NHS People Plan: we need ambition, funding and leaders who are legally accountable

Safe staffing crisis is crying out for solutions that are radical, says RCN England director

I woke up on Tuesday to find the health press summing up the week’s biggest NHS news as ‘jam tomorrow’ – perhaps a little unfairly.

A fuller read of the Interim NHS People Plan revealed a welcome but underdeveloped set of proposals to improve NHS management, boost ethical overseas recruitment, create more clinical training places and increase the number of nursing associates. There’s also a much-reported partnership with Mumsnet to tempt leavers to return. 

What we have is a plan for a plan

There’s little to disagree with in any of this, and it is heartening to see an acknowledgement that a national staffing crisis needs a nationally coordinated response, with better integration of primary and secondary care and the full backing of government. We now have a plan for a plan, rather than no plan at all.

• RELATED: Mumsnet, online degrees and more CPD funding: government ideas to boost nurse numbers 

But today’s unprecedented crisis in our health and care system demands more. NHS Improvement chief Baroness Harding and her team have been, in my view, refreshingly accurate about pinpointing individual areas where staff retention or recruitment are a problem, but too vague in setting out solutions to address the fundamental, national staff shortage that now affects almost every corner of the NHS.

‘Those of us with direct experience of what understaffing means for nurses and patients are impatient for change’

I’d have liked this report to signal a serious and radical set of measures, not just to help reverse the ever-growing deficiency of staff, money and morale, but to support our profession as a viable destination for ambitious people from all backgrounds.

As with so many things, we’ll only get what we are prepared to pay for. We can only hope that when the final People Plan is published, the Treasury will have been persuaded to release the funds to make this possible.

Our message to the government is clear: let’s be honest about the state we are in, and then be ambitious about what we can do about it. Those of us who have direct experience of what understaffing means for nursing professionals and for patients are impatient for change and determined to help build a better future.

Fallout from the student bursary’s demise

There is no escaping the fact that since 2016, when the government announced it would end financial support for nursing students in England, the number of applications to nursing degrees has dropped by almost a third.

To stop the nurse shortage spiralling further, the RCN is calling for at least £1 billion to be invested in higher education. Failure to deliver this in 2019 means we now face another lost year for student recruitment. Nursing is a degree like no other, we need a new, improved funding system specifically to develop a new generation of home-grown talent.  

• RELATED: RCN leader demands 'return' of £1 billion to nurse education

On top of this, we should expect to see much more tangible, ambitious and financially supported plans to stem the loss of experienced staff. However, Treasury ministers are speculating that the Conservative Party ‘goings on’ will place the promised spending review in limbo, potentially leaving the NHS and other big-spending areas without the funding and stability they need.

Accountability for safe care

The most recent NHS Improvement vacancy statistics show there are currently 8,995 unfilled registered nursing positions in the south of England, where I used to practise; the picture is replicated up and down the country. 

Friends and colleagues often tell me they are struggling to cope and many are considering quitting – a painful choice for people who love their profession.

To make sure that fixing this crisis remains a priority, ministers and NHS leaders must now be made explicitly accountable in law for delivering safe and effective care throughout the health and care system – and clear mechanisms must be put in place to assess which staff are needed where, to meet clinical need.

Making it clear where the buck stops would give Baroness Harding’s project, and the wider NHS Long Term Plan, a far greater chance of success.

Patricia Marquis is director of RCN England