09.09.16
Nurses must have ‘day in day out’ involvement in STPs
A central leadership role for nurses is crucial for the success of sustainability and transformation plans (STPs), the chief nursing officer has said.
Speaking at the NHS Expo conference, Professor Jane Cummings said: “There is no point having STPs or vanguards that provide a few GPs or a few managers or a few commissioners. It has to be the professional workforce that leads and drives that change. I want to see nurses in STPs day in day out actually leading that and supporting new ways of working.”
Professor Cummings said that she had received “mixed responses” to the idea that nurses need to play a bigger role in STPs, but she urged healthcare professionals “if you haven’t got them, go out and get them”.
STPs are radical new plans designed to get NHS spending on a sustainable footing, but they attracted controversy recently when an investigation by pressure group 38 Degrees found that they could involve hospital closures and mergers in many places.
An investigation by NHE’s sister title Public Sector Executive then found that health devolution in Manchester has been more successful at delivering integrated care than the STPs.
In his keynote speech at the conference, Simon Stevens, the CEO of NHS England, urged critics to recognise the “incredibly difficult but incredibly important” work of STPs and “get behind” the process.
Matthew Swindells, national director for operations and information at NHS England, also told the conference that technology should be embedded in STPs.
Need to ‘clarify’ nursing roles to address shortages
Professor Cummings admitted that the NHS is facing a nursing shortfall, as part of staffing shortages which the Royal College of Physicians has warned will lead to an “extremely difficult autumn” this year.
However, Professor Cummings said this could be addressed by redefining nurses’ roles.
“There’s a lot of debate at the moment about have we got enough registered nurses, enough registered midwives,” she said. “The short answer is we know we haven’t and there’s a lot of vacancies, but are our workforce doing the right things and doing it the right way? Do they have the time and space to be the leaders that I think they should be?
“We need to clarify who does what, who can do what and who needs to do what. People say to me things like ‘Oh, we’ve got this issue or that issue, we need lots more nurses.’ What we should be doing is turning this issue on its head and saying what do the people we serve need, and then from that, what’s the best place to do it?”
She said that the new nursing associate role was part of the “urgent” need for a “more structured career path” where health staff “have a role that’s meaningful, exciting and that they want to stay in”.
“It provides a career for people who may or may not decide to become a graduate,” she said. “If they do, it helps them on their way. If they don’t, it still provides meaningful development.”
Other changes Professor Cummings said were needed for the nursing workforce included making preventative healthcare “part of everyday business” and a “dramatic” increase in the use of geonomics in healthcare.
In addition, she said that patients should be more actively involved in care and play “a radical role in determining what is happening to them”.
‘Real concern’ about abolition of bursaries
However, she said that lead nurses were closely monitoring the impact of the abolition of bursaries for student nurses, which she admitted could lead to a further reduction in the profession.
“It does mean students can access more money, more support while they’re undergraduates, but it does mean that they end up with a much bigger debt,” she said. “There are some risks around this programme, but there are also some potential benefits, and there are very different views about this, and I think those views, we need to recognise and we need to really look carefully in the long-term what the impact is.
“If we can truly get 10,000 students going through university places, that’s brilliant, but if it means that in some parts of the country we can’t attract people because they don’t want to take the risk of a loan, then I think that’s a real concern, particularly in the environment we’re in at the moment, about the need to have more people.”
She also called for EU NHS staff to be granted the right to remain in the UK, saying diversity in the health workforce “gives better outcomes”.
“We support the populations we serve in a much more healthy way,” she said, “and it’s really vital that we continue to do that, it’s really vital that our European colleagues are welcomed and are able to stay and are able to contribute to our workforce.”
She also called it “frankly appalling” that “so few” directors of nursing are from ethnic minority backgrounds.
The NHS has promised a crackdown on racism in the service after the first Workforce Race Equality Standard (WRES) found black and ethnic minority staff reporting higher rates of bullying than white colleagues at many trusts.
In addition, Professor Cummings said it was “very disappointing” that lead nurses are “often” blamed if their organisation receives a disappointing CQC report.
She said nurses should be “prepared” for leadership roles and that organisations should “be transparent and learn, not blame” when problems occur.
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