The NHS 10 Year Plan - Nightingale’s Take
The NHS 10 year plan has just been announced to much fanfare and back-slapping, but how much substance and sustainability lies behind the shiny promises?
For the uninitiated, Theresa May launched the Government’s 10 year plan last week and grabbed headlines over more patient care taking place at home. Patients can also expect GP and outpatient consultations by screen by 2024, earlier cancer detection, more mental health support and resources for young people and an NHS remit for tackling issues such as smoking, drinking and obesity.
So far, so good. One particularly impressive detail is the pledge to follow up every diagnosis of cancer in a child with detailed DNA screening so that medical professionals are armed with the most relevant information possible before making decisions on treatment - certainly a great idea, with real potential impact for young cancer patients and their families.
But amidst all of these grand plans there’s one sticky issue which refuses to be swept under the carpet: staffing. The Government and the NHS have committed to training more medical professionals, but 100,000 NHS vacancies suggest - *understatement incoming!* - they’re starting on the backfoot.
The plan acknowledges the scale of the challenge. By targeting international nurses the NHS can “increase nurse supplies by several thousand each year”, or so says the plan. But this is still problematic: aside from the ethical issues (what might the impact be on the health services in developing countries if Britain makes a point of poaching a significant percentage of their most skilled workers?), relying on nurses from overseas also contradicts a recent Government declaration that the NHS is aiming for staffing self-sufficiency within two years.
Speaking frankly, the NHS is at a tipping point. Staffing shortages have reached a critical level and international recruitment can only and should only ever be viewed as a short-term solution while we work on delivering a more sustainable approach.
There’s also the impact of Brexit to consider. Numbers of nurses from the European Economic Area working in the NHS were down by 3,000 in 2018, with the collapse presumably due in part to the delays in reassuring European NHS workers about their future in Britain post-Brexit. Even now, with Britain’s exit from Europe just weeks away, there’s very little clarity about how difficult it will be to recruit medical staff from outside Britain after 29th Match 2019.
The Government, it seems, is listening to the fact that Britain needs to produce more of its own nurses and doctors - well, sort of. Contained within Theresa May’s shiny NHS package are plans for a new online nursing degree which will cost far less than the £9250 a year charged by many institutions. Lest we forget, a significant factor in the NHS staffing situation was when many young potential medicine and nursing applicants voted with their feet after the scrapping of NHS bursaries. But there are concerns that an online degree option might be too little, too late for an organisation that has been underfunded and overstretched for so long.
Like Brexit, it seems we’re going to have to wait and see. Without the numbers of experienced and skilled staff this 10 year plan relies on for implementation, however, one thing is certain: the whole thing will fall flat on its face.
Our prescription? Recruitment, training and retention of quality staff first, shiny promises second.
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