FACING THE FUTURE
Nursing and Midwifery Recruitment and Retention
Issue 2 January 2003
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Welcome to the second in a series of newsletters designed for Nurses and Midwives, whether in training or in practice. These newsletters aim to keep you updated on the progress made on the various initiatives under the banner of Facing the Future.
What's in this Newsletter?
What is Facing the Future? - a refresher
One Year On
Update on the Regional Workforce Conventions
Updates on the key issues under FtF
What is Facing the Future?
The Scottish Executive is committed to improving the current position on the recruitment and Retention of Nurses and Midwives across Scotland.
Facing the Future is the banner under which a range of initiatives are being progressed to ensure that a modern Health Service in Scotland has the right quality and quantity of Nurses and Midwives to meet the growing demands of local communities for now and in the future.
Success will only be achieved in partnership on a multi- disciplinary and multi-professional basis. The Facing the Future Group is Chaired by the Minister for Health and Community Care and is charged with overseeing the realisation of the goals and objectives set out in the Facing the Future Action Plan.
The National Facing the Future Convention, held on 19th November 2001, was followed by a number of regional conventions held to facilitate discussion about the current issues and to allow delegates to feed local views into the national debate for the nursing and midwifery workforce.
The key themes that emerged from all of these conventions are as follows:
Updates on these themes, as well as other issues of interest, are included in this newsletter.
One Year On
Mr Malcolm Chisholm, Minister for Health and Community Care, gave the opening address at the "Celebrating Best Practice" event on 19th November 2002 at Westpark Conference Centre, Dundee. There he took the opportunity to meet a number of nurses who had taken part in initiatives arising from the National Facing the Future Convention held in 2001.
Speaking at the Event, Mr Chisholm said, "I am really pleased to be with you to open the conference on celebrating best practice. There is much to celebrate and value in what you do and the difference you make to patients and families."
Mr Chisholm went on to inform the delegates of the progress made under the banner of Facing the Future. "Since the first national convention on nursing recruitment and retention in November last year, we have provided additional funding of 1.5 million to create an extra 250 student nurse places this academic year."
"In July, we announced an additional 1.75 million for continuing professional development for nurses and midwives. This extra investment is already enabling staff to benefit from educational courses, which support the sharing of good practice, development of overall skills, increased opportunities for mentorship and effectively improve the overall standards of care offered to patients.
"Other developments this year include a 1 million investment announced last month to fund Return to Practice for nurses and midwives throughout NHSScotland during the next two years. This is already encouraging staff who have left the service for personal or domestic reasons, to return to the NHS. We have also made available 380,000 in funding for the RCN Leadership Programme." The Minister also added, "As part of a commitment that from September this year (2002) all newly-qualified nurses and midwives will be given at least a year's employment in NHSScotland."
However, the Minister warned of complacency. "The challenge now is to build on these developments and come up with innovative solutions to address two further areas which I know staff are concerned about. Their overall workload and the need for more flexible working arrangements to enable them to balance their work and family life. We are determined to step up our efforts on these two issues and will be working closely with the Health Department's new Centre for Change and Innovation on this."
In closing the Minister added, "Only through partnership with staff and their representatives - a partnership approach which lay at the heart of the Facing the Future Action Plan - can we ensure that our aims to address recruitment and retention in NHSScotland are achieved in both the short and longer term. And that we create a strengthened NHSScotland workforce which will benefit staff and patients alike."
Case StudiesMr Chisholm met with a number of nurses representing both Primary and Acute services. The following are some of the case studies from the event. Additional 250 Students in Training Lisa McBay, Student Nurse, Adult Branch, October 2002, University of Dundee.
Reasons for coming into nursing: "Offers good career options. Challenging, exciting and I enjoy working with people." 6 Mairead McEnvoy, Student Nurse, Adult Branch, October 2002, University of Dundee.
