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Allowing nurses to work more flexibly across settings is among the proposals included in a new national plan for addressing the patient backlog that has built up during the pandemic. However, critics said the blueprint fails to confront nurse shortages.

The elective recovery plan was launched yesterday and sets out how the government and NHS England intend on tackling the growing waiting list for elective care, which now stands at six million patients.

“We want staff to be better able to support patients across settings, mirroring the flexible approach to other areas of elective recovery”

Elective recovery plan

By 2025, the plan commits the NHS in England to be delivering nine million more tests and checks and to have made it so no patient is waiting longer than a year for elective care.

It proposes to do this by increasing capacity, prioritizing treatment and redesigning the way services are organized and delivered.

In her foreword to the plan, NHS England chief executive Amanda Pritchard recognized that “any solutions for tackling the Covid-19 elective backlog cannot rely on making the same staff – whether in primary, secondary or community care – work ever harder”.

“To succeed, we have to grow and support our workforce, so they can deliver excellent care,” she added.

The document indicated that the government is not planning to expand the registered nurse workforce beyond existing plans, created before the pandemic, to deliver 50,000 more nurses by 2024-25 through improved recruitment and retention.

As part of efforts to achieve this, the document stated that, by the end of this financial year, 10,000 international nurses will have been recruited from overseas, with focus having been placed on those with experience in critical care and surgery.

The plan also promised efforts to retain nurses by “providing a positive experience and appropriate professional and pastoral support” including “encouraging more nurses to take up training grants to support them to become cancer nurse specialists”.

It added that 5,000 more healthcare support workers would be in place by the end of this year to help plug gaps.

The blueprint also included plans to enable staff to work more “flexibly and remotely” which it said could involve nurses working across acute and community services.

“We want staff to be better able to support patients across settings, mirroring the flexible approach to other areas of elective recovery,” it stated.

“For example, registered nurses working across acute and community services and more cancer pathway navigators to help patients move between services.”

Meanwhile, the plan also signaled that nurses may be required to join new “perioperative care co-ordination teams” that will be established from April 2023 to support patients to prepare and recover from surgery.

“Nursing staff will look at this plan and ask where the staff will credibly come from to deliver it in good time”

Pat Cullen

Other plans included increasing the number of community diagnostic centers from 69 to 100 over the next three years, and expanding the use of surgical hubs that will be dedicated to carrying out elective surgeries.

Health unions have said the plan needed to go further on addressing workforce shortages.

Pat Cullen, general secretary and chief executive of the Royal College of Nursing, said: “Nursing staff will look at this plan and ask where the staff will credibly come from to deliver it in good time.”

She added: “Too many of our members are considering their career choice this year and measures to keep them in post, including fairer pay, must be announced at speed.”

Meanwhile, Unison said the plan was not ambitious enough on staffing. It also called for a decent pay rise for those delivering health services.

The union’s general secretary, Christina McAnea, said: “There’s nothing new to see here.

“Without fresh ideas to deal with the growing NHS staffing crisis or the broken care system, services won’t be there for those needing help.”

Similarly, doctors’ union the British Medical Association (BMA) said workforce constraints must be tackled if the elective recovery plan was to deliver.

Dr Chaand Nagpaul, BMA council chair, said: “The NHS and patients desperately need this plan to succeed but there are some big questions still to be addressed if this plan is to be effective.

“The biggest limiting factor will be workforce shortages, given that there are currently 100,000 unfilled vacancies across the NHS.”

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