PATIENT SAFETY
Providing continuing support to our people to develop their careers and their skills to respond to the changing needs of patients and citizens
Continuing to focus on safe and effective staffing, building on existing policy and support to boards and staff in making effective decisions.7
Taking account of the time it takes to train a nurse, there needs to be an immediate focus on international recruitment. This will have to be done hand in hand with the Nursing and Midwifery Council who have made it significantly more difficult in recent years, to register for practice in the UK. Obviously, it needs not to be an issue of patient safety risk. In addition, the full People Plan needs to take account of a reduction in agency working and notification made of expanding local hospital and service delivery provider banks. In equal measure, if we are to meet the challenges of the NHS Long Term Plan we need to ensure that the workforce can adapt to changing patient needs. The need to enable the workforce to transform, as well as significant financial pressures and growing problems with recruitment and retention, are fuelling policy interest and local innovation in workforce development. Traditional workforce planning has focused on the training pipeline, but it also requires significant investment in skills development and role redesign in the current workforce, to address both the current and future skills mismatch. For example, the growing number of patients with multiple health and social care needs necessitates roles that cross current professional and sector boundaries and manage patient needs holistically. Yet the central investment in ongoing training and development for existing staff has been cut by two-thirds since 2013/14.8
The NHS Long Term Plan
contains a welcome commitment for Health Education England to increase the proportion of its total budget spent on workforce development,
but with no specifics on how much this will be until the Spending Review provides clarity later this year.
Looking ahead
The challenges of filling all the vacancies, changing the culture to a much softer less aggressive management one, of enabling adaptive practice in local areas without troubling scope of practice issues with the regulators, all provide the service with huge seemingly impossible challenges. However, there are already beacons of hope, places where we would all like to work, if they can do it, others can too! The Integrated Care Systems, in their
infancy, will have a huge learning curve as they develop relationships and get to grips with many clinical and financial issues and are, in addition, expected to lead the way in workforce planning. The providers
AUGUST 2019
themselves are tasked with improving working conditions and culture, which is a very big tanker to turn when financial issues are always at the top of the agenda. It is to be sincerely hoped that there will be support freely given by the centre and regional teams. The Annual Spending Review has to provide extra funding for the education and training budget, which was not agreed last year as part of the NHS settlement. It is to be hoped, returning it to sensible levels where the support for workforce development and new skills for new roles will be enabled. The critical issue which must be solved, and urgently, is the nursing vacancies. There is no magic wand, the executive and indeed local organisations will have to be very creative in order to find new ways to recruit and retain. The future of healthcare is in their hands!
References 1 The Kings Fund 2019. Closing the gap. Key areas for
action on the health and care workforce Accessed at
https://www.kingsfund.org.uk/ sites/default/files/2019-06/closing-the-gap-full- report-2019.pdf
2 RCN News.
https://www.rcn.org.uk/news-and- events/news/uk-nhs-people-plan-good-on- ambition-but-too-light-on-detail-030619
3 NHS England Integrated Care Systems.
https://www.england.nhs.uk/integratedcare/ integrated-care-systems/
4 NHS Improvement. The interim People Plan 2019
https://improvement.nhs.uk/resources/interim-nhs- people-plan/
5 Ibid 6 Ibid 7 The Kings Fund 2019. Closing the gap. Key areas for action on the health and care workforce Accessed at
https://www.kingsfund.org.uk/sites/default/ files/2019-06/closing-the-gap-full-report-2019.pdf
CSJ
8 In Kings Fund Closing the gap 2019. Health Education England (2014). Annual Report and Accounts 2013/14. And Health Education England (2018). Finance report: 2018/19
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