Reasons for coming into nursing: "I have always wanted to be a nurse, as I believe it suits my personality. Nursing is what I see myself doing and being happy while doing it." 6 Gilread Wallace, Student Nurse, Adult Branch, October 2002, University of Dundee.
Reasons for coming into nursing: "I wanted a career with job prospects so I can support my son. Plus you get the job satisfaction of knowing that you've made a difference to someone's life." Leadership Alison Struthers: BSc Nursing, RN, RM. Alison Struthers is a Midwife of 15 years' experience, currently working as a Ward Manager of a mixed ante and post-natal ward in Aberdeen Maternity Hospital. As part of the ongoing development, she participated in the RCN Leadership programme based in Grampian. From this came the opportunity to be part of the Facing the Future Implementation Groups at both national and Grampian levels, giving her a broad perspective on issues surrounding the recruitment, retention and development of staff.
As a Ward Manager, she supports newly-qualified nurses on a regular basis and has recently benefited from three such appointments. She has played a full part in ensuring that newly-qualified staff have a smooth transition from student to newly-qualified status. This entails discussing with her manager the future needs of the ward both in terms of care and staffing requirements so as to plan ahead and give students the certainty of employment on completion of their studies. Margaret Mitchell: RGN, EN, BSc Nursing, Senior Charge Nurse Acute Stroke and General Medicine Ward. "The leadership programme has provided me with appropriate skills to transform a group of staff into a 'team'. I firmly believe that as a Senior Charge Nurse, I have the ability to influence how patient care is delivered. This course has enabled me to recognise how to develop a team to provide patient-focused care. Observations of care provided an avenue to request structural changes within the ward to provide better storage space, resulting in a less cluttered, safer environment. They have also challenged the team to look at patients' meal times and how we can ensure staff are not interrupted when feeding patients. "I am hoping to pilot a scheme where an answer phone is used during mealtimes. This work is progressing. Patient stories have informed us as to what they require from a Stroke service. This will assist us to work in partnership with patients to ensure that they are included in our vision for developing a Stroke Unit. We have already divided the nursing team into two teams, one stroke and one general team. This is providing continuity of care which was requested in patient stories." |
One-Year Guarantee
Coral Forgie: Staff Midwife, Aberdeen Maternity Hospital.
Coral describes herself as a wife, mother of four daughters and "Nan" to one granddaughter. She is a newly-qualified Midwife, having completed the Pre Registration Shortened Midwifery Programme at Robert Gordon University, Aberdeen at the end of September 2002. She has now commenced her first Midwifery post in Aberdeen University where she has commenced the E grade development programme with her first placement in an antenatal ward. Within the year she will also have placements in a Labour Suite and the Neonatal Unit and during this year her knowledge, skills and confidence will grow in a supportive environment. Because of her obvious family commitments, she has chosen to work on a part-time basis, four days per week.
Continuing Professional Development (CPD)
Gail Fyffe, Senior Staff Nurse, Directorate of Surgical Oncology.
Example of CPD -
6 Undertook BSc in Cancer Nursing and Palliative Care
6 Fitness for Practice (Cytotoxic) Module
6 Four Chemotherapy study days
6 Part of working group developing trust policy on complimentary therapies
6 Preceptorship Preparation Programme
Impact of CPD -
6 "I feel I have an in-depth knowledge of cancer and its effects on patients. I am able to answer questions asked by patients regarding related symptoms, side effects of chemotherapy and other drugs. I have become more aware of the impact that cancer has on patients and their families, and feel better equipped to give psychological support as well as therapeutic nursing care."
David Benton: BSc, MPhil, RGN, RMN, Director Of Nursing.
As part of work on developing a local nursing and midwifery strategy for the whole of NHS Grampian encompassing contributions from the two trusts and both university providers, it was identified that staff were enthusiastic about steering and driving practice and service change. They felt that to be successful, they would require some additional knowledge and skills alongside support. Discussion with Dr Alice Kiger commenced to see if we could build on an already established model of using evidence in practice. A new learning module will give staff:
the necessary skills and knowledge
support them through tackling a real practice or service change that they wish to pursue
will provide if staff wish academic recognition which they can then link to other modules for either a post-graduate certificate, diploma or masters degree.
