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Nursing apprenticeships could put 'both patients and apprentices at risk'

Previous research found hospital-based apprentice training was unsafe and inefficient, and did not equip nurses with the necessary skills for the future.

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by James M.
Nursing apprenticeships could put 'both patients and apprentices at risk'
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The Royal College of Nursing has warned MPs that the apprenticeship system risks putting both patients and apprentices at risk.

Speaking at the Education Select Committee, Janet Davies, Chief Executive and General Secretary of the RCN, said there was clear evidence that trainee nurses should complete degree-based training - which is safer and more consistent than the old-style apprenticeships.

Evidence from the Judge Report and Project 2000, both carried out in the mid-1980s, found hospital-based apprentice training was unsafe and inefficient, and did not equip nurses with the necessary skills for the future. Under the old system, apprentices had to learn from an inadequate number of fully qualified registered nurses, which reduced both patients’ quality of care, and the quality of the training.

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With more than 40,000 nurse vacancies in England alone, there are fears history could repeat itself with the new apprenticeship scheme.

The RCN claims that apprenticeships risk putting undue pressure on overstretched NHS services, as they place the responsibility for training staff on cash-strapped employers, instead of universities.

Apprentice levy does not cover the full cost of training.

Danny Mortimer, Chief Executive of NHS Employers, previously told the House of Commons Health & Care Select Committee that the cost was “probably something in the region of £125,000 to £155,000 over the four years of a nursing apprenticeship, and the levy will not capture all that cost.”

Nursing degree students fund their own studies and spend 50 per cent of their time in practice placements - where they can learn directly from experienced staff.

For apprenticeships to work as they must...

The Royal College of Nursing believe that the following steps should be taken to ensure apprenticeships works.

  • Ensure access to a variety of clinical placements across community, general practice, social care and acute settings to ensure nursing students have the necessary exposure and experience of working in different environments.
  • Ensure access to safe, effective and appropriate learning environments where nursing apprentices have protected time for learning and access to mentors and assessors. Currently, providers will struggle to meet this requirement due to the unprecedented pressure they are facing.
  • Protect the supernumerary status of nursing students. Any compromise to supernumerary status of nursing students would compromise patient safety as well undermine nursing students’ learning ability.
  • Ensure a robust quality assurance process is in place to make sure that patient and learner safety is guaranteed and that there is consistency is the skill, knowledge and abilities of all nursing graduates, whatever route they take into becoming a registered nurse.

We need to keep both students and patient safe.

Janet Davies, Chief Executive and General Secretary of the RCN, said: “The big challenge we have is ensuring we’ve got a proper environment where students can be students and where patients can be kept safe.

“Many of the Directors of Nursing that we talk to feel the cost of training has just been transferred from the Government to employers, who are already overstretched.

“We are currently working in an environment where we have 40,000 registered nursing vacancies. These are the people who have to be the mentors and supervisors and their focus has to be providing safe care to their patients.

“It is not chance that we have the level of vacancies that we have. This was because of poor policy, and saving money in the past. Apprenticeships themselves will not fix this. We need a whole picture of where we need investment in nursing education.

“Before the introduction of the graduate fee, 41% of people on nursing degree programs were over the age of 25. We know the representation of people from local communities and ethnic minority backgrounds was better than the rest of the student population.

“We need to have incentives for people to be able to have a university education as well as people having the opportunity via an apprenticeship. Both models need investment not just one over another.”

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Unions call for pay deal to be extended to the private sector

Thousands of NHS workers, many of whom are the lowest paid, have been excluded from the deal because they are indirectly employed by the NHS.

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by Ian Snug.
Unions call for pay deal to be extended to the private sector

Healthcare unions have warned that a “dangerous imbalance” between sectors could cause harm to patients.

The Royal College of Nursing and Unite have called on the government to ensure the NHS pay deal is extended to those providing NHS services in social care, the private sector and primary care.

The NHS pay deal, formally accepted by healthcare unions earlier this month, will mean at least a 6.5% increase for the majority of NHS staff in England. Pay negotiations in Scotland, Wales and Northern Ireland are ongoing.

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However, thousands of NHS workers employed by social enterprises, general practice, social care, arms-length bodies, independent and charitable providers, have been excluded from the deal because they are indirectly employed by the NHS but still have a direct impact on patient care.

Made to feel like the poor relations.

Colenzo Jarrett-Thorpe, Unite National Officer, said: “Excluding indirectly employed NHS workers from the new pay deal is unjust. It will be a disaster for morale with thousands of low paid NHS workers being made to feel like the poor relations of NHS employees. 

"Regardless of whether an NHS worker is employed by a private company or the NHS, they are still health workers and their contribution to patient’s health must be recognised.”

In a letter to Jeremy Hunt, Janet Davies, Chief Executive and General Secretary of the Royal College of Nursing, said: "“I urge you to consider how to address the pay of all nurses and health care assistants providing NHS services, whoever their employer, so that a gap in pay does not result in workers being drawn away from primary, community and social care services.

”This would include those employed by social enterprises, general practice, social care, arms-length bodies, independent and charitable providers.

"I do believe that without this additional funding, we will see a dangerous imbalance of the workforce, which will significantly harm patients of non-NHS services.

