Changing demands of health care require extended nursing roles

Developing the skills of nurses, healthcare assistants and other non-medical staff is the only way the NHS can meet the changing demands of patient care.

That is the view expressed in Reshaping the Workforce to Deliver the Care Patients Need, by the Nuffield Trust, which says extended roles of non-medical staff, especially support workers, are required.

The Nuffield Trust conducted a survey of Health Education England leaders and found traditional workforce planning has focused on recruiting large numbers of staff with identical skills – which it says is costly and time-consuming.

The report identified four areas where expanding the skills of existing non-medical staff would have a more positive effect. These are:

Healthcare assistants – who are a large and flexible group with short training times.

Registered professionals including nurses – who manage chronic disease effectively. New roles could bridge workforce gaps.

Advanced practice nurses – who mentor and train less experienced staff. This is a clinical career option for experienced nurses who might wish to remain in a role that gives them direct patient contact.

Physician associates – who are trained to take on some junior doctor duties. With 250 in the UK, there is scope to expand.

One of the case studies in the report was Sheffield Teaching Hospitals NHS Foundation Trust, where the chief nurse explained how people in further education are encouraged to join as healthcare support workers and to progress from there to registered nursing.

The benefits of associate practitioners (APs) were highlighted in the report, including at Bradford District Care NHS Foundation Trust, which employed four APs in 2014 to conduct physical health checks. The service manager told the authors ‘we didn’t need a qualified nurse but we needed someone who was competent’.

The report, commissioned by NHS Employers, acknowledges nurses can feel threatened by the rapid upskilling of support workers because they believe these staff will either replace them, or be used to save money. But there could be scope for nurses to enhance their skills too, with the authors suggesting more should become advanced clinical practitioners (ACPs).

Heart of England NHS Foundation Trust nurse consultant Garry Swann, a member of the report’s steering group, welcomed this. He said there are currently few ACP opportunities.

Report author and Nuffield Trust director of policy Candace Imison said: ‘Our research shows reshaping the NHS workforce can offer huge opportunities for staff, through more rewarding roles and better career pathways.’

To read the report click here