At a recent partnership meeting with my colleagues from our local higher education institute we reviewed the likely numbers of prospective preregistration nurses who have been offered a place to begin their programmes. This meeting revealed that we are barely able to meet our planned numbers.
Ford (2019) reported that, although applications to study nursing in England have increased by 4% from last year, they are still down by more than 15 000 since the removal of the bursary. Potential mature students are the most affected, with applications from those aged 25 and over seeing a reduction of 71% since 2016 (Ford, 2019).
With the national nursing vacancy position reported to being in excess of 40 000, alongside all of the multiple interventions that we are working on locally to transform roles, recruit and retain nurses, it is evident that we need to further strengthen our plans to grow our future supply of registered nurses.
As a group, we debated a number of actions that we need to refresh our approach—and reflected on the work of Reed et al (2019). Reed et al introduced the concept of ‘anchor institutions’, and the potential application to the NHS. First developed in the USA, the term refers to large, typically non-profit organisations such as hospitals, local councils and universities, whose long-term sustainability is tied to the wellbeing of the populations they serve. These anchor institutions get their name because they are unlikely to move, due to their connection to the local population, and typically have a significant influence on the health and wellbeing of a local community, including their influence on local economies. There is a very good infographic published by The Health Foundation (2019) that outlines what makes the NHS an anchor organisation, and how, through its size and scale, the NHS can positively contribute to local areas in many ways beyond providing health care.
This led our conversation towards how using the principles of the anchor organisation our partnership could maximise its potential as an employer. Recognising that preregistration student nurses are not employed by either the university or the NHS, we felt that there was learning from the case studies included in the Health Foundation (2019) publication that gave us the opportunity to develop our joint strategy and make the required improvements.
With most NHS organisations being one of the largest, if not the largest, employer in many areas Reed et al (2019) suggested that, by increasing the amount of local employment an NHS organisation can create, this may offer the opportunity to increase the impact that it has on the wellbeing of the local community.
Case studies include some good examples of the NHS working in partnership to support local residents through schemes that target apprenticeships and work placements for people who are long-term unemployed and supporting career opportunities for younger people in the area.
This led on to discussions around the widening participation agenda, and the opportunities to focus on actions to deliver the benefits of this. The Health Foundation (2019) sees the benefits of anchor organisations, such as their role in delivering widening workforce participation, building the future workforce and being a good employer, in addition to having the opportunity to develop strategies to deliver:
It is time to widen our thinking locally to consider how we can re-examine a number of national drivers, to co-produce a local plan based on our local population. This includes the Health Education England (HEE) Talent for Care strategic framework (HEE, 2014a), alongside the Widening Workforce Participation strategy (HEE, 2014b), which aims to increase opportunities for people to begin a career in the NHS and to expand access to education, employment and development opportunities for under-represented communities. This all fits well with the direction of the NHS Improvement Interim NHS People Plan (2019), which explicitly recognises the potential for the NHS to act as an anchor.