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Expanding skills of existing staff will help NHS cope with patient demand

New research from the Nuffield Trust suggests the NHS expands the role of nurses to meet changing patient needs in the future.

Commissioned by NHS Employers, the Trust's report, Reshaping the workforce to deliver the care patients need,examines how best to reorganise NHS staff, including nurses, community and support staff, to find new ways to provide patient care.

The report expresses a sincere need for changes as recruitment and retention continues to be a problem in nursing, with turnover rates particularly high in the NHS at 34% and 25% in adult social care.

The Trust is working with Health Education England to fill the gap by exploring the possibility of a nursing associate role that would bridge the gap between senior health care assistants and registered nurses.

In addition, the report suggests more advanced roles for nurses linking primary and secondary care, providing specialist advice to GPs and playing a greater role in follow-up care.

Other benefits of advanced nurses highlighted by the report include, improved patient access, reduced hospital admissions and increased patient satisfaction.

While the changes suggested in the report would mean fundamental organisational challenges to NHS Trusts, report author and Nuffield Trust director of policy, Candace Imison, said the outcome would be rewarding.

She added: “Our research shows that reshaping the NHS workforce can offer huge opportunities - for patients, through improved health outcomes, and for staff, through more rewarding roles and better career pathways.

“But we stress in our report that this is not simply a 'nice to do' - it is urgent, and essential if the health service is to find a sustainable balance between available funding, patient needs and staff needs, and deliver services fit for the 21st century”.

The report includes countrywide case studies, and interviews with local Heath Education England leaders and consulted a range of relevant organisations, including the Royal College of Nursing.

Janet Davies, chief executive and general secretary of the Royal College of Nursing, said: “Care has changed from being based on short-term instances of illness or injury, to being overwhelmingly about managing long-term complex conditions.

“Health service roles and the way people are trained for them must reflect this new reality and building a workforce to deal with these new challenges requires serious investment.

However, Davies was not optimistic about the successful implementation of the Trust's suggestions.

She added: “Unfortunately, many nursing staff currently find it almost impossible to take the time to expand their skills as frontline pressures mean that many cannot be spared without there being an impact on patient care.

“The NHS often finds itself caught between having too few staff available to keep care safe in the here and now and being able to develop the roles needed to cope with rising future demands. In the meantime, the gap can only be filled with expensive agency staffing and overseas recruitment.

“Flexibility and expanded nursing roles will be vital to the NHS's future and so it's crucial that a training and funding system is put in place that reflects nursing's future contribution.”