NHS plan delivery must equip and empower nurses, midwives and nursing associates

What does the 10 Year Health Plan for England mean for the nursing and midwifery workforce? Emma Westcott looks at what’s needed from the perspective of the Nursing and Midwifery Council (NMC)

The government’s 10 Year Health Plan for England marks a significant moment for our health and care system – and a chance to reshape it in ways that improve the experiences of both the public and the professionals delivering care.

Nurses, midwives and nursing associates form the largest part of the workforce. They are present at every stage of life, in every setting. Their contribution will be critical to the success of this plan. To deliver on the health plan’s ambitions, the workforce must be properly equipped, supported and empowered.

To deliver on the health plan’s ambitions, the workforce must be properly equipped, supported and empowered

The number of professionals on our register is at a record high. But growth is slowing, and too many are still leaving earlier than they envisaged.

Our most recent NMC data report revealed that less than a quarter of those who left the register last year would recommend a career in nursing or midwifery, and the second most common reason for leaving the register was the toll work took on their physical or mental health.

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It is also significant that the rate of growth in internationally qualified professionals joining the register has slowed compared to previous years.

It is more urgent than ever that we invest in a sustainable, homegrown workforce

With rising patient demand, an ageing population, and increasing complexity, it is more urgent than ever that we invest in a sustainable, homegrown workforce. While internationally educated professionals are welcome and valued, long-term resilience depends on educating and retaining more nurses, midwives and nursing associates within the UK.

This means positive routes to registration, support for new entrants, and a decent work-life balance. We must sell the attractions of these critical professions to generations with different priorities regarding work and tackle the frustrations and irritants – the plan recognises this.

No recruitment drive can succeed without a serious, sustained commitment to retention, wellbeing and culture.

The focus on training reform is important. Expanding routes into the profession – including through apprenticeships – can help create a more diverse and inclusive workforce. The nursing associate role has, among other benefits, created an effective progression route to registered nurse.

Increasing and diversifying placement capacity, improving supervision, and tackling financial barriers are all essential steps in building a stronger pipeline into our professions.

Recruitment alone isn’t enough. The system must also retain the people it educates

But recruitment alone isn’t enough. The system must also retain the people it educates. That means improving the environment for care, addressing workload pressures, and making sure early-career professionals feel respected, safe and supported.

I am also encouraged by the plan’s attention to stark health inequalities. As our most recent data shows, the nursing and midwifery workforce is more ethnically diverse than ever – and so are the communities they serve. Equity must be a guiding principle across the system. At the NMC we have set our own ambitious targets to eliminate bias from our processes and have boosted our internal capabilities around equality, diversity and inclusion.

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One of the most welcome aspects of the plan is the renewed focus on care closer to home and at home. Many of our professionals already practise in the community, and our standards equip them to work preventatively alongside other services and professions.

The plan rightly recognises that care closer to home can improve outcomes, empower people, support prevention, and ease pressure on hospitals. This aligns with our encouragement of social care and community-based practice placements.

We are also supporting the development and regulation of advanced practice in nursing and midwifery, so that our registrants can offer more, safely and expertly.

Co-locating services in neighbourhood hubs is a great first step, but not the same as fully delivering coordinated support around the citizen

Crucially, the shift towards prevention and early intervention cannot rest on the NHS alone. It demands a coordinated, multi-agency approach. Co-locating services in neighbourhood hubs is a great first step, but not the same as fully delivering coordinated support around the citizen.

We strongly support the plan’s commitment to transparency and safety – particularly in maternity and neonatal services, where we are reviewing what more we can do to support safe and effective practice, as well as supporting people who have had poor experiences.

The 10-Year Plan offers a compelling vision. We will need to harness the commitment and expertise of the workforce to make it happen

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The 10-Year Plan offers a compelling vision. Implementing widespread change is a different challenge, and we will need to harness the commitment and expertise of the workforce to make it happen. An important measure of impact will be the daily experiences of people who use health and care services, and those who care for them.

Emma Westcott is executive director of strategy and insight at the Nursing and Midwifery Council