Giving nurses more flexibility in their roles, and even reducing the length of training required to become a nurse, could help tackle the NHS workforce crisis, a healthcare policy adviser to the Prime Minister has argued.
In a paper commissioned by the King’s Fund and the charity Engage Britain, Bill Morgan, who was appointed Rishi Sunak’s health adviser this month, argues that there are a number of political obstacles in the way of effectively tackling the NHS’s workforce shortages and suggests a number of solutions – including blurring the lines between nurse and doctor roles.
The research, written before he entered Downing Street but published this week, Mr Morgan identifies difficulties in workforce forecasting, a tendency towards not training enough healthcare staff, and ‘insufficient strategic use’ of overseas recruitment as crucial barriers to building a sustainable NHS workforce.
‘Planning for the future health care workforce is difficult,’ wrote Mr Morgan. ‘At the heart of this difficulty is the length of time it takes to train a healthcare professional… and the likelihood that, by the time those in training enter the workforce, the world will look very different from the one that workforce planners had prepared for.’
To address this problem, the paper suggested that the NHS could ‘reduce the amount it takes to train a doctor or a nurse, either by reducing the amount of time for training set out in legislation, or by increasing the number of doctors and nurses trained through shorter postgraduate courses’.
Mr Morgan also advocates for making it easier for staff to move between professions, so it would take less time for a nursing associate to train as a registered nurse or for a nurse to train as a doctor. It is hoped that this would create a more flexible workforce that would be better adaptable to the uncertainties inherent in workforce forecasting.
Responding to the suggestions, Geraldine Walters, NMC executive director of professional practice, told Nursing in Practice: ‘For most registered nurses, nursing isn’t seen as a progression route to becoming a doctor. We would prefer to see a long-term, sustainable workforce plan that includes greater career development within nursing as a profession in its own right.
‘This could include more education opportunities to support nurses to work at a more advanced clinical level. This would enable them to deliver a wider range of care and treatments in tandem with their unique nursing skills. In our view, more education opportunities would be of greater benefit to patients than encouraging skilled nurses to retrain as doctors would.’
In addition to the development of a more flexible workforce, Mr Morgan also proposed the introduction of more transparent workforce reports and an independent NHS Pay Review Body style workforce-planning organisation.
Workforce forecasts should be made public to expose them to external challenges and bring to light the assumptions the government is making, he argued.
A Department of Health and Social Care spokesperson said: ‘This report raises important issues about the NHS workforce, which we are already taking action to resolve.
‘We have commissioned NHS England to develop a long-term plan for the NHS workforce for the next 15 years, and have over 34,500 more staff than a year ago, including over 9,300 more nurses and almost 4,000 more doctors.’