Focus on the future The Five Year Forward View by NHS England chief executive Simon Stevens sets the future direction for the NHS. The ‘transformational changes’ outlined in the slim document have huge implications for nurses, who will have to work in different ways to restructure care around the patient and help the NHS operate within its means. Author Alison Moore is a freelance journalist Get patients more involved in their own care. Break down the barriers that exist between different parts of the health service and between health and social care. Develop new models of care. This ambitious programme will have enormous implications for nurses. Mr Stevens says: ‘We can design innovative new care models but they simply won’t become a reality unless we have a workforce with the right numbers, skills, values and behaviours to deliver it.’
He points out that the number of community nurses has barely increased in recent years. And he notes that the workforce has become more specialised over the past few years, while those who need care often have more than one condition and may need generalists. The huge increases in demand for health care, and the need to deliver the Forward View, may drive an expansion in nursing numbers. Health Education England (HEE) director of nursing Lisa Bayliss-Pratt says: ‘Nursing numbers have increased and I think they will continue to increase. The nurse and the care team are seen as real agents to make the changes that need to happen.’ Other commentators point to the ongoing financial squeeze and the pressure to become more efficient, which suggest that future demand is likely to be met largely by the existing workforce, with only limited scope for expansion. Within this workforce, there is likely to be a shift towards working in the community. Ruth Robertson, a fellow at
DANIEL MITCHELL
The future of the NHS may be a momentous and complex subject but how it will look has been outlined in just over 40 pages. Regardless of which government is elected in May, the Five Year Forward View produced by NHS England chief executive Simon Stevens is likely to be the blueprint for how the NHS develops over the next five years. While the NHS Plan of 2000 was big on targets, Mr Stevens’s slim document focuses on the ‘transformational changes’ that – if matched by funding increases – could improve efficiency and care and close the £30 billion NHS funding gap expected by 2020/21. Mr Stevens suggests the NHS needs to: Put greater emphasis on prevention and public health.
SUMMARY
Alison Moore begins our series on the Five Year Forward View by considering what the ambitious plan means for the NHS and nurses
20 february 11 ::from vol RCNi.com 29 no 24 by :: 2015 STANDARD Downloaded ${individualUser.displayName} on Nov 18, 2015. For personal use only. NoNURSING other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
health think tank the King’s Fund, says: ‘The structure of the NHS workforce is not aligned to meet the complex needs of an ageing population at home and in the community. We need to retrain and develop staff.’ She argues more district and community nurses will be needed, not just to implement the Forward View but to help deliver the government’s Better Care Fund initiatives. Queen’s Nursing Institute director Crystal Oldman says IT could help community nurses work more efficiently, but she is concerned that adoption of new technologies has been variable across the country. She says there is still a need for more community nurses to be trained, and for those coming out of general nurse training to be encouraged to consider a
How will nursing look under the Five Year Forward View? Nurses’ prime role will always be to deliver nursing care, but some attributes and skills may be valued more in the future. Relationships with patients may shift, with emphasis on empowering patients to make changes that benefit their health and to be active partners in decision making. As barriers between different healthcare providers and social care are removed, nurses may work with a wider group of professionals in delivering holistic care. Employers are more likely to encourage nurses to live healthy lives and to become ‘health ambassadors’ in their communities. Nurses are likely to be required to be more flexible throughout their careers, and may find themselves working in unfamiliar situations where the delivery of care is organised differently. The teams nurses work in may increasingly span both social and health care, and there may be new roles within them. Nurses must be IT-literate. Paper records will be a thing of the past and IT will increasingly be used not just to record information, but to monitor patients.
‘THE STRUCTURE OF THE NHS WORKFORCE IS NOT ALIGNED TO MEET THE NEEDS OF AN AGEING POPULATION’ career in community nursing. Failure to train enough nurses to work in the community could make it harder to move to the new models of care outlined in the Forward View, she warns. Ms Bayliss-Pratt adds that it is a myth that caring for people in their own homes is a cheap
option, as many of these patients have extremely complex needs. One of the groups that could find new opportunities under the Forward View is midwives. The report suggests they could take charge of the maternity services they provide, with more women giving birth in less medicalised environments. Royal College of Midwives England director Jacque Gerrard welcomes this, but says that more midwives will still be needed. RCN head of policy and international affairs Howard Catton believes the long-term trends identified in the document will put nurses at the forefront of meeting the rising demand for health care. ‘It is rare for a high-level document to say that we
must think about planning the workforce in terms of what we want to do for the future,’ he says. The Forward View suggests that NHS pay will need to stay ‘broadly in line’ with private sector wages if the NHS is to attract the staff it needs. The report also suggests that pay and terms and conditions may need to ‘evolve’ to reward high performance, support job redesign and aid recruitment and retention in clinical and geographical areas with high vacancies. There is no doubt the Forward View could offer great opportunities for nurses, but the devil will be in the detail – and it will be up to nurses to ensure their voices are heard NS
NURSING 11 other :: voluses 29 no 24 :: permission. 2015 21 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 18, 2015. For personal february use only. No without Copyright © 2015 RCNi Ltd. All rights reserved.
