Empower the Nurses to Secure the Future of the NHS
Nurses have played a central role throughout the history of the NHS — at the bedside, in theatre, and in homes and clinics everywhere in the country. Looking back over 70 years we can celebrate many generations of British nurses and, of course, the Windrush generation and successive waves of immigrants who have contributed so much.
Looking forward, I believe nurses will play an even more important role as diseases change and with them our needs and expectations. Empowering nurses will be key to a sustainable, high-quality and caring health system.
We can already see this happening. Nurses often take the lead in managing chronic diseases and play an ever-increasing role in primary care. Many are trained to prescribe or have become specialists. There are now Advanced Nurse Practitioners in almost every area from, for example, infection control and sepsis care to cardiac and palliative care. Some nurses are now included in what were formerly all medical on-call teams. Support from artificial intelligence and other technologies will undoubtedly enable nurses to do even more in the future.
The changes are closely linked to the increase in chronic diseases and the fact that many older people are now living with more than one condition. Doctors, with their education in the bio-medical sciences, led the way in the 20th Century in bringing about remarkable improvements in health and enormous increases in life expectancy. New drugs, new procedures and new technologies have benefitted us all enormously and will continue to do so in the 21st Century.
However, the changes in disease patterns have brought with them the need for a more person centred, holistic view of health that considers psychological, social, and environmental aspects as well as the purely biomedical. Other professions — including, of course, doctors — also take this wider view, but for nurses it is at the centre of their philosophy and their practice. Nurses work with their patients as they manage their diseases and help them to have as full and fulfilling a life as possible, whatever their disease or disability.
While nurses are gradually taking on the leading role in managing chronic diseases they have not yet, in my view, achieved their potential in Public Health. Nurses are generally from the community they serve. They understand it and its culture and norms and are therefore well-placed to work with local people on promotion of health, prevention of disease and increasing health literacy. They can also help identify and address the barriers to health in the local community and advocate for improvement.
These positive developments are not, however, the whole story. Nurses very regularly complain about the pressure of work, poor morale, and poor working conditions and pay. Surveys also reveal frustration that nurses often cannot work at the level they are trained to do — not being given responsibility to work at the top of their licence — and of being taken for granted, “invisible”, and not being listened to.
The developments and problems described here are global which is why the All-Party Parliamentary Group on Global Health set up Nursing Now as a campaign to improve health globally by raising the profile and status of nursing. It was launched in February and has gone viral with campaigns already launched in more than 40 countries — as wide apart as Uganda, Mexico, Malaysia, the Bahamas and Germany. Only last week the Pakistan Health Minister launched the campaign in his country.
Health is, of course, about team work and there are very many groups of health workers that need to be involved in providing for the needs of a country, all of whom have vital roles to play. Nurses, however, make up half the health professional workforce globally and strengthening their role will have enormous direct benefits.
Empowering nurses means building on the remarkable examples that already exist of innovative new nurse-led services, of role development, and close working with patients and the public. There is particular scope for nurses to do even more in primary care and public health — helping us all to stay healthy and to manage our disabilities and limitations.
Empowering nurses also means giving nurses a greater voice in leadership and in the design of services. Policy and planning need far greater nursing input if our services are to reflect the needs for more person-centred, holistic and community based NHS for the future.
Empowering nurses is key to a sustainable, high-quality and caring NHS.