References

Bryant A, Kazan A. Self-leadership: how to become a more successful, efficient and effective leader from the inside out.New York (NY): McGraw-Hill Education; 2012

Council of Deans of Health. Council welcomes the publication of Interim People Plan. 2019. https://tinyurl.com/y6lff53k (accessed 5 November 2019)

Health Education England. NHS staff and learners' mental wellbeing commission. Executive summary. 2019. https://tinyurl.com/y4uhrw9a (accessed 5 November 2019)

NHS England, NHS Improvement, Health Education England. Interim NHS people plan. 2019. https://tinyurl.com/y2w9pbm4

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Thompson N. Promoting equality. Working with diversity and difference, 4th edn. London: Red Globe Press; 2017

The Interim NHS People Plan: implications for nurse education

14 November 2019
Education Matters
02 November 2019
Volume 28 · Issue 20

Abstract

Proposals to tackle nursing recruitment and retention issues centre on addressing workplace culture and improving leadership, as Janet Scammell, Associate Professor (Nursing), Bournemouth University, explains

Janet Scammell

The NHS is the largest employer in the UK and provides a fundamental service to the population. Maintaining recruitment and retention of staff is clearly central to care quality now and in the future. In June, the Interim NHS People Plan (NHS England et al, 2019) was published to address workforce requirements to deliver care priorities over the next 10 years as outlined in The NHS Long Term Plan (NHS England and NHS Improvement, 2019).

By far the most urgent healthcare staff shortage relates to the nursing workforce. Currently, there are 40 000 vacancies in substantive nursing posts across all hospital and community services, with significant shortages in mental health and community nursing (NHS England et al, 2019). What part does pre-registration nursing play in the Interim NHS People Plan proposals and what are the implications for its delivery within university and practice settings?

The vision for the Interim NHS People Plan is to map out the immediate challenges and actions to address workforce concerns in 2019/20. Two major themes have emerged: first, an analysis of the working culture prevalent in the NHS and, second, the quality of leadership and ensuring inclusivity. Pre-registration implications should be reflected in nursing curricula and the quality of practice learning environments; these will be essential to make the Interim NHS People Plan vision a reality.

Making the NHS the best place to work

The report recognises that healthcare work attracts dedicated, committed people. However, the evidence suggests that job satisfaction is compromised in places by a culture of bullying and harassment. In addition, workload pressures are high, leading to increasing levels of stress and burnout among both students and qualified staff (Health Education England, 2019). Suggested interventions include:

  • In practice settings: a zero tolerance of bullying; clear policies around raising concerns, harassment, and health and wellbeing. Role modelling of supportive staff behaviours by practice assessor nurses; effective links with university-based practice support staff and academic advisers to address concerns in a timely manner
  • In university: pre-registration curricula content to include equality and diversity education; ‘elegant challenging’ skills (Thompson, 2017) to ensure humanised care and collegial relations; reflective practice seminars linked to personal resilience development.

    • Improving our leadership culture

    The interim plan outlines the link between person-centred leadership cultures and engaged staff, leading to improved productivity. However, in places this is an aspiration rather than a reality, leading to staff feeling unsupported and devalued. Inclusive and compassionate leaders are needed at all levels, not least at bands 6 and 7, where ‘shop-floor staff’ engage with clinical leaders daily. Suggested interventions include:

  • In practice settings: practice assessors and clinical leads should demonstrate engaged and inclusive leadership styles to include the diversity and talents of the student population, so they feel valued as people rather than just pairs of hands
  • In university: the concept of self-leadership (Bryant and Kazan, 2012) should be embedded from year one until final placement, so that skills are taught and embedded as part of the emerging registered nurse role; this will challenge perceptions that leadership is only for those with leader in their job title.

    • Recruiting and retaining students

    One section of the interim plan focuses on specific issues around nursing. Looking at the pre-registration element, there is an ambitious plan to increase student numbers by expanding placement capacity by 5000 this year, as well as looking for growth in the future. Health and wellbeing issues are acknowledged in preventing attrition, as well as help with placement-related financial support; this is a significant source of student stress. However, there is no commitment to reintroduce bursaries or grants, which was seen as a missed opportunity by the Council of Deans (2019).

    In conclusion, the Interim NHS People Plan is comprehensive and ambitious. While making areas of responsibility clearer, it underplays perhaps the complexity of nurses' (students and registered staff) decisions to leave or stay in the profession. The picture is complex and requires sustained investment and leadership. However, it is a positive step forward; we can reflect on progress when the full people plan is released next year.