The module will be co-led by Dr Kiger and David Benton reinforcing the link between service and education.
This approach offers flexibility of delivery and much relevance to the service and practice change agenda within NHS Grampian. Whilst targeted initially at nursing and midwifery staff, the design and content is such that all those who wish to lead service or practice change can undertake this learning experience.
Return to Practice
Gerry Cahill, Staff Nurse, Medical Ward, Ninewells Hospital.
"I attended the Return to Nursing Practice Course at Ninewells Hospital, Dundee, working on wards 2 and 11, gaining experience in Medical and Surgical Nursing. I was given every opportunity and was encouraged by the staff to bring my inherent nursing skills up to speed and I learned many new techniques, e.g. using the latest infusion and monitoring equipment. The course was extremely well prepared and intensive, it lasted 60 days, i.e. eight days in class, seven study days and 45 days on the wards. Without this course, I doubt if I could have built up my skills or confidence in such a well structured and timely manner.
"I was unemployed at the time and wanted to return to nursing but I knew that without training and updating my skills, I would realistically be unable to do this. I discussed the possibility at the Job Centre and we made enquiries. After interview I was accepted for the Return to Nursing Practice course. There was no funding mentioned at that time but once the course began, we made enquiries to the Scottish Executive as to the possibility of funding or reimbursement and were told that we would hear about this in the very near future. We were all awarded funding by the Executive, but none was received by any of us until after the course had been completed. The funding is an absolute necessity although it was not the deciding factor for me returning to nursing."
Regional Workforce Conventions It is widely accepted that tackling "Workforce Development" is crucial to securing the future workforce for the NHS in Scotland. Not only that, but it is integral to the successful reform of health services in Scotland as well as to improving patient care. To help move this agenda forward, three regional workforce conventions were held during November and December and were designed around the regional service planning boundaries as follows: South East Regional Convention - Edinburgh, 20th November 2002 North Regional Convention - Aberdeen, 5th December 2002 West Regional Convention - Glasgow, 10th December 2002
Key speakers at these conventions included Malcolm Chisholm, Minister for Health and Community Care; David Robb, Head of the National Workforce Unit; June Andrews, Head of the Centre for Change and Innovation, as well as the Chairs of the Regional Service Planning Groups. These conventions offered key stakeholders the opportunity to contribute to the workforce programme in their own area, as well as to explore how the new workforce development arrangements may operate in practice. All three events were received enthusiastically and the next steps are to begin to put into action some of the identified workforce priorities. This will require the commitment and engagement of key stakeholders in order to develop meaningful workforce plans that further this whole agenda at a local, regional and national level. www.show.scot.nhs.uk/sehd/workforcedevelopment |
Website
The website will include updates on the eight key themes identified under the Facing the Future Agenda. It will also contain a summary of all the key action points taken from various regional conventions along with those identified from the national convention.
Facing the Future website: www.show.scot.nhs.uk/sehd/facingthefuture/
These will be regularly updated as the Facing the Future Agenda is developed.
Flexibility
June Andrews has been appointed Head of the Centre for Change & Innovation (CCI). The whole issue of flexibility will now be taken forward as part of the CCI allowing June to make a reality of the Flexibility agenda.
To date, a multi-disciplinary subgroup, led by June, has met to consider a possible approach to a nationally-supported programme of development on flexible working. A Project Implementation Plan will be developed and presented to the next Facing the Future Group Meeting on 17th January 2003.
Research & Evaluation
The Scottish Executive is committed to commissioning integrated research into issues such as workforce numbers, workload, quality of nurse training entry and factors that encourage staff to return to practice. With the departure of Maggie Boyle from NHSScotland, Mr Gerry Marr, Chief Executive, Tayside University Hospitals NHS Trust, has agreed to chair this activity. A small subgroup has been set up to scope and develop a work programme, taking into consideration a number of national and international studies on related subjects. To date, an Action Plan for Research and Evaluation has been drafted, and this will be taken forward under the leadership of Gerry Marr.
