NHS Bursaries — House of Commons, 2016-05-04
Topic: Health
Helen Olivia Bicknell Whately (Conservative, Centre-right): If we ask any patients about their experience in hospital, one thing they are sure to talk about is the nurses who looked after them. In doing so, they are usually talking about both nurses and healthcare assistants—in my experience, patients do not tend to make a distinction. We know that nurses have far more interaction with patients, day to day, than doctors. Nurses’ quality and time are absolutely critical to patients’ experience Nurses are also critical to outcomes for hospital patients. Good nursing can be the difference between life and death. We have known that since Florence Nightingale, we were reminded of it by the inquiry into Mid Staffordshire and the Francis report, and we can see it from recent research into stroke outcomes. It will be clear to anyone who has looked at how Salford Royal has such good outcomes and such a good reputation—a lot of that is because of the focus on extraordinarily high standards of nursing The excellent NHS that I believe we all want needs excellent nurses. It also needs enough of them. This afternoon, people have talked about how we need something in the order of perhaps 10,000 to 20,000 more nurses—the numbers range widely. We also know that we need a shift in nursing skills, as we will need more nursing care for older people and people with long-term conditions, as well as more mental health nurses Right now, however, there are not enough nurses in our system, and hospitals across the country have vacancies. We know that they use large numbers of agency staff, and international recruitment is important to many hospitals, including those serving my constituents in Kent. I am not confident that more of the same will solve the problems, and neither was the nursing department of a London university that I spoke to last year. It said that it needed more funding per nurse place, but recognised that asking for more money for their nurses could mean taking money from front-line care in the NHS. That was not a good answer, and the department was open to a new funding model Last summer, the Council of Deans of Health and Universities UK stated that the "current funding system is no longer working for either students or universities." Universities have to subsidise the cost of nursing and physio degrees from other courses, and NHS-funded nursing students have less to live on than others, even though they often study longer, more intense degrees with more hours, and are therefore even less able to do other work outside their qualification. We know that we need more nurses, and that the current funding system is not working. How should we get more nurses? Around 2008-09, when plans were being drawn up for the Centre for Workforce Intelligence, I remember hearing that the answer was better workforce planning, with lots of skilled experts doing fabulous modelling of future workforce demands. I remember being a sceptic about that then, because when we consider the history of the NHS, and systems around the world that have centralised planning for the healthcare workforce, we find that it is almost always wrong. There are periods of over-supply and of under-supply—right now, we are in a period of under-supply, with all its knock-on consequences. Doing things better and having more experts sounds great in theory, but in practice we have seen that it does not work A much better answer is to set universities free to offer more places to all those students who, as we have heard, want to study nursing but are currently being turned away. I hope that we will have more nursing applicants, and that that career will become even more attractive, particularly as universities work more closely with employers on what is needed, and we must consider more of the specialist skills and expertise required within nursing by our care system now and in future To do that we must uncouple the funding of nurse training from the NHS, and take away the constraint that every £1 spent on training an NHS nurse is £1 potentially taken from front-line care, because that puts a premium on avoiding excess nurses. That is the right direction of travel, and it is also important to increase maintenance grants for nurses so that they do not struggle with their living costs as currently happens. There should be more routes into nursing. The nurse associate role is welcome, as is the apprenticeship route so that nurses can work and train in parallel. We know that that is appealing to more mature students who need an income and who want to be more hands-on during their training, and for whom a university environment has less appeal. Having worked for some time with healthcare assistants, I would like more recognition to be given to their role and qualifications, and I recognise the opportunity to support them even more to train to become qualified nurses We must invest more in continuous professional development for nurses. We know that we need a more flexible workforce that can adapt to future demands, yet in times of financial pressure, the investment and time given to ongoing training are often squeezed. Let us use this opportunity to try to shift that balance, and repurpose the workforce to meet the system’s demands and needs I would also like more attention paid to the appeal of nursing and the experiences of nurses in work. I have heard many nurses on the frontline say, "This weekend, I’ll be on my own—I will be the only permanent nurse on this ward. I will be working alongside agency nurses who do not necessarily know this ward, and it will make this weekend really difficult." We badly need to put an end to that. The only way to do that, alongside the ongoing work to reduce the use of agency staff, is to increase the number of nurses who have been trained to work in the NHS I am out of time, but to sum up I think the direction of travel is absolutely right. Let us make sure that we get the details right on how the proposals are put into practice.