Flu jabs are all in a day’s work for nurses – and Matt Hancock should know this

Shadowing a nurse for a day would help senior health officials gain some understanding of the role

On the topic of flu vaccines, the health and social care secretary Matt Hancock stated in an interview on BBC Breakfast that the government had ‘changed the law’ so that more people could administer the jab.

‘We want pharmacists to be administering them, and nurses and technicians, as well as GPs,’ he told the programme on 27 August.

Nurses incredulous at minister’s lack of understanding of their role

This pronouncement was received with incredulity from the nursing profession. Nurses have been administering immunisations for decades, from the full programme of childhood vaccinations to the annual flu vaccines for vulnerable and older populations.

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Nurses have also been leading and managing travel clinics to enable people of all ages to travel internationally to countries where protection from immunisations is required.

It is alarming, therefore, that the health and social care secretary seems not to have understood the significant role of nurses in the administration of the annual flu vaccine.

Annual flu vaccination programme plans complicated by COVID-19

In every corner of the UK, general practice nurses are actively planning for this vaccination programme.

It is work that they have undertaken for decades and it involves careful and detailed preparations to ensure that the most vulnerable in our society receive the vaccine in a timely and safe way.

This year, in the midst of the pandemic, the planning will be complex.

‘For the health and social care secretary to have so clearly indicated a lack of basic understanding of the role of the nurse in the community is a huge disappointment’

Arrangements are being made to ensure that people are safe when they come for the vaccine, including the use of ‘drive-through’ clinics and alternative venues such as village halls, to allow for social distancing.

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Nurses are working out how to ensure the population is fully immunised in a timely way by offering flu clinics in the evenings and weekends and working with the wider community nursing team to ensure that people who are housebound are included.

It makes sense for senior health ministers to shadow nurses

For the health and social care secretary to have so clearly indicated a lack of basic understanding of the role of the nurse in the community is a huge disappointment, when registered nurses make up the largest part of the clinical workforce in the NHS and social care.

It demonstrates a view of nurses’ work that stems from ‘work as imagined’, rather than a view informed by seeing the work and spending time with practitioners.

The Queen’s Nursing Institute has for many years supported shadowing visits by senior policy leaders, including in recent years then prime minister David Cameron’s health adviser Nick Seddon.

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Health adviser ‘blown away’ by expertise seen while shadowing a Queen’s Nurse

After spending time with a Queen’s Nurse in general practice, he told me he was ‘blown away’ by the expertise of nurses in general practice and was now far better informed, having seen the reality of their work and spent time with them.

Mr Seddon undertook a second visit, to a Queen’s Nurse leading a district nursing team, and again commented that he had learned much that could inform policy for community services.

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The Nursing and Midwifery Council (NMC) is reviewing new educational standards for specialist community public health nurses, which includes health visitors, school nurses and occupational health nurses.

The regulator is also reviewing standards for the community specialist practitioner qualification, which includes district nurses, community children’s nurses, general practice nurses, community learning disability nurses and community mental health nurses.

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Nursing in the community: this is what independent, advanced practice looks like

A common feature of all eight community specialist roles is that, having undertaken a specialist programme, they work at a level of complete independence, with no reliance on medical direction for their work.

These are all registered nurses working at an advanced level of practice, with a focus on population health. They lead teams whose work includes complex assessments of individuals, families and carers with multiple interdependent health, social and psychological need, and delivering care in non-clinical environments.

The feedback from the prime minister’s health adviser centred on the expertise and independent nature of these leading nursing roles in the community.

Understanding the nurse’s role could help inform better policies

The minute-by-minute independent and complex decision-making required reflects an advanced level of practice in safeguarding and safety that is unparalleled outside of the community setting.

I would urge the health secretary to spend some time with nurses in practice, or to spend time speaking with them about their work.

We have the potential to be a bountiful source of rich intelligence that will result in more informed statements, decisions and policies created at the highest level.

Crystal Oldman is chief executive of the Queen’s Nursing Institute