Silver linings amid the clouds

It's been quite a start to the year, even without Brexit. There's been more than the usual number of announcements, the closest to home being from the Nursing and Midwifery Council (NMC) (2019) on the imminent arrival of registered nursing associates (RNAs). A warmest welcome! Having spent much of the 1990s waving goodbye to the state enrolled nurse (SEN) in the blind pursuit of graduate status for nurses, this baby was thrown out with the bathwater. Hopefully, we've learnt the importance of having a path that leads to registered nurse (RN) status. I am but one who would have started my career today as an RNA.

January also saw the launch of The NHS Long Term Plan (NHS England, 2019), a significant moment, in that it officially abandons the policy of competition in the English NHS. As with nursing, it brings us back around the block, with a focus on integration within health and across the blurred lines of social care. It continues the trend of shifting resources from hospital to community started 20 years ago in mental health with the National Service Framework. Having been involved in policy development and implementation work over the past 20 years here and abroad, the one critical factor has been (the lack of) persistence, seeing through a strategy and working incrementally with feedback to understand, refine and build.