You might not even have heard Ben Gummer’s voice yet, but you will certainly be familiar with the changes to nursing he is at the heart of. Since taking over the role of health minister with responsibility for nursing and midwifery in 2015, his personal approach has been low-key at a time of change for the profession.
Already he has overseen the introduction of nursing associates and nursing apprenticeships. Incoming challenges include the controversial abolition of student nurse bursaries and the start of mandatory revalidation for nurses.
The son of former Tory minister John Selwyn Gummer, his critics argue that he finds himself in a similar predicament to his father, after his infamous burger-munching stunt during the BSE crisis. Has this rising star bitten off more than he can chew?
Revalidation
But the minister Independent Nurse encounters, seems unphased by the challenge, with a no-drama approach at odds – perhaps, for some people, refreshingly – with the heated tone of the current debate over health.
We begin by referencing our survey on revalidation which found that 20% of nurses questioned would rather retire than go through the process. When these statistics were presented to the minister he answered that nurses should welcome revalidation.
‘For a profession which prides itself on training and on the high standards of quality and care which the nursing profession does, revalidation is an opportunity rather than a threat which is precisely why the RCN and the RCM support it,’ he says.
When asked whether he thought revalidation caters sufficiently to primary care nurses, he pauses before answering. ‘In its technical sense revalidation is a matter for the regulators and I think it broadly has been welcomed across the service.’
He acknowledges that there are reservations about particular parts of the process, but he believes that widespread support and continued conversation and development will be needed to get revalidation right.
However, these statistics shine a light on the wider problem of low morale,which is leading many nurses to exit the profession early.
Mr Gummer said that the question of NHS staff morale was one that ‘ministers are challenged with and they have done for decades’.
He says that he takes comfort in the annual NHS staff survey which shows overall levels of engagement in the service are going up and people are feeling more valued based on a number of different metrics. That’s not to say that he doesn’t acknowledge that there are problems in the service, but he sees them as internal rather than policy-related.
‘Bullying and harassment is one of the biggest single components on why people might feel like they don’t want to go to work,’ he says. Mr Gummer assures us that he is working hard with partners in the trade unions and the rest of social partnership forum to tackle this culture.
Student nurse bursaries
There is no question that the student nurse bursary debate has provoked outrage among the nursing profession.
However, Mr Gummer prefers to focus on how he was ‘encouraged by the open mindedness’ from organisations and healthcare partners towards the proposal.
He says that he did take into account the views that many frontline nurses expressed that it wasn’t a good idea but that he was following a series of imperatives that would reflect what nurses and nursing leaders would want to see happening in nursing.
This includes recruiting extra nurses (the figure being touted at the moment is 10,000 more) and better quality in training. ‘We can’t possibly expand numbers to the degree that we or the service or the nurses want without reform of student finance so that has to be part of the package,’ he says.
But training 10,000 extra students would surely put a strain on an already pressurised workforce? Mr Gummer says that it will be down to universities and NHS providers to work as part of their local health economy to secure extra placements for the additional students.
Concern has also been raised that with the incoming retirement bulge in nursing, and the influx of newer nurses, some of the expertise from senior nurses will be lost. Mr Gummer acknowledges that senior nurses are an integral part of the NHS workforce. Due to this there has been an investment of £40million in leadership training to create a new generation of senior nurses as well as a campaign to get experienced nurses, who have left the profession back to return to practice.
Nursing Associates
Not only are there plans to increase the workforce through the removal of the student nurse bursary also to introduce a new layer to the nursing workforce in the form of ‘nursing associates’.
Nursing associates will ‘bridge the gap’ between nurses and healthcare assistants. As yet there are no clear cut plans on how the nursing associate role will slot into primary care but Mr Gummer states that those discrepancies will be ironed out in the consultation.
Nursing leaders have raised concerns about introducing a new level of nurses when parts of the workforce, such as advanced nurse practitioners, feel they are not being supported. Crystal Oldman, the chief executive of the Queen’s Nursing Institute (QNI), called it ‘perplexing’ to suggest another role to support nurses.
But Mr Gummer says that there was widespread demand for the role, not just from academics but from the nursing service itself. Mr Gummer says that he has had conversations with frontline nurses who have been excited at the prospect of a new role.
‘First of all it will add an additional element to the skills mix available to nurse teams and care teams and the second is the promise it gives for career progression for people who might otherwise have not had their careers progress,’ he says. ‘That’s why I think this is a terrific opportunity and one I’m very excited about.’
In relation to the introduction of nursing associates is the creation of nursing apprenticeships. The minister says that the government is committed to introducing 100,000 in the NHS by 2020 covering a whole range of professions from clinical roles to business administration, digital, catering and facilities.
The Nurse Trailblazer group (made up from employers in the health and social care sector and the Nursing and Midwifery Council) continues to work to develop a Higher Degree Level Nurse Apprenticeship standard.
Once finalised the Nursing and Midwifery Council will need to approve the apprenticeship to ensure it meets their standards as the regulator.
It is also important that this work aligns to the outcome of Health Education England’s consultation on nursing associates. Mr Gummer may have a technocratic line in health, but at a time when the Secretary of State seems ever more at odds with the medical profession, this may not be a bad thing. Come this summer’s reshuffle this could be the new style.