ÌìÃÀ´«Ã½

This is a once-in-a-generation opportunity to fundamentally change our health and social care system. The nursing profession is the key to unlocking the government’s ambitions and we're lobbying ministers to make sure nursing is central to the plan.

With proper investment and empowerment, the nursing profession can be instrumental to delivering the three 'shifts' the government says it's committed to achieving, as set out below.

Hospital to community

The nursing profession leads a significant number of health care services in community settings, including people’s homes, primary care and care homes. It's well placed to identify solutions and services that, with investment, will reduce avoidable admissions to hospitals and length of stay.

The plan should set out an infrastructure that empowers community nursing to take local decisions and scale up these nurse-led services. For example, specialist nursing roles in the community support those with long-term conditions to manage it, and provide clinical care that can prevent admission or re-admission to hospital.

The plan should also consider community nursing's essential role in delivering neighbourhood health, which emphasises ‘home first’ care. This approach relies on primary and secondary care clinicians supporting individuals at risk of hospital admission. Nursing roles should be central to delivering a neighbourhood health agenda, both through the provision of specialist care for long-term conditions (including mental health, learning disability and neurodevelopmental conditions), and providing continuity of care and rehabilitation as part of step down from hospital care.

Sickness to prevention

Prevention can support reduced rates of illness, premature mortality and create a healthier population. This can in turn contribute to reducing pressure on the system, increasing productivity and economic activity.  The nursing profession is pivotal to public health and prevention.

When afforded the time they are able to identify specific risks to individuals and their families, and take action to link in wider agencies to support them. This is the kind of prevention that has a real impact on the social determinants of health. This kind of nursing-led prevention is only possible when caseloads are manageable and the administrative burden placed on nursing staff is reduced. Through the creation of more community nursing posts, covering smaller geographical areas, and by improving digital systems, nurses will be able to return to a focus on treating the whole patient Strong local public health services are also key to achieving this shift. However, public health services in England have been subject to significant spending cuts

The Plan must include clear commitments to increase investment in prevention, not just reiterate past rhetoric. This investment should be particularly targeted in areas which are proven to have high impact such as:

• children and young people
• addressing key risk factors for ill health such as smoking
• physical activity and diet
• a focus on specific diseases

Analogue to digital

Investing in the basic digital and IT infrastructure must be prioritised if the NHS is to be in a position to embrace the potential of more innovative solutions. The issue of interoperability between digital platforms, across systems and even within trusts, can often mean time that could be focused on patient care is lost. Addressing this by implementing clear requirements for interoperability should be one of the first priorities of the plan.

A cultural shift in digital leadership with nursing at the heart would also ensure that digital processes are improved in ways that liberate nursing time to focus on patient care, such as exploring the role of artificial intelligence in improving risk management efficiency.

Alongside investing in digital transformation, there is a need to improve digital proficiency within the health and care workforce and provide support to teams adopting new systems. We are clear that quality standards must be set for simulated learning methods being used within the nursing education pathway, which will likely require significant national investment in supporting technologies.

The key to change: prioritise and value nursing

The Westminster government must waste no time in delivering a 10 Year Health Plan that fully values the nursing profession. To do this, it must:

• Commit to building capacity in nurse-led community and public health services 
• Deliver a national strategy for improving the nation’s health and reducing health inequalities
• Invest in the technology requirements of the NHS to enable digital innovation and the possibilities of artificial intelligence 
• Deliver a national nursing strategy that addresses long standing barriers for supply and retention across all nursing roles and specialisms 
• Publish a fully-funded refreshed Long Term Workforce Plan and strengthen government accountability for workforce supply and retention 
• Place the Chief Nursing Officer at the heart of government, alongside the planned Chief Medical Officers
• Implement student loan forgiveness for nursing graduates working in publicly funded services to address early career attrition
• Deliver a substantial, restorative pay rise for nursing, and central funding for registered nurses to progress from band 5 to band 6 after a period of preceptorship
• Produce a parallel plan for a strong and stable social care sector and long-term vision for this sector 
• Commit to the eradication of corridor care as a clear success measure to judge the plan against