The new roles introduced into the NHS have diversified care teams but come with their own challenges. The ‘Lessons for changing the mix of professions in NHS services’ report by the Nuffield Trust found that 78% of staff growth in general practice had been through the Additional Roles Reimbursement Scheme (ARRS). The scheme saw the development of new roles such as health practitioner and nursing associate, to diversify the skill-mix of health teams and revolutionise patient care. However, the report also highlights that a lack of capacity to train and mentor these new roles have hindered their effective integration, alongside insufficient managerial support and organised leadership.
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‘This report shows that there are big challenges to overcome in bringing on any new role,’ said Nuffield Trust Senior Policy Fellow Dr Billy Palmer. ‘Ensuring existing staff have time to supervise them, having clarity on the scope of the new role, having the right checks and balances in place if things go wrong, to name a few.’
The discordant integration of these new roles is having a knock-on effect on patient care. Organisations such as the Royal College of Nursing have highlighted the necessity of these new roles for the functioning of the system as they provide the required specialisms to provide care for complex cases. However, they also claim that the lack of training has actually lead to a deterioration in patient care, with corridor care becoming ‘routine,’ said RCN General Secretary and Chief Executive Professor Nicola Ranger.
‘Nursing staff are regularly being asked to carry out tasks and deliver care beyond their competencies, this puts them and their patients at risk,’ she said. ‘Any future plans for the nursing workforce must ensure the right mix of skills to ensure those with complex needs get the care they need and no member of the nursing team is left to carry the weight of failed investment.’