"Many of our members delivering NHS services but not employed by NHS organisations complain that they endure poorer working conditions, loss of career and education opportunities,"

"We recommend the establishment of a new and separate national staff council, negotiating for all nurses and care assistants in health and social care who are not directly employed by an NHS organisation."

 

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Government announces £20bn cash boost for NHS services

The Government intends to draw up a 10-year plan for the NHS, which will include "more doctors, more nurses" and "significantly more money going in to the NHS".

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by James M.
Government announces £20bn cash boost for NHS services

Theresa May has announced a £20bn funding increase for the NHS over the next five years.

Speaking on the BBC's Andrew Marr Show on Sunday, Ms May stated her intention to draw up a 10-year plan for the NHS, which will include "more doctors, more nurses" and "significantly more money going in to the NHS".

During the interview Ms May said; "Some people may remember seeing a figure on the side of a bus a while back of £350m a week in cash"

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"I can tell you that what I'm announcing will mean that in 2023-24 there will be about £600m a week, more in cash, going into the NHS.

"That will be through the Brexit dividend. The fact that we’re no longer sending vast amount of money to the EU once we leave the EU and we as a country will be contributing a bit more."

The announced comes only months after the NHS took the unprecedented decision to suspend all non-urgent activity in January.

'A welcome birthday present'.

Janet Davies, Chief Executive and General Secretary of the Royal College of Nursing, said: “Theresa May and Jeremy Hunt are to be congratulated on securing this increase, which is a great deal more than some of the sums being talked about earlier this year.  The extra money should enable trusts to invest more in staff and therefore reverse some of the cuts in patient care nurses are reporting to us.

“The extra funding is a welcome birthday present for the NHS, but we need to make sure there are enough candles on the cake. Health economists are saying that only an increase above 4% would have been enough to genuinely transform the NHS into the 21st century service all nurses want. If the PM only gives the health service enough money to jog on the spot, she must not expect great strides forward.”

The Prime Minister has promised that by 2023 an extra £20 billion a year will be available for the NHS in England on top of any rises to keep up with inflation. However, the RCN insists more focus needs to be given to support vulnerable people in the community.

“The Government’s social care cuts have piled pressure onto hospitals,” added Janet. “Investing in home care and local community services helps stop hospitals becoming overwhelmed. Theresa May must be under no illusion that there can be a long-term solution for the NHS without a solution for social care too.”

'We must invest this money wisely'.

Jim Mackey, the former head of NHS Improvement, said; “This settlement is good news for the NHS but we must invest this money wisely and ensure as much as possible impacts positively on frontline patient care.

“Whilst it is clear that many commentators believe the money isn’t enough, I think we need to recognise that it is a huge investment by any standards, especially given where the country is with regards to the wider economy. This is hard fought and we need to give credit where due for securing this investment.

“What is key now is to ensure that the full engagement with the service, patients and staff, starts immediately to work through what we can deliver with this money. We will all want to see improvements countrywide in key access standards, financial stability, better winters than previous years, improvements in cancer, primary care and mental health and, importantly, patient and staff satisfaction. With this investment comes the responsibility to deliver this – without fail.

“We all know that the NHS delivers more, pound for pound than any other health system and I am sure we will continue to do that”.

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Patients waiting more than 18 weeks for planned operations hits ten year high

We are seeing the highest figures since August 2008 when the number of people waiting more than 18 weeks stood at 520,564.

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by Chloe Dawson.
Patients waiting more than 18 weeks for planned operations hits ten year high

The amount of patients waiting more than 18 weeks for planned surgery has hit a ten year high.

Patients waiting for planned operations are paying the price for seeing the NHS through one of the worst winters in recent memory, warns the Royal College of Nursing, as waiting lists hit half a million.

Waiting lists are on the rise following the decision at the beginning of January to delay tens of thousands of operations as the health and social care system struggled to cope with the pressures of a colder than average winter.

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According to the latest figures, in April this year 500,068 people had been waiting more than 18 weeks for planned operations, an increase of more than 30 per cent (382,000) on the same time last year.

This is the highest figure since August 2008 when the number of people waiting more than 18 weeks stood at 520,564.

'A worrying upward trend'.

The April figure marks a worrying upward trend since January 2018, when the waiting list stood at 392,000.

The latest April figures also show the number of patients waiting more than a year has increased 83.8 per cent since the same period last year, from 1,568 to 2,882. This represents a 637 per cent increase from the same period in 2013.

Janet Davies, Chief Executive and General Secretary of the Royal College of Nursing, said: “Cancelling non-urgent care may have helped the NHS fight though one of the worst winters in recent memory, but patients in need of elective surgery should not have to pay the price for chronic staff shortages and years of underfunding.

“Half a million people have waited more than 18 weeks for planned care, the highest figure in ten years. And the number waiting more than a year is approaching 3,000. That is truly shameful. For these people, the Prime Minister’s promise of more NHS funding cannot come soon enough.

“But more funding is only half the battle. Addressing the 40,000 nurse vacancies in England alone is not just a question of money, but requires long term workforce planning and a determined focus on improving recruitment and retention.”

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