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NHS long term plan falls short of what is needed, warns experts

Published today, the NHS Long Term plan sets out the health services roadmap for the next ten years. 

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Experts claims the NHS Long Term plan falls short, failing to address key issues such as staffing and chronic underfunding.

The Nuffield Trust, an independent health think tank, has warned that although the NHS Long Term plan is a step in the right direction is still falls short of what is needed.

Published today, the NHS Long Term plan sets out the health services roadmap for the next ten years. NHS England claims the plans will help save up to half a million lives.

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The plans include; offering digital GP consultations, investment in disease prevention, improvements to neonatal and maternity care and the development of integrated support services to help prevent hospital admissions.

Critics warn the plan is disproportionatly aimed at primary care services.

Nigel Edwards, Chief Executive of the Nuffield Trust, said: “The goals of this plan look right – carrying on with joining up care and improving services for older people, while pushing vital issues like heart attack survival and children’s health up the agenda. These are the most important issues for patients, and the level of ambition is good. What worries me is how difficult it will be to roll out such wide ranging changes. There are several big pitfalls ahead.

‘Below the historic average’.

“The extra funding will actually be below the historic average and what experts thought was needed. It’s enough to move forwards, but with little room for manoeuvre. If we face a no deal Brexit, the extra costs and tasks required would eat up the first instalments, stopping progress dead in its tracks. And if social care and public health continue to be starved of funding, a stretched NHS will have even less to spare.

“In the NHS it is always difficult to take changes from the whiteboard to the ward. Success depends on extra effort and initiative from staff. But relations are frayed by shortages and increasing burnout, so some real leadership will be needed. Some ideas in this plan seem to assume one size fits all. But it often does not in the NHS because the distribution of people and services varies so much across England.”

Calculations from the Nuffield Trust and The King’s Fund and Health Foundation predict a staffing shortfall of 250,000 by 2030 – making delivering even current services near impossible.

Mr Edwards adds; “the biggest levers to resolve the workforce crisis are out of NHS England’s hands. Only bold policies on training, immigration and Brexit can deliver enough nurses, GPs and therapists for the next few years. The system of workforce planning has failed us, and needs deep reform.”

Education

One in six nursing associates drop out before qualifying, finds report

Despite this trainees showed “high levels of enthusiasm and commitment to the programme”.

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Only 65% of trainee nursing associates said they planned to work as a nursing associate once qualified.

An independent evaluation of the nursing associate role commissioned by Health Education England (HEE) has found that while there are “high levels of enthusiasm and commitment to the programme”, one in six nursing associates are dropping out before completing the course.

Attrition rates for trainee nursing associates fell slightly below that of student nurses, with 18% leaving before completing the course.

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While ill health and personal issues were some of the most common reasons for leaving the programme, nearly a quarter (23%) withdrew because they failed to meet the academic requirements of the programme – with numeracy skills cited as a key issue.

One trainee said they found the “attitudes towards the role and the negative feedback about Nursing Associates” challenging.

Only 65% of trainees said they intend to continue working as a nursing associate once qualified as the programme is often seen as a stepping stone to becoming a registered nursing.

Highlighting challenges.

Mark Radford, Chief Nursing Officer, Health Education England said the report “highlights some challenges that we must address to ensure that students such as ensuring the quality and oversight of placements, attrition and numeracy support.”

“We also recognise that further work and research is required to ensure that the profession is supported and utilised in the workforce of health and social care as part of the MDT. I am pleased to be able to report that we are in the process of identifying candidates to be considered as NA ambassadors across England.

Commenting on the report, Andrea Sutcliffe, Chief Executive and Registrar for the Nursing and Midwifery Council (NMC), said; “Having had the pleasure of meeting many nursing associates across the country, I am continually inspired by their enthusiasm and dedication for providing care and they should be very proud of the difference they make for the people they support.”

“I look forward to seeing how nursing associates continue to develop and be supported in their work, long into the future.”

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Education

UCAS accused of having an ‘outdated’ view on nurses

They describe the nursing role to prospective students as looking after people when they are sick or injured.

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UCAS describes nurses as providing “support to doctors and other medical staff”.

The Universities and Colleges Admissions Service (UCAS) has been accused of having an “outdated” view on nurses after it described the profession as providing “support to doctors and other medical staff”.

UCAS describes the nursing role to prospective students as looking after people when they are sick or injured. Adding; “You’ll provide support to doctors and other medical staff, take blood and urine samples, and in some cases, you may carry out minor surgical procedures.”

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Nurses, alongside a multitude of other healthcare professionals, have taken to social media calling for the description to be amended so it “adequately reflects nursing in the 21st century”. They also criticised the article for failing to highlight a large number of health promotion and research roles frequently undertaken by the profession.

BJ Walto, a senior member of the Royal College of Nursing (RCN) commented that the description is “inaccurate, demeaning and totally misleading portrayal of nursing.”

Tom Wavlin, a Lecturer in Adult Nursing & Admissions Tutor at the University of Plymouth, suggested the description could instead read; “an autonomous practitioner of nursing who works closely with other healthcare professionals”.

In comparison, the Nursing and Midwifery Council (NMC) website reads; “Registered nurses play a vital role in providing, leading and coordinating care that is compassionate, evidence-based, and person-centred. They are accountable for their own actions and must be able to work autonomously, or as an equal partner with a range of other professionals, and in interdisciplinary teams.”

A spokesperson for UCAS said; “It’s clear that our current role profile for nurses doesn’t reflect the amazing work that nurses across the country do each day, and we welcome the feedback we’ve recently received.

“We want to make sure that students considering their future options have up-to date information about all different careers available to them.

“We’re currently updating all of our job profiles and are in touch with nursing experts to help us make sure that we better reflect the roles and responsibilities of nurses today.”

UPDATE (17/10/19 09:55): This article was updated to include a comment from UCAS.

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