Matter for discussion, submitted by the RCN Education Forum
That this meeting of Congress discusses the impact of the reducing investment in the education and development of the nursing workforce across the UK.
The most important resource in the NHS is its people. As Health Education England states on its website, they must be skilled, knowledgeable, and sufficient in number to meet the needs and wants of individuals and communities, now and in the future. Education and learning facilitate the delivery of evidence-informed, safe and effective person-centred care. Due to constant and rapid development in treatments and technology, combined with fast-changing roles and service delivery models, strategic planning and investment in education and training is needed.
Nursing is a shortage occupation, and the numbers of new nursing graduates are failing to compensate for the ‘leaking bucket’, where more nurses are leaving the profession than joining it. Internationally increasing the number of nurse graduates entering the profession through rapid growth in nurse training numbers, supported by bursaries and other financial benefits, has been shown to be an effective strategic investment.
The nursing shortage may also be addressed through ‘grow your own’ workforce strategies, where training and development of the support workforce increases access to pre-registration nursing education, widens participation and creates a clinical workforce more reflective of the local community. This supports the Robert Francis recommendation in 2013 that care experience should form an entry-level requirement for continuing in nurse training.
Strategic investment in ongoing education and training is essential to support a changing skill mix and service transformation, whilst maintaining core services. There is also evidence to suggest that it can significantly improve staff retention rates.
However, for 2016-17 in England, investment in education and training has been subject to cuts of up to 45%, whilst the funding for postgraduate medical education remains protected. This threatens the quality of patient care.
In Northern Ireland, the most recent Health and Social Care (HSC) staff survey revealed that over one-third (34%) of nurses employed in the HSC had no appraisal or development review during the previous year. Of those who did, one-quarter (25%) did not receive the training and development activity that was identified in the plan. More than half (52%) of all nurses employed in the HSC in Northern Ireland have never received patient or client experience training.
In contrast, the Cabinet Secretary for Health, Well-being and Sport in Wales, Vaughan Gething AM, announced in February a £95 million package to support a range of education and training programmes for health care professionals. This included an increase in the number of student nurses. In December last year, he also announced that the student bursary will remain in Wales for 2017-18. A new body will be established by April 2018 to oversee strategic workforce planning, workforce design and education commissioning for NHS Wales.
Scotland’s recent announcement on nurse training places for 2017-18 included a modest uplift in student nurses being trained – reversing the Scottish Government’s own cuts from previous years. The RCN has been clear that this increase does not reflect the significant uplifts which are required to meet the country’s nursing need. Scotland’s Chief Nursing Officer is leading work to identify and fund post-registration career pathways, which includes supporting the funding of 500 ANP training places and £2 million to support CPD for general practice nurses (GPNs). The RCN has a seat on both the ANP and GPN groups. The RCN has also recently responded to the Scottish Government’s proposals for its health and social care workforce plan.
As the NHS Five Year Forward View states: “We can design innovative new care models, but they simply won’t become a reality unless we have a workforce with the right numbers, skills, values and behaviours to deliver it.” It is essential to invest in the education and development of the nursing workforce across the UK, as this will ultimately have a positive impact on patients’ experiences and outcomes.
The most important resource in the NHS is its people, Sarah Burden told Congress, and the priority as a profession is to deliver effective passionate care. She said that investment in education and training is vital. Training can also significantly improve staff retention rates.
However, in England, investment in education and training has been cut by up to 45%. This threatens the quality of patient care.
Roisin Devlin said we need to equip the junior nurses to be our leaders of the future, but employers seem to know the cost of everything, but value of nothing when it comes to nursing.
The impact of not investing in education and development is seen in a reduced quality of care, Andy McGovern said, and this leads to patient harm. Jean Rogers was in agreement, speaking of demoralised staff and an increased risk to patient safety.
However, other delegates raised a positive note by speaking of their own experiences of gaining increased funding and encouraged members to think outside of the box when it came to gaining funds for training opportunities.
Sarah Burden closed the discussion by saying the there is a real significant impact and risk to patients if we do not fund staff education. We need a good career and education structure that supports education and there are opportunities to do things differently.