Improving workforce planning is essential
THE NHS in Wales is in need of a radical overhaul – and nurse staffing levels must be one of its major priorities.
The recent winter crisis has again demonstrated that the system as it is can’t cope with the increasingly complex demands of the population.
It is simply not acceptable for the ill and vulnerable to be waiting in ambulances outside A&E departments, on trolleys in corridors or in wards for transfer to more appropriate environments.
The Royal College of Nursing in Wales has long argued that the diversity of the NHS workforce is its strength. Staff have coped admirably with these unprecedented challenges but the service model and its workforce has to be right to provide for the needs of patients.
The recent Parliamentary Review into Health and Social Care in Wales recommends a new model of delivery of NHS services and says that cultural changes to help alter population behaviour and attitude are needed to drive this forward.
It goes on to make a series of recommendations that echo the RCN in Wales’ concerns about the recruitment, retention and ongoing professional development of nursing staff.
We are pleased to see that the workforce is central to the Parliamentary Review recommendations, and the crucial role of the workforce in delivering health and social care is acknowledged by the panel.
We are pleased to see the importance of addressing the existing shortages in the workforce is also highlighted and the recommendation for long-term recruitment and retention strategies.
But central to sustainable change to the way the NHS delivers its services has to be having the right staff, in the right place, at the right time to ensure safe care for patients, and maintaining adequate nurse staffing levels is crucial to delivering safe and effective services.
Our members know this, demonstrating creative and innovative ways to do just this in delivering services to people who need them.
For example, Louise Walby, respiratory nurse facilitator, primary care, Cwm Taf University Health Board, won the RCN Wales Nurse of the Year Award 2017 for improving early recognition and earlier intervention in patients with respiratory illnesses.
Some of our members – learning from the Netherlands – are also championing a new way of delivering community nursing services that concentrates resources on district nurses working in their communities, an innovation that brings care closer to home.
The Welsh Government’s “Train Work Live” campaign has been successful in highlighting the benefits of a career in Wales, but on its own it’s not sufficient.
Investing in and valuing the workforce is crucial. Our members have campaigned successfully to “Scrap the Cap” on nursing pay and are now calling for the UK Government to “Close the Gap”. Focusing on the shortfall in real terms suffered by nursing staff over the past seven years, the RCN in Wales argues that this shortfall needs to be funded by the UK Government.
The RCN in Wales was instrumental in the first legislation to be introduced in Europe to ensure health boards consider the required numbers of nurses to provide sensitive care to patients in services they commission and provide.
As part of the Act, a nurse staffing level must be set on acute medical and surgical hospital wards to ensure patient safety.
And this comes into force in April. We know it will be challenging for health broads, but we also know that it is the right thing to do.
For these reasons we are now lobbying for the legislation to be extended to include other areas of care including community, paediatrics and mental health.
Make no mistake about it, across the UK, the nursing profession is in crisis, with more nurses leaving the profession than joining it.
Action is needed now as the recruitment and retention of nurses into NHS Wales is at a critical point, with health boards reporting significant vacancy levels against this backdrop.
Recently the Older People’s Commissioner has also reported her concerns on workforce planning for nursing within health and social care.
We in Wales need to get this right, building on the workforce planning already undertaken and working closely with the new Health Education and Improvement Wales Board – a single body for the commissioning, planning, and development of education and training for the NHS workforce in Wales.
The challenges are set out for us by the review. Nurses and healthcare support workers have much to offer for the solutions.
Improving workforce planning and the wellbeing of the workforce is the next step and we urge the Welsh Government to embrace this as a matter of urgency.
Helen Whyley is Royal College of Nursing Wales Associate Director (Employment Relations)