No-one is more on the frontline in the National Health Service than nurses, and 70 years on from its formation they are facing unprecedented challenges, says Glenn Turp.

NURSING in 2018 offers a diverse and varied professional career with those in senior positions having opportunities to inform policy and governance at every level of the NHS and beyond.

If recalling a famous nurse from history most people will think of Florence Nightingale or Mary Seacole in their starched uniforms, looking stern, listening to the doctors they worked for and helping patients to take their medicine.

Today becoming a nurse can involve high levels of decision-making, running a nurse-led clinic or taking on an executive position in a large hospital trust that employs several thousand people. Career development can take someone down a clinical, research, education or management role.

Nurses don’t just work in hospitals either. There are opportunities to work in GP surgeries, clinics, nursing and residential homes, community and voluntary organisations, occupational health, the pharmaceutical industry, or in the military. Nursing also requires a high level of training, technical competence and clinical decision-making skills.

In 1948 – the year the NHS was born – things were a little bit different and the route into nursing simply involved a twelve-week period of study and practice while based in a nurses’ home at one of the newly publicly-funded NHS hospitals.

Then and now, however, the basic foundations of nursing practice haven’t changed – patient care will always be at the heart of our role with all those who come into the profession requiring dedication, compassion and competence.

Royal College of Nursing members working in today’s NHS face unprecedented challenges in terms of demand, with a rising and ageing population and an increasing requirement from those who hold the purse strings to keep costs down. At the same time cuts to nurse training places, changes to the student bursary and poor pay have discouraged the next generation of nurses. As a consequence, the NHS has a chronic recruitment and retention problem.

According to official figures, the number of registered nurses and midwives in the NHS in the North-East dropped from 22,265 in 2014 to 21,979 in 2017, whilst fewer EU nurses are coming to this country to work.

So, the RCN is proud to have led last year’s campaign to remove the damaging one per cent pay cap on public sector workers. This had been imposed as part of austerity measures and was leading our members into desperate financial situations, as well as increasing a feeling that they were being undervalued and ignored. Now all staff working for the NHS will see an increase in their pay from July onwards. It’s a small step, but a positive one that we hope will be the first of many small steps towards better pay.

In May of this year we published our report into NHS staffing ‘Staffing for Safe and Effective Care: Nursing on the Brink’ highlighting that staff shortages are now threatening the quality of patient care. Following Wales’ success in implementing legislation to set safe staffing levels we will now be pushing for something similar to happen in the remaining parts of the UK. The evidence is clear – without the right levels of suitably qualified staff, patient care suffers and can even become unsafe.

Theresa May has announced a welcome 3.4 per cent increase in funding for the health service, but if we genuinely want to protect the NHS and transform it so it is fit for the 21st century there must be much more to come.

This increase fails to consider the swingeing cuts that have been made across all health sectors since 2010 and does not acknowledge the fact that public health budgets have been transferred to local authorities and so are no longer included in NHS budgeting.

We now need to see some of the rhetoric around joined up services across health and social care being genuinely put into practice, with areas like public health and staff training and recruitment also being properly funded for the long term.

When they first drew up the National Health Service Bill Aneurin Bevan and his Government could not possibly have foreseen the massive leaps in health care technology and public health awareness that would take place in the following decades. The basic principles of Bevan’s creation, to provide health care that is free at the point of use to all, regardless of ability to pay, is one that is embedded in RCN thinking and one that our members will continue to defend for the next 70 years and beyond.

  • Glenn Turp is regional director of RCN Northern and Yorkshire