Healthcare Students
Current Recommendations are to develop a more innovative scheme than traditional Nurse Cadet Schemes under the name, Healthcare Students. This is being led by Rosslyn Crocket, DNS, Greater Glasgow Primary Care NHS Trust. Such a proposal would allow the following to take place:
Increased opportunities for existing staff to fast track schemes, e.g. HNC allows direct access to year 2 nurse training.
Map SVQ level 3 competencies against those of HNC, to consider bridging needs that allow for "top ups" to HNC level and direct entry to year 2 training.
Work with "Job Centre Plus" to attract additional support workers into the healthcare system.
Fill 50% of vacancies made possible as a result of staff moving into HNC schemes, from areas of social exclusion and New Deal projects.
Continue to work in partnership with HEIs, FEIs, Trusts, etc.
The benefits of such a proposal is that it demonstrates commitment to staff, encourages overall recruitment by providing real career pathways, facilitates targeted NHS recruitment in areas of social exclusion thereby helping to develop a workforce more representative of the communities they serve. In addition, partnerships with current holders of training programmes will be explored further, e.g. Bursaries.
FtF Action Plan
An updated Action Plan from the FtF Convention on 19th November 2001 Convention incorporating actions from all six local conventions is being developed. This will track progress already made as well as highlight those actions that remain outstanding and require immediate allocation. The action plan will be posted on the website.
Leadership
As one of the eight key themes, this commits to developing 1000 clinical leaders across Scotland, 500 via the RCN Programme. Between March 2001 and November 2002, 1400 nurses have attended a leadership development programme, 240 of which attended the RCN Leadership Development Programme.
New Nursing Roles
Pat Dawson, RCN, continues to lead this work on behalf of the FtF Group with a small subgroup set up to help further this agenda, reporting back into the FtF Group for reference purposes. It is proposed to hold a "Consensus Conference" in late 2003 to agree a national framework for new nursing roles.Updates will be given regularly.
Working Conditions and Tools for the Job
Every nurse will have access to IM&T in the workplace. The Executive has visited all NHS Boards in Scotland to raise awareness as well as to gain commitment to the above agenda.
"Budgetscan" is now being piloted within 17 NHS Trusts in Scotland. This system allows for PCs to be made available in ward areas to support nurse rostering. These come with an overall "standard" package which allows access to a range of software programmes as well as access to the internet.
To date, 5000 European Computer Driving Licence places (ECDLs) have been distributed across Scotland with a further 5000 to follow. This training allows a standard of basic transferable computer skills to be developed by the individual.
Employment Packages
UK talks on a modernised pay system (Agenda for Change) were successfully concluded in November 2002. The proposals are now subject to consultation but if accepted will provide the opportunity to reward nurses fairly according to the contribution they make.
Education & Training
1.75 million of additional monies have been made available to support Continuing Professional Development (CPD) for nurses and midwives. This is additional to the money already set aside for CPD by individual trusts. This money has been distributed across all NHS employers in Scotland.
1.5 million has been provided to create an extra 250 student nurse places this financial year
Return to Practice
1 million has been allocated to fund Return to Practice (RtP) for nurses and midwives across NHSScotland for the next two years. The funding for each individual for a RtP programme is linked to an offer of employment in NHSScotland, either in a permanent post or on the nursing bank with regular hours of work required. Up to 1500 funding will be available for each successful returner. As of November, 140 of the 150 places, to be allocated by March, have been taken up
What's Next?
6 Flexibility
6 Research & Evaluation
6 CPD funding feedback
For further information on any of the initiatives within Facing the Future, please contact:
Neil Wilson
National Workforce Unit
Ground Floor Rear
St Andrew's House
Regent Road
Edinburgh
EH1 3DG