Rights at work: a road to nowhere?

08 February 2019

Colenzo Jarrett-Thorpe, Unite national officer for health, takes us through the reaction to the NHS long-term plan from Unite and community practitioners.

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January saw the launch of the NHS long-term plan for England following the government’s commitment last year to increase levels of spending on the NHS until 2023-24 by £20bn.

The long-term plan is high on ambition and aspiration, but low on detail and mechanics

Community practitioners should note the following: the proposal to create a children and young people’s transformation programme, which should underpin the plan to expand and invest in access to community-based mental health services; improving the responsiveness of community health crisis response services; and a proposed £4.5bn new investment to fund multidisciplinary teams aligned with new primary care networks based on neighbouring GP practices.

The long-term plan is high on ambition and aspiration, but low on detail and the mechanics of how it is possible to meet these ambitions in the spaghetti junction of confusion and chaos in the English NHS structure.

Following the transfer of commissioning of 0 to 5 community health services from the NHS to local government in October 2015, the number of health visitors in England had fallen by almost 25% at August 2018, and school nurses by almost 20%. There are consequences to this fall in numbers, judging by the feeling of health visitors and school nurses taking part in last November’s Unite health members’ pay survey.

Some of the salient points that indicate why they are feeling under pressure or leaving the service and not being replaced, can be seen in Unite health survey results, below.

The NHS long-term plan must tackle the issues of why so many skilled and dedicated professionals are leaving, and prevent this, as well as investing in the CPs of the future. So much of the funding that has been earmarked for investment in our public health services is simply replacing the funds that have been systematically removed over the last nine years. Does the plan signal a bright new future for the NHS or does it merely add to the list of this government’s broken pledges? 

See more results from the survey in our cover story, shining a light

Unite health survey results

  • Both 80% of HV and school nurse respondents frequently or always work through their breaks.
  • Compared with the previous year, 76% of school nurses and 80% of HVs believe that morale is worse or a lot worse. This compares with 73% across all respondents.
  • When asked why this is the case, the leading answer from HV respondents was an increase in workplace stress (87%), and the leading answer from school nurse respondents (77%) was dissatisfaction with the quality of care they feel they are able to provide.
  • 83% of HV respondents frequently reported staffing shortages in their department or working area in the last 12 months, with 65% of school nurse respondents frequently reporting staff shortages.
  • 80% of HVs and 75% of school nurse respondents have raised concerns regarding safe staffing levels, compared with 62% of all respondents.

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