What the military could teach the NHS about supporting nurses

In seeking to retain nurses the NHS could learn from how armed forces' healthcare personnel are treated, especially in housing and education

The NHS could learn from how military healthcare personnel are treated, says senior nurse Sam Foster

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When I look at the NHS Long Term Plan through the eyes of a nurse I have some scepticism.

While it specifies a number of areas where nursing roles are due to be developed, there is little or no detail about any proposed national response concerning, for example, ‘action to improve nurse retention’ to reduce vacancy rates to 5% by 2028, or about the as-yet unquantified commitment for an ‘increase in investment’ in continuing professional development.

Speakers at the chief nursing officer for England’s summit in March included NHS Improvement chair Baroness Dido Harding and Leeds Teaching Hospitals NHS Trust chief executive Julian Hartley, who have been asked to lead the workforce implementation plan.

Addressing the real issues

They spoke about their approach to ‘our people’ and sought to debate what we as senior nurses expect to be addressed in the plan.

I raised a question from the floor on whether the NHS is doing enough to address some of the real issues for our nurses, and specifically highlighted how the armed forces support their nurses. This question gained support from colleagues in the room and later on social media.

I am married to a military surgeon, so I speak from experience and know how we as a family benefit from the military terms and conditions that come with his role.

Recruitment and retention packages

In relation to housing, for example, our rent is heavily subsidised, and we do not pay water rates or council tax, which significantly benefits our standard of living.

Over the years I have worked alongside military healthcare personnel in a range of multi-professional roles and, while there is the obvious important difference in terms of the risks associated with the duties that our military teams have, when reviewing armed forces' nursing careers I would suggest that as fellow public servants there are several areas where the NHS can learn from their recruitment and retention packages.

Perspectives on military life

Military recruitment websites for nursing professionals outline what life is like from both pre- and post-registration perspectives:

  • Health and well-being. The military offers free dental care and annual health and fitness checks. A certain level of fitness is required but support and training as well as access to free gymnasium and swimming facilities are offered. There is also at least two weeks a year, on top of annual leave, when there is an opportunity to develop leadership and fitness by learning new sports such as scuba diving and to take part in adventure training trips.
  • Pastoral care. As well as the managerial chain of command, each regiment or platoon has military chaplaincy support. The military welfare support service also helps personnel and their families, for example with mediation and counselling.
  • Career progression and development. There are well defined career pathways in the military setting with robust appraisal processes, and time off for study is seen as required and not taken from annual leave allocation. The military fully supports funding of pre- and post-registration educational requirements and this includes paid-for travel and sustenance.
  • Accommodation and food. Provided for single individuals during training, and then heavily subsidised benefits for accommodation.
  • Wages. Comparable with the NHS, but military staff have the benefit of a non-contributory pension.

Need for a national approach

I am not advocating that we all sign up to the military, but there are areas the NHS needs to consider, specifically in relation to how it supports staff with housing and education.

Locally, I am progressing how we, as a trust, might support staff with accommodation issues, for example by underwriting deposits or considering options for subsiding other cost of living expenses such as council tax or transport costs. However, if we are to have a national service, this needs a national approach.

Sam Foster is the chief nursing officer at Oxford University Hospitals NHS Foundation Trust



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NHS (2019) NHS Long Term Plan

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