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Role changes no substitute for skilled staff - Patients' Association

Published 17/05/2016

New roles and extra responsibilities for NHS staff is not a 'quick fix' solution, the Patients' Association says
New roles and extra responsibilities for NHS staff is not a 'quick fix' solution, the Patients' Association says

Giving existing staff new roles and extra responsibilities should not be seen as a "quick fix" solution to plug the NHS's workforce gap, a patients' group has warned.

The Patients Association also said that such proposals should not be seen as a cheaper alternative to hiring highly-qualified staff.

The comments come after a report by the Nuffield Trust, commissioned by NHS Employers, suggests that equipping NHS nursing, community and support staff with additional skills to deliver care is the best way to develop the capacity of the health service workforce.

But Katherine Murphy, chief executive of the Patients Association, said: "The proposed new roles and extra responsibilities for existing staff should not be adopted as a 'quick fix' solution to the complex staffing problems within the NHS, nor be seen as a cheaper alternative to highly-qualified staff.

"These proposals will not solve the shortage of skilled doctors and nurses across the health service and should not aim to do so. Instead, the Government needs to do more to invest in the training and retaining of these qualified practitioners."

The Nuffield Trust was commissioned to examine how best NHS staffing can be reorganised to support new ways of delivering care to patients.

The authors concluded that best way to "grow" the workforce is by expanding the skills of the existing workforce.

The authors argue that extending the skills of registered healthcare professionals, such as nurses, pharmacists, physiotherapists and paramedics, provides opportunities to manage the growing burden of chronic disease more effectively.

Meanwhile, advanced practice roles for nurses - those that require a further period of study, typically a two-year Masters qualification - offer opportunities to fill gaps in the medical workforce, provide mentoring and training for less experienced staff and offer a new career option for experienced nursing staff.

The authors point out that Sheffield Teaching Hospitals NHS Foundation Trust developed the role of an advanced clinical practitioner (ACP) in 2006 to help fill growing gaps in junior doctor rotas. ACPs undertake a two-year, part-time, Masters degree in advanced professional practice at Sheffield Hallam University. The trust now employs up to 80 ACPs across a range of services.

Report author Candace Imison, director of policy at the health think-tank, said: "Our research shows that reshaping the NHS workforce can offer huge opportunities - for patients, through improved health outcomes, and for staff, through more rewarding roles and better career pathways.

"But we stress in our report that this is not simply a 'nice to do' - it is urgent, and essential if the health service is to find a sustainable balance between available funding, patient needs and staff needs, and deliver services fit for the 21st century."

Saffron Cordery, director of policy and strategy for NHS Providers, welcomed the suggestions, saying that it would lead to improved continuity and better care for patients, adding: "Today's report rightly makes it clear that this is not just about training more staff, or even about creating new roles, it is also about developing, training and equipping the existing workforce, especially the vast non-medical workforce.

"This should result in a more stable substantive workforce with reduced reliance on temporary staff and outsourcing. This will help improve continuity and better patient care by closing the gap between what patients need and the skills available to care for them."

It would "absolutely" not be the responsibility of NHS staff to take over the role of doctors once they are trained with additional skills, Ms Imison told BBC Breakfast.

The Nuffield Trust director of policy said her report intended to highlight the need for health workers to take on responsibilities outside of their traditional roles.

Asked if her report was suggesting the responsibilities of doctors should be carried out by others, she said: "It absolutely isn't. What we are pointing out is that there is a growing gap between patient needs and the skills that staff have got.

"We are suggesting many ways that staff can be given new skills to meet those patient needs.

"One option is that nurses take on some of the responsibility that doctors have had, but that is absolutely not the whole of it - there is a whole range of opportunities to give staff better skills to meet patient needs."

She added that the drive to develop the variety of staff capabilities is what the future of the health service is likely to be, rather than an interim response to plug the workforce gap.

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