Letter from the adviser

Published: 07 September 2011

This newsletter greets ANPs who, for the main part and particularly those in England, are working in a time of great uncertainty, challenge and confusion. The Coalition Government, in terms of the NHS in England, takes two steps forward and one back. Decisions are made by certain ministers who, often following considerable dissent from interested parties such as the RCN and the British Medical Association, announce that they have changed their minds and wish to listen to what the public has to say.

In England, the commissioning bodies, in the form of primary care trusts, have been given a huge amount of work to do but with a skeleton of a workforce left to complete the awesome tasks. GP consortia are now clinical commissioning groups, but most of them will not have any real cash to spend until 2013 – that is, unless minds and direction of travel shift yet again.

It is, currently, impossible to see where NHS England is heading, apart from the fact that significant financial savings have to be made. This is the painful part, and there is little doubt that essential services – often those provided by specialist nurses – are gravely threatened.

While Scotland, Wales and Northern Ireland are not having to deal with the turbulence of organisational upheaval so much as England, they too are charged with making financial cuts while maintaining services.

But we neglect the nursing profession at our peril. If we fail to nurture and sustain it, or prepare successfully for the future, the nation’s health will suffer.

The RCN has recently gathered some pretty shocking figures, which have serious implications for all services that require nurses to keep them going safely.

Twenty-eight per cent of nurses currently working are destined to leave the profession by 2021, meaning, in real terms, that 352,000 nurses, health visitors and midwives will be around 253,000 in 10 years’ time. On top of this prediction, the RCN, through its Frontline First campaign has identified almost 40,000 nursing posts that are planned to be cut over the next three years.

Advanced nurse practitioners are in the middle of this worrying scenario. Even if the numbers of ANPs continue to increase it is of great concern to the RCN that this trend could be reversed, should we radically reduce the number of student nurses and reduce the funding for post-registration nursing programmes.

Worrying times indeed, but we all know that on its own the ‘worry’ emotion is a negative force. It saps energy, brings gloom and dismay and fails to motivate or prompt effective action.

So the RCN has presented the facts and predicted the size of the future nursing workforce should the right action not be taken.

However successful various health promotion programmes might prove to be, an increasingly older population needs expert nursing care – and much of that care needs to be carried out by and/or monitored by ANPs. We not only need to get the numbers right, but the skill mix too.

Lynn Young

RCN Primary Health Care Adviser