He points out that the number of community nurses has barely increased in recent years. And he notes that the workforce has become more specialised over the past few years, while those who need care often have more than one condition and may need generalists. The huge increases in demand for health care, and the need to deliver the Forward View, may drive an expansion in nursing numbers. Health Education England (HEE) director of nursing Lisa Bayliss-Pratt says: ‘Nursing numbers have increased and I think they will continue to increase. The nurse and the care team are seen as real agents to make the changes that need to happen.’ Other commentators point to the ongoing financial squeeze and the pressure to become more efficient, which suggest that future demand is likely to be met largely by the existing workforce, with only limited scope for expansion. Within this workforce, there is likely to be a shift towards working in the community. Ruth Robertson, a fellow at
DANIEL MITCHELL
The future of the NHS may be a momentous and complex subject but how it will look has been outlined in just over 40 pages. Regardless of which government is elected in May, the Five Year Forward View produced by NHS England chief executive Simon Stevens is likely to be the blueprint for how the NHS develops over the next five years. While the NHS Plan of 2000 was big on targets, Mr Stevens’s slim document focuses on the ‘transformational changes’ that – if matched by funding increases – could improve efficiency and care and close the £30 billion NHS funding gap expected by 2020/21. Mr Stevens suggests the NHS needs to: Put greater emphasis on prevention and public health.
SUMMARY
Alison Moore begins our series on the Five Year Forward View by considering what the ambitious plan means for the NHS and nurses
20 february 11 ::from vol RCNi.com 29 no 24 by :: 2015 STANDARD Downloaded ${individualUser.displayName} on Nov 18, 2015. For personal use only. NoNURSING other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
health think tank the King’s Fund, says: ‘The structure of the NHS workforce is not aligned to meet the complex needs of an ageing population at home and in the community. We need to retrain and develop staff.’ She argues more district and community nurses will be needed, not just to implement the Forward View but to help deliver the government’s Better Care Fund initiatives. Queen’s Nursing Institute director Crystal Oldman says IT could help community nurses work more efficiently, but she is concerned that adoption of new technologies has been variable across the country. She says there is still a need for more community nurses to be trained, and for those coming out of general nurse training to be encouraged to consider a
How will nursing look under the Five Year Forward View? Nurses’ prime role will always be to deliver nursing care, but some attributes and skills may be valued more in the future. Relationships with patients may shift, with emphasis on empowering patients to make changes that benefit their health and to be active partners in decision making. As barriers between different healthcare providers and social care are removed, nurses may work with a wider group of professionals in delivering holistic care. Employers are more likely to encourage nurses to live healthy lives and to become ‘health ambassadors’ in their communities. Nurses are likely to be required to be more flexible throughout their careers, and may find themselves working in unfamiliar situations where the delivery of care is organised differently. The teams nurses work in may increasingly span both social and health care, and there may be new roles within them. Nurses must be IT-literate. Paper records will be a thing of the past and IT will increasingly be used not just to record information, but to monitor patients.
‘THE STRUCTURE OF THE NHS WORKFORCE IS NOT ALIGNED TO MEET THE NEEDS OF AN AGEING POPULATION’ career in community nursing. Failure to train enough nurses to work in the community could make it harder to move to the new models of care outlined in the Forward View, she warns. Ms Bayliss-Pratt adds that it is a myth that caring for people in their own homes is a cheap
option, as many of these patients have extremely complex needs. One of the groups that could find new opportunities under the Forward View is midwives. The report suggests they could take charge of the maternity services they provide, with more women giving birth in less medicalised environments. Royal College of Midwives England director Jacque Gerrard welcomes this, but says that more midwives will still be needed. RCN head of policy and international affairs Howard Catton believes the long-term trends identified in the document will put nurses at the forefront of meeting the rising demand for health care. ‘It is rare for a high-level document to say that we
must think about planning the workforce in terms of what we want to do for the future,’ he says. The Forward View suggests that NHS pay will need to stay ‘broadly in line’ with private sector wages if the NHS is to attract the staff it needs. The report also suggests that pay and terms and conditions may need to ‘evolve’ to reward high performance, support job redesign and aid recruitment and retention in clinical and geographical areas with high vacancies. There is no doubt the Forward View could offer great opportunities for nurses, but the devil will be in the detail – and it will be up to nurses to ensure their voices are heard NS
NURSING 11 other :: voluses 29 no 24 :: permission. 2015 21 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 18, 2015. For personal february use only. No without Copyright © 2015 RCNi Ltd. All rights reserved.
