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A plea for evidence based policy

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The DH is to scrap its nursing policy unit The DH will scrap the nursing policy unit

The purpose of the Queen’s Nursing Institute (QNI) is to improve and enhance the care of people in their own homes and communities. We campaign on issues which are relevant to our charitable purpose, we conduct activities which help to deliver our purpose and we always base our work on robust evidence.

However, the recent government decision to implement wholesale changes to nurse education, starting with the September 2017 intakes, is not based on evidence from consultation with all stakeholders.

If there had been prior engagement on the possible options for the future of nurse education and the implications of each – rather than a decision to simply remove the bursary and introduce tuition fees – we may not be where we are now: standing on a precipice looking into the dark chasm of uncertainty below. Nurse education is facing an unknown future, and one which may ultimately lead to the destabilisation of the NHS.

The QNI responded to the Department of Health consultation on the impact of the reforms and we sent an open letter which summarised our main concerns. We have asked for a pause in the process, a proper consultation, consideration of all viable options and the impact of all this on patient safety. We urgently need an exploration of available evidence on the options before a final decision is made.

This is nothing less than what we teach our nursing students: evidence-based practice is knowing and understanding the reasons for the way in which we deliver care. We also need to understand the context in which this momentous change is being implemented – where a potential shortage of student nurses leads to a shortage of registered nurses, compounded by a likely reduction in the number of European nurses working in our NHS.

In September 2017, Health Education England is also withdrawing funding for programmes leading to specialist and advanced nursing qualifications, which includes district nursing, health visiting, school nursing, general practice nursing, independent prescribing, advanced practice and nurse practitioner.

Patient safety is at risk if we cannot guarantee a supply of registered nurses nor those with the appropriate specialist and advanced qualifications to meet patient need. After the nursing unit at the Department of Health is disbanded later this year, who will provide the independent, evidence-based advice to ministers when making decisions on the future of our profession?

Crystal Oldman, chief executive, Queen’s Nursing Institute

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