There has been much attention on the new NHS workforce plan for England and the fact that it took an age to emerge blinking into the sunlight.
The initial verdict seemed to be that, while it was probably a decade too late in coming, it was a decent attempt at something very complex, with a welcome focus on demand not just now but in the future.
“This week the document came under scrutiny in public for the first time when MPs on the cross-party health select committee took evidence on it from NHS and health sector leaders”
However, analysts also noted that among other things, some of its ambitions for increases in the nursing workforce would be limited by such factors as pay levels and placement capacity.
MPs said they wanted to probe the ability of the plan to meet the challenges facing the NHS and would consider particular measures to improve retention and the greater use of apprenticeships.
Patricia Marquis, England director for the Royal College of Nursing, represented the nursing profession at the committee’s session on Wednesday, upon which Nursing Times reported.
Ms Marquis said the plan was full of “good aspirations”, but that it was lacking detail, particularly around retention and how ambitious targets to increase student nurse numbers would be achieved.
She also said increasing spaces for student nurses was one thing, but attracting enough applicants to fill them was another. An important point, given the competition among university degree subjects.
In addition, Ms Marquis warned that an increase in apprenticeship degrees without further financial support on traditional degrees would create a divide, with fears of a “two-tier system approaching”.
According to others giving evidence at the session, demand for nurse apprenticeships seems to be rising while that for traditional nursing degrees is falling, with financial pressures cited as the reason.
Latest data, also published this week, shows the number of people applying for undergraduate nursing courses across the UK has dropped by 16% since last year.
It seems wrong to me that it is the inability to be able to afford the degree route that is driving many to apprenticeships, rather than it being a genuine life choice, which is how the idea was first pitched.
However, the nursing profession is not new to two-tier systems, when it comes to qualification and training, and I would suggest that at least one already exists to a lesser extent.
Only since 2013, just a decade ago, have all new nurses needed to hold a degree-level qualification to enter the profession. There are many staff still working who qualified before then with diplomas.
Looking even further back to before 1990, you could become a state enrolled nurse after two years of training – akin to healthcare assistant – or be fully trained as a state registered nurse after three.
These systems were reformed to create more singular routes into nursing, so while apprenticeships are no bad thing and will suit many, I think the profession needs to be careful in handling them.
Another factor highlighted by those giving views to MPs on the NHS workforce plan was the “missed opportunity” to include social care nursing within its scope.
This point was also alluded to in a separate report this week from Skills for Care, which urged the government to publish a fully funded workforce plan for social care.
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On a positive note, the body said the adult social care workforce in England had grown slightly over the last year, with international recruitment being a key reason that employers can plug gaps.
However, it warned that international recruitment was “not a long-term solution” and that there were still 152,000 social care posts vacant.
As all readers will know, many of the capacity problems facing the NHS are in some part due to similar problems affecting social care.
We are, therefore, very much at the start of the journey to sort out the myriad workforce problems facing the NHS and social care. There is a plan at least, finally, for part of it.
But a plan needs to be implemented to have an effect or it remains just a plan. Implementation is the next step that needs to be taken, and urgently, as we are already playing catch up on workforce.
Before I finish, I would like to flag that the 2023 Nursing Times Workforce Awards are still open for entries, but you only have a few hours left to complete and submit yours.
They aim to recognise nurses having a positive impact on tackling workforce challenges, highlighting those making a difference in areas such as recruitment, retention, wellbeing and inclusion.
You have until midnight tonight, Friday 14 July, to submit your entry. Good luck!