In 2018, it could not have gone unnoticed that the NHS reached its 70th birthday, an important milestone, some may say it limped its way to its 70th birthday. Our NHS, often seen as a much-loved and ageing aunt with no money in the bank is, we are told, safe with the Government of the day, as the population ages, as I age, I can only hope that this is true.
In January of this year, Jeremy Hunt became theSecretary of State for Health and Social Care bringing the two services closer together amid much political turmoil. The longest ever serving Secretary of State for Health was moved in another cabinet reshuffle mid-year and Matt Hancock took up the mantle of Secretary of State for Health and Social Care.
In England, the government made a decision to stop paying student nurses bursaries. Those commencing a nursing degree no longer receive a bursary and have to pay fees to study, not the case in other UK countries where students still receive the bursary and fees are paid. This has resulted in a number of Universities in England failing to meet their recruitment targets, the effects of which will not be truly felt until three years hence.
The Nursing and Midwifery Council (NMC) became the regulator for nursing associates (NAs), the new health and care role designed to bridge the gap between unregulated health care assistants and registered nurses. The NA it was announced will pay the same registration fee as the Registered Nurse £120.
In August, the Royal College of Nursing’s (RCN) (a trade union and professional body representing over 435, 000 members) General Secretary stepped down as she faced criticism over how the RCN communicated details of the long-awaited pay deal to members. The General Secretary misinformed members telling them they would receive an immediate three per cent pay rise in summer. Despite an apology and admission that the RCN were wrong in thinking that the pay deal was as straightforward as they had said it was prompted members to call for a vote of no confidence. The vote of no confidence was passed, the council of the Royal College of Nursing will officially stand down end of this year.
The NMC Chief Executive also stood down as issues of public protection and the ways in which the NMC manage this again hit the headlines. The resignation came just days before a review of the NMC's handling of midwifery failures at University Hospitals of Morecambe Bay NHS Foundation Trust were published.
The NMC have issued a raft of new standards relating (predominantly) to pre-registration nurse education – the future nurse. These standards detail the proficiencies all nurses must demonstrate to gain entry to the professional register. The first ever NA proficiencies have also been published. The 2008 Code is now replaced by a revised Code applicable to the NA.
In mid 2018, the Prime Minister gave the NHS its 70th birthday present setting out a 5-year NHS funding plan whereby the NHS will receive increased funding of £20.5 billion per year by the end of 5 years. The devil will be in the detail.
In July 2018 it was announced that adolescent boys will be offered the human papilloma virus (HPV) vaccine to protect them from cancer. The vaccine not only protects men from HPV-related diseases, it also helps to reduce the overall number of cervical cancers in women. Why the decision to include boys in the vaccination programme took so long remains a mystery
Once again this year nurses top the list of the UK’s most trusted professions, with the vast majority of the public reporting they have confidence in nurses to tell the truth.
Oh and did I mention Brexit?
As we move into 2019 there will inevitably be much change as result of happenings in 2018. Speculating, as economic markets will attest, can be a dangerous hobby. Nonetheless, looking forward it can be safe to say that there will be change.
The RCN and its functions will need to rearticulated. This will come about as the new council is formulated, and as the new President takes up her position. There has to be a strengthening of the RCN’s function as a professional body and clearer understanding of its trade union role. For sure the RCN must invest in how it communicates with its large and diverse membership.
The NMC will need to gain trust again not only with the public whom it is charged to protect but also among those registrants who pay to be regulated. They must make definitive statement about the role and regulation of the advanced nurse practitioner, the debate has go on for too long and this stifling the true potential of the nurse and the ability to provide even more high quality, safe and effective services.
Will government u-turn on the student bursary? Well that remains to be seen, what they will do, what they will have to do, is to think of other ways of improving the dire state of recruitment into the profession, possibly by increasing the number of the NAs and using the nursing apprenticeships entry route.
In 2019, we will see increased joint working between local providers and commissioners of care. There is already evidence of this happening, ensuring that the patient does not fall between the cracks when transitioning between the complex health and social care systems that the most vulnerable in society often have to navigate.
With a general election looming, our NHS will continue to be used as a political football by politicians who seek political gain. With regards to the NHS there is a need to move from the competitive, combative model of politics to a more collaborative, negotiating style with the patient truly at the heart of all that is done.
As the dust settles on the £20.5 billion increased funding for the service this will come with terms as the strategy for spending this money emerges. Nurses need to be ready to improve productivity and efficiency and with this willcome an impact on service provision and terms and conditions.
England will have new Chief Nursing Officer (CNO) as Jane Cummings announced her retirement after more than six years in the role. As Cummings leaves she has recommended that the CNO should be the executive nurse lead for both NHS England and NHS Improvement as organisations move towards greater alignment, it can only be hoped that these wise words are heeded Oh and did I mention Brexit?