In the balance: lessons for changing the mix of professions in NHS services
This new report from the Nuffield Trust provides some lessons for how new and emerging roles could be better implemented and integrated into the NHS.
Commissioned by NHS Employers, this report looks at the history of how distinct and different roles - including physician associates, nursing associates and advance nurse practitioners - have been brought into the NHS; how the mix of staff skills in the NHS in England compares to that of other countries; and what issues need to be addressed if the government’s plans to expand the workforce and invest in new and emerging roles are to succeed.
The report identifies the recommendations for NHS employers, policymakers and professional groups involved in reshaping the NHS workforce including:
Implementation capacity and support
- Support NHS trusts and integrated care boards to develop strategies to enhance frontline organisational development capacity.
- Develop a strategy around further communicating good practice and lessons on introducing new and emerging roles.
- Revisit the principles, practicalities and impact of salary reimbursement initiatives.
Education and supervision capacity
- Explore what incentives and support are needed to ensure sufficient and fair access to supervision.
- Commission work to explore the capacity implications of the projected expansion of education and training.
Wellbeing
- Develop a research and monitoring strategy around wellbeing of staff in emerging roles (and of their wider team) and ensure clear roles and responsibilities for addressing any shortcomings.
Scope of practice and regulation
- A clear strategy that protects and strengthens the relationship between higher education institutions and health and care providers.
- A clear outline of the governance arrangements for new and emerging roles and/or up to date guidance on the scope and ongoing development of these roles.
- Ensure that any job adverts and role descriptions are appropriately aligned to any updated guidelines.
- More independent research – underpinned by appropriate access to relevant data – on the impact of different staffing mixes on patient outcomes.
- Ensure that the regulatory framework for key new and emerging roles is future proofed, UK-wide, part of a wider strategy, sufficiently consistent between professions and conscious of any unintended consequences.
Public and patient awareness
- Monitor public and patient understanding of different roles involved in delivering frontline care and, where necessary, use communications campaign programmes to improve public recognition and understanding.
