MR 05

Ymchwiliad i recriwtio meddygol

Inquiry into medical recruitment

Ymateb gan: Coleg Nyrsio Brenhinol Cymru

Response from: Royal College of Nursing Wales

Dai Lloyd AM

Chair of Health, Social Care & Sport Committee

National Assembly for Wales

Tŷ Hywel

Cardiff Bay

CF99 1NA

Dear Dr Dai Lloyd,

We are very grateful for the opportunity to contribute to the Health, Social Care & Sport Committee’s current inquiry into medical recruitment.

As outlined in previous evidence submitted to the Committee, the Royal College of Nursing Wales believes that it is important to consider wider workforce issues, and not to focus solely on medical recruitment. Nevertheless, we fully recognise that medical recruitment is a key vulnerability in the healthcare system and one that needs addressing urgently in order to improve patient care. We are therefore very supportive of any measures being taken to find solutions for the benefit of patients.

The Committee has asked for comment on a variety of specific issues, not all of which we have chosen to address directly. We do however have some general comments, and these are outlined in our response attached.

Please do not hesitate to get in touch if you would like any further information.

Yours sincerely,

TINA DONNELLY

DIRECTOR, RCN WALES 1

Response from the Royal College of Nursing Wales to the Health, Social Care & Sport Committee’s Inquiry into Medical Recruitment

I. As outlined in previous evidence submitted to the Committee, the Royal College of Nursing Wales believes that it is important to consider wider workforce issues, and not to focus solely on medical recruitment. Nevertheless, we fully recognise that medical recruitment is a key vulnerability in the healthcare system and one that needs addressing urgently in order to improve patient care. We are therefore very supportive of any measures being taken to find solutions for the benefit of patients.

II. The medical workforce in Wales operates as part of a multidisciplinary team which includes a full range of healthcare professionals. In this way, the medical workforce and medical recruitment cannot and should not be considered in isolation from the rest of the workforce. It is increasingly important to fully understand the way in which development within one healthcare profession impacts on others and the system overall. This will require a different approach regarding workforce planning and a shift towards a more holistic, multi-professional workforce planning system. It could be argued for instance that the Physician Associate role was introduced in Wales before an all Wales perspective from the wider workforce had been established, even though these roles will have an impact not only on physicians themselves but their colleagues and patients across the healthcare system.

III. The interdependence of the different healthcare professionals and sectors within the healthcare system means that any shortages or issues in recruitment have implications not only on the directly affected workforce, but on the workload of other professionals and across the whole healthcare system.

IV. The Royal College of Nursing Wales has expressed our concerns previously around workforce planning for nursing in Wales, with particular concerns regarding the number of district nurses, children’s nurses and the recruitment crisis in nursing in the care home sector. This is of relevance to medical recruitment because, inevitably, a shortage of nurses within the community and independent sectors will cause hospital admission to rise, and increase the work demand on medical practitioners.

V. RCN members are reporting that nursing shortages within the care home sector are beginning to negatively affect patient care. Patient outcomes and safety will be adversely affected without adequate nursing care provided by registered nurses, and this will inevitably result in more patients being admitted into hospital, additional demand for GP visits to care homes, and additional pressure being put on the medical workforce and the system as a whole.

VI. Also of relevance to this inquiry is the issue of access to primary care and the primary care skill set. We know that it is important that people are able to be seen, treated and advised on minor illnesses within their own communities. Not only does this mean people being treated more quickly and efficiently, it also avoids unnecessarily impacting on the acute sector.

VII. The RCN in Wales has long been calling for more innovative ways of supplementing the system of primary care, using advanced nursing skills and extended nursing skills (for example prescribing) and using salaried medical practitioners. It is vital that healthcare professionals working within the primary care and community sectors are being adequately skilled up and are employed in sufficient numbers in order to prevent pressure on the A&E admission route and the wider healthcare system.

VIII. In relation to Brexit, depending on the settlement that the UK negotiates with the EU post-Brexit, it is likely to have an impact on international recruitment, both in the NHS and the independent sector. Brexit is also likely to have an impact on access to research funding. Pan European collaboration has contributed significantly to the success of UK science and research, and continued access to sustainable financial support for world-class infrastructure and facilities are essential for UK medical and health research.

About the Royal College of Nursing

The RCN is the world’s largest professional union of nurses, representing over 430,000 nurses, midwives, health visitors and nursing students, including over 25,000 members in Wales. The majority of RCN members work in the NHS with around a quarter working in the independent sector. The RCN works locally, nationally and internationally to promote standards of care and the interests of patients and nurses, and of nursing as a profession. The RCN is a UK-wide organisation, with its own National Boards for Wales, Scotland and Northern Ireland. The RCN is a major contributor to nursing practice, standards of care, and public policy as it affects health and nursing. The RCN represents nurses and nursing, promotes excellence in practice and shapes health policies.