The machinations on The Apprentice have drawn the unique values of the NHS into sharp relief for Dean Royles
The government has just issued the mandate for the recently created body Health Education England. It seems this will be a mechanism used to drive change in the new NHS system.
The mandate aims to outline the strategic objectives for workforce planning, health education and training and development.
Many will argue the mandate should have included a national ratio of ‘nurses to patients’ but I'm not a fan. Now, just because I'm not in favour of nationally set nurse ratios, it doesn't mean I'm in favour of poor staffing levels - in fact the opposite is true. The right number of staff is absolutely central to patient safety. As is transparency about staffing levels. But I believe the best place to make that decision is at the local level, where local clinical managers know and understand the acuity and dependency of patients, use recognised models and tools to determine safe levels and publish their results.
I don't want a national ratio to get in the way of good multidisciplinary care - so the right number of nurses, absolutely, but also the right number of physios, occupational therapists, speech therapists, dieticians etc. They too make a fantastic contribution to patient care. Let’s not let a national target, set in a cash-strapped environment, be the enemy of the right team in the right setting.
We know that ratios for one group or in one setting would change recruitment patterns for others, detrimentally.
But it's not just about numbers is it? It's about staff with the right skills, training and values working in the right culture to build on and enhance the education and training they have received.
The unique values of the NHS have been drawn into stark relief for me recently. Does anyone watch The Apprentice? Did anyone spot it's on at the same time as Keep Britain Alive: One day in the NHS? What a stark contrast.
For example:
- in The Apprentice, working life is depicted as a game with the aim of personal reward...
- in the NHS working life is about caring for people at their most vulnerable
- in The Apprentice it's about people presenting themselves as the best....
- in the NHS staff seek to give of their best
- in The Apprentice people are put in teams but encouraged to stand out as individuals, putting ‘self’ first....
- in the NHS disparate personalities and diverse occupations have to work in a team to ensure patient care is first
- in The Apprentice they are looking for one stand out leader...
- in the NHS we need all our staff to show leadership
- in The Apprentice pressures are invented through artificial tasks...
- in the NHS the pressures are very real. Often life and death real.
So it's vital we recruit staff onto our university programmes and into our organisations with the right values and I look forward to working with Health Education England and employers to help ensure that. It's essential we have alignment between universities and employers on this and it will be a fundamental change to how we see the link between education and employment.