Shaping the future nursing workforce - Professor Lisa Bayliss-Pratt

On 3 May, I was delighted to lead HEE’s second Thought Leadership Lecture, Shaping the nursing and care workforce for the future, in partnership with the Nursing and Midwifery Council (NMC).

Attended by a range of stakeholders including senior nursing leaders, commissioners, educators, grassroots staff and educators, the purpose of the event was to enable delegates to think positively about the future of the nursing and care workforce – while acknowledging that things need to change. Yes, we need to protect what we value across the nursing and care profession, but we also need to collectively agree that we can’t always hold on to what we have done in the past – change is inevitable.

As a registered nurse I have had the privilege of working at a local, regional and national level and I’ve always felt honoured to have been given the opportunity to serve patients, communities and populations – as a frontline staff nurse, educator, advocate, researcher and improver and 'system navigator'. Looking back over my career to date, it's clear to me that the profession of nursing has given me many opportunities to work with many fantastic people. Howeer, there is no doubt that one of my proudest achievements is the co-sponsoring the national review of the education and training of the nursing and care workforce with the NMC - the Shape of Caring review, ably led by the inspirational peer Lord Willis of Knaresborough.

To quote Lord Willis: "the education of our nursing and care workforce over the next ten years will determine the strength of our healthcare system for decades". We really are at a pivotal point in determining what the future workforce will look like, and there are some key questions we all need to ask ourselves honestly. How proactive will the nursing profession be in rising to the challenges? Will the profession take the opportunity to shape its own future? Things will only get better if those who work and lead nursing and care are willing to shape their own future – as the review makes clear, the transition to a truly innovative health and care system will never be achieved without a paradigm shift. We must grasp this opportunity – we owe it to the patients we serve now and in the future.

The growing need for change in the system of care

So, did I 'rock the boat' in driving this national review? From my perspective, the boat had already been 'rocked'. Against the backdrop of the tragedies at Mid-Staffordshire and the knowledge that healthcare systems are facing unprecedented challenges – new technology, pharmaceutical advances, genetic engineering – all of which will require us to develop new ways of working with an ageing population that will have more complex needs and greater expectations of what the care system should deliver for them.

I strongly believe that we need change; we need to change how we educate and train our nursing and care workforce; and we need to change the very premise of nursing and care – we can’t go on asking a patient ‘What’s the matter?’ without also asking ‘What matters to you?’. Rightly, we should 'co-produce' care with patients, rather than tell them what we are doing to them.

Of course one of the key recommendations in the Shape of Caring review is the creation of a new nursing role. This, as Lord Willis made clear, is neither a panacea for future workforce supply, nor is it a substitute for increasing the supply of graduate registered nurses. If we take forward this new nursing role (our consultation response is currently awaiting publication), then what opportunities would this offer our graduate nurses? Would it help us to retain them for longer? Is the advanced practice of today going to become the standard practice of tomorrow and is it therefore time that we encouraged more people to work at the edge of the scope of practice? If so, what should the content of the future curricula look like? This is all food for thought.

These thought-provoking questions demonstrate we are on the frontier of interesting and exciting times, but if we create a new role, we need to get it right. That’s why I’m creating an international community of practice to shed light on how intermediate nursing roles can be developed improve patient care without compromising on our graduate workforce. If you would like to join this community, please get in contact with my office at charlotte.reyner@hee.nhs.uk.

I’d like to close this blog by paying tribute to Lord Willis of Knaresborough and Jackie Smith, CEO and Registrar of the NMC. These dynamic, forward-thinking leaders made the Shape of Caring review gain pace and traction across England and beyond. Without their backing it would be quite possible to imagine that the review could have stopped in its tracks.

About the author

Professor Lisa Bayliss-Pratt was appointed as Director of Nursing at HEE in 2012 and in this role she is responsible for leading national policy, workforce planning, and multi-professional education and training commissioning for the non-medical healthcare workforce. She includes in her remit the role of Deputy Director of Education and Quality. Key achievements include establishing the Shape of Caring review, development and piloting of pre-degree care experience for aspirant nurses and leading the ‘return to practice’ initiative. Lisa’s work also includes the creation of a three tiered dementia education and training framework which enabled HEE to achieve one of its Government Mandate requirements demonstrating that 100,000 NHS personnel had received dementia awareness training. Lisa also led the development of the ‘Fundamentals of Care’ certificate for support/care workers across health and social care in England.