Wrightington, Wigan and Leigh NHS Foundation Trust use an online survey platform to capture real-time feedback on how staff are feeling about their work and provide timely insight on the drivers for turnover.

Mid Yorkshire NHS Trust has developed a comprehensive early year’s career support program that has significantly improved retention of new starters to the profession.  Frimley Health NHS Foundation Trust holds regular confidential forums at which staff of all grades discuss difficult emotional and social issues/experiences arising at work, in a safe environment. University College London Hospitals have introduced a career development service for nurses, enhancing career progression and support with over 200 staff now through the program.  And Sandwell and West Birmingham Hospitals have a comprehensive staff support offer, including practical help.

We also need to think longer term, about the future role of the nurse, the skills and the expertise, including the development of advanced practice.   The NHS published the first national advanced practice framework in 2017 which set out the key principles of a multi-professional framework.

This framework recognises that the health and care system rapidly evolves to deliver innovative models of care, and that health and care professionals have adapted to meet the increasing demands of individuals, families and communities.  The framework sets out a key platform for developing this critical workforce role in a consistent way to ensure safety, quality, and effectiveness. It has been developed for use across all settings including primary care, community care, acute, mental health and learning disabilities.

I will touch on the topics and issues covered in this short blog at the 2018 CNO Summit and look forward to seeing you all at this important event.

Professor Mark Radford

Mark Radford is currently Chief Nurse of Health Education England and Deputy Chief Nursing Officer for England. Mark led the national NHS vaccine workforce programme, ensuring success in phase one, with the delivery of 15 million vaccinations. The programme recruited and trained over 250,000 people including 90,000 clinicians and 70,000 volunteers, in a few months, to launch one of world’s fastest programmes. He also led the deployment of student nurses in the wave one and two pandemic response, with 71 universities in England.

Mark has led other major NHS, workforce policy and delivery programmes as National Senior Responsible Officer for domestic supply for the government’s 50,000 nurses manifesto commitment, led the expansion of 5,400 additional places at universities and 7,700 additional placements in the NHS to support expansion.

Mark qualified as a nurse in 1994 and has previously worked in anaesthetics, preoperative assessment, perioperative care, critical care and A&E in the UK and Europe. He was a Consultant Nurse in Perioperative Emergency Care and worked as an advisor to the Department of Health, the National Confidential Enquiry into Patient Outcome and Death, the Medicines and Healthcare products Regulatory Agency and The National Institute for Health and Care Excellence on a range of areas including perioperative hypothermia, emergency management and nurse prescribing.

He is also a Professor of Nursing at Birmingham City University and Coventry University, with research covering emergency care models, advanced practice, staffing, risk modelling, clinical decision-making, expertise and sociological issues in healthcare.

He has published widely on advanced practice nursing and perioperative care. 

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One comment

  1. Sarah Trigg says:

    I am commenting on the inconsistency of the return to practice course. I have been out of nursing for 10 years and I am just completing my clinical hours of 400+. I have written 9 essays and done 30+ pieces of supporting evidence. I am a very competent nurse and my placement is very happy. I haven’t done extra hours or extra work, this is what is expected of me to rejoin the register.
    I have spoken to other RTP students who have been out of nursing for 15 yrs yet are expected to complete the course in 120/70 hrs, with one essay.
    How can it be that inconsistent between universities? I feel I have been unfairly treated and my course friends feel the same with one already left and three more considering it. There was 7 on the course. The financial strain is huge.
    I wondered what your opinion on this would be?