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Health and Care Bill latest: peers back RCN calls for law to address nursing workforce crisis

Proposed reforms to the health and care system in England are being debated in the House of Lords, with widespread support for amendments sought by the RCN.

Putting on PPE
The Health and Care Bill is currently at committee stage in the House of Lords, which is where peers scrutinise the proposed legislation and any amendments line by line.  

The bill sets out a package of reforms to the health and care system in England but doesn’t address the urgent workforce crisis or how it will be fixed. Since the introduction of the bill, the RCN has been calling for amendments to be included to tackle this.  

In advance of the bill reaching committee stage, we issued a briefing to peers setting out our arguments for key changes to the legislation, namely that if nursing shortages are to be tackled, the bill must be amended so there are legal responsibilities for the Secretary of State for Health and Social Care to be accountable for the planning and supply of the health and care workforce.  

The briefing also stressed that there must be a new duty on the Secretary of State to publish an assessment of workforce requirements based on the health needs of the population.   

A number of amendments relating to the health care workforce were tabled by peers and debated in the House of Lords this week. The RCN specifically supports two of them, which mirror our above priorities.  

Presenting the amendment about workforce assessments, Baroness Julia Cumberlege said: “I am the first to admit that my amendment will not solve the workforce crisis. It will, however, provide the NHS and the care sector with a regular accurate national picture of the numbers of staff needed now and in future to meet demand.  

“It will be publicly available, so we will all be able to see what is needed. It will provide a strong and much-needed foundation on which to take decisions about funding, skill mix, regional shortfalls and shortages of specialists. It will be published every two years.”  

The amendment received widespread support in the Lords, with a number of peers citing evidence supplied by the RCN ahead of the debate.  

Dame Sarah Mullally, the Lord Bishop of London and a former chief nursing officer, strongly backed the other amendment: “We do not have a sustainable model of workforce planning,” she said. “We need to do better.” 

“The Secretary of State needs to be held accountable for both workforce planning and supply…because if workforce planning systems are not co-ordinated at a national level, there is often limited ability to respond to local variations on the ground, such as those between rural and urban settings or between professions or sectors. 

“The Health and Care Bill must have embedded in it accountability for workforce planning and supply sitting with the Secretary of State.” 

Baroness Dido Harding, former chairwoman of NHS Improvement, stressed the significance of the workforce debate, arguing that it was probably the most important peers have had, or were likely to have about the bill. 

Summing up the debate, Baroness Joan Walmsley expressed her disappointment that current workforce planning hasn’t better supported staff under intense pressure during the pandemic.   

“Staff are absolutely essential to the delivery of health services, but unfortunately we’ve heard in this debate about a great deal of failure,” she said. “We’ve failed the staff because we haven’t provided them with enough colleagues for them to be able to do their work without feeling stressed, burnt out and worried about patient risk.” 

The strength of feeling about workforce issues was acknowledged by the Parliamentary Under Secretary of State for Health and Social Care Lord Syed Kamall who said further work was needed on the bill. The legislation will continue to be debated through committee stage in the House of Lords before moving on to report stage in February where the bill and any amendments will be voted on.  

The RCN will continue to campaign extensively as the bill passes through parliament to ensure that our members’ key priorities are communicated and reflected within the legislation.