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 Director of Nursing (Improvement) for NHS Improvement with a portfolio that covers workforce, quality improvement and Governance.

Mark has worked in Perioperative, Emergency and Intensive care in the UK and Europe. He was previously been a Chief Nurse of a University Teaching Hospital and Consultant Nurse in Emergency & Trauma care. Mark is Professor of Nursing at Birmingham City and Coventry Universities, and has published research on staffing, advanced practice, perioperative and trauma care.

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