Number 20, Steve Barclay arrived at the NHS with a bit of ‘form’.
As health minister, in 2018 he acquired a ‘reputation’. Writing about Barclay, the editor of the HSJ, reported;
‘…[he’s] a real nightmare, vindictive, arrogant, a bully, hostile to the NHS… a micro-manager of the wrong things…’
And for good measure;
‘… he made few friends in the NHS…’
Barclay’s backing Rishi. Poll ratings tell me Liz will be looking for a replacement Health Secretary…
… for now, we’re stuck with him.
He once recorded a pod-cast, for a journalist at the Telegraph, speculating about training nurses in two years, not three.
Yes, you could create a curriculum to produce a qualification in 2 years.
You could train an air traffic controller in six weeks but I wouldn’t fancy getting in a plane. Knowing how to do the job is not the same as performing in the job. The Germans call it ‘praxis’.
Now, I hear, he’s been discussing, at NHSE; ‘do nurses need a degree?’
A nursing degree? Another sort of qualification would, certainly, be possible.
There’s a third question he hasn’t asked. I will. Do we want either of the first two?
Deskilling nurses, in a technologically advanced healthcare system? Not a good move… doesn’t bode well for quality and safety.
However, with 400 nurses, a week, walking away and applications to train as a nurse, nose-diving by 8%… it’s right to have a conversation about the future.
Nursing is complex. One research data-base lists 74,000 NHS job-titles, the majority… nurses.
Re-titling is a cunning way around Agenda for Change pay scales. It’s confusing and annoys the hell out of nurses, who see their seniority and skills diluted.
Barclay, I’d guess, won’t be around for much longer. In case he’s minded to leave an envelope for his successor, here are eight suggestions that might help stem the flow.
1. Pay.
There is a lot of research saying, pay is not a key determinant. No one becomes a nurse to get rich.
But… and it’s a big but… with the economy heating up, it’s increasingly significant.
I’m hearing there are 13 London hospitals with food banks. It is not unique. Nurse pay needs a serious, second look. Agenda for Change may need changing?
2. Forgive nurse’s university loans.
The repayment, earning-threshold is £27,295 a year. This puts Bands 4 and 5 into repayment territory.
It’s no big-deal for HMG to scrap them and it would be a big-signal… ‘nurses are valued’.
3. Outlaw down-drift in Bands.
It’s too easy to move nurses into work at a lower band. It’s mean. And, re-banding disincentivises changing career direction. For example a Band 6 or 7 wanting to switch to community nursing for the second half of their career… they’ll be down graded.
4. Fund post-graduate diploma courses.
It’s another way into nursing, cost effective and easy. Just do it.
5. Nursing Associates.
Probably, most care is delivered by support workers and NA’s are a type of support-worker.
There’s a role for a skilled support-worker but increasing their work load and responsibility is exploitative, without accredited training.
6. ‘Motivators and hygiene factors’.
No, not hand washing… Hertzberg.
Factors leading to job satisfaction are separate from those that lead to job dissatisfaction.
Think: rota flexing; mandatory breaks; hot affordable food, 24/7; Creche; car-parking charges scaled to income.
Then think; bullying and ‘speaking up’.
7. Continuing Professional Development.
In 2019, Javid announced a £1,000 personal development budget for every nurse, midwife and AHP for their continuing professional development.
It’s been swallowed up. In Trust training budgets?
Fish it out, make them give it back, use it in an accountable, transparent way, so the individual sees the benefit.
8. Returners.
It’s a horrible labyrinth to get through. Since its launch in 2014, only 8,000 nurses have returned. Twenty a week.
When people come back don’t expect anyone over 50yrs to do 12hr shifts, back to back.
Flexible rotas are part of the answer.
Returners have to fit in with University timetables and terms. Let Trusts organise their own local, return packages. Dump the Uni’s, give the money to the Trusts.
Any organisation that’s losing 400, trained people a week, with a fall in recruitment, is in trouble.
Time is what we don’t have. Keeping people is quicker and achievable.
Barclay or his successor will have to realise; in most places in England the hospital is the biggest local employer.
If they can’t be the best employer, what are they?
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
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