All going according to plan

The Department of Health announced last week that from 2013 all nurses in England would be educated to degree level.

The Times had their views:

DOCTORS AND NURSES

“The demand that all nurses have degrees will not increase the status of the profession very much. But it will worsen the shortage of nurses”

“There could scarcely be a worse moment to make becoming a nurse more difficult. Over the next ten years 180,000 nurses are set to retire. There are 100,000 nurses aged 50 and over and another 80,000 aged 55 and over. It is proving difficult enough to retain the current workforce. A third of nurses told the Royal College of Nursing in 2007 that they were thinking of quitting because of poor pay. The Department of Health has predicted a shortfall of 14,000 nurses by 2010. The increased cost is also likely to exacerbate the shortage.”

Melanie Philips in The Spectator had much to say about it too:

NIGHTINGALE MUST BE TURNING IN HER GRAVE

“The news reported in the Times today that nursing in Britain is to become a degree-only qualification should strike a deep chill into every heart. Ostensibly to ‘improve patient care’ it will achieve precisely the opposite. That is because the real aim of such a move is to improve not patient care but the professional status of the nurse. The effect on patient care overall will be disastrous.”

Melanie Philips also quotes from an old article in the Telegraph by Harriet Sergeant.

THE TRUTH ABOUT NHS HOSPITALS: NURSES

“The catering staff slam the food down. No one bothers. Spooning food into a patient is just too demeaning for professional nurses, it seems. I always thought nurses were meant to care for patients. I might be wrong. I may have missed the plot somewhere.”

Another described the difficulty of trying to find a particular patient on a ward. Every patient is supposed to have his name above the bed. But, in some hospitals, they refuse to display the name “in case it infringes your autonomy”. So the consultant found himself wandering around, trying to find his patient. “There never seems to be anyone in charge who knows anything,” he said.

He would try to find the patient’s nurse. Then the patient’s notes. “I don’t often strike lucky with all three.” Finally, he had to translate the nurses’ diagnoses.

“They refuse to use hierarchical, male-dominated medical terms, so they will not say the patient is unconscious. No, the patient has to have ‘an altered state of awareness’.”

From the medical blogosphere The Ferret Fancier had something to say about it too.

WHO WILL DO THE NURSING?

“This loss of the apprenticeship and the reduction of basic standards is a direct result of one thing, money, the government does not want broadly trained competent workers who have learnt the ropes adequately, they want to isolate individual competencies and shift work down to people who have had way less training than in years gone by. To see this in action all one has to do is see who does most of the basic nursing on wards, it is done by ‘health care assistants’ who have had very minimal levels of training, they are the modern day nurses.”

The Witch Doctor did not bat an eyelid when she heard the news that all nurses will require to have degrees.

For some time now, she has been waiting for this announcement.

This is just one part of The NHS Plan

The Skills Escalator will soon be in full force because some of the medical profession are actively complicit and others are letting it happen.

CAREER FRAMEWORK FOR THE NHS

“MORE SENIOR STAFF -LEVEL 9
More senior staff with the ultimate responsibility for clinical caseload decision-making and full on-call accountability

CONSULTANT PRACTITIONERS-LEVEL 8
‘Consultant Practitioners’ are staff working at a very high level of clinical expertise and/or have responsibility for planning of services 8

ADVANCED PRACTITIONERS-LEVEL 7
‘Advanced Practitioners’ are experienced clinical professionals who have developed their skills and theoretical knowledge to a very high standard. They are empowered to make high-level clinical decisions and will often have their own caseload. Non-clinical staff at Level 7 will typically be managing a number of service areas

SENIOR PRACTITIONERS/SPECIALIST PRACTITIONERS-LEVEL 6
‘Senior Practitioners/Specialist Practitioners’ who would have a higher degree of autonomy and responsibility than ‘Practitioners’ in the clinical environment, or who would be managing one or more service areas in the non-clinical environment.

PRACTITIONERS-LEVEL 5
‘Practitioners’ –most frequently registered practitioners in their first and second post-registration/professional qualification job

ASSISTANT PRACTITIONERS/ASSOCIATE PRACTITIONERS-LEVEL 4
‘Assistant Practitioner/Associate Practitioners’ –probably studying for Foundation degree, BTEC higher or HND. Someof their remit will involve them in delivering protocol-based clinical care that had previously been in the remit of registered professionals, under the direction and supervision of a state registered practitioner.

SENIOR HEALTHCARE ASSISTANTS/TECHNICIANS -LEVEL 3
‘Senior Healthcare Assistants/Technicians’ –this is a higher level of responsibility than support worker, probablystudying for or have attained NVQ level 3, or Assessment of Prior Experiential Learning (APEL).

SUPPORT WORKERS -LEVEL 2
Support Workers –frequently with the job title of ‘Healthcare Assistant’ or ‘Healthcare Technician’ –probably studyingfor or has attained NVQ Level 2.

INITIAL ENTRY LEVEL JOBS -LEVEL 1
Initial entry level jobs such as ‘Domestics’ or ‘Cadets’ requiring very little formal education or previous knowledge,skills or experience in delivering, or supporting the delivery of healthcare.”

THE SKILLS ESCALATOR NOW – WATCH HOW IT WILL CHANGE

The diagram below comes from a document:

“Who are the doctors of tomorrow and what will they do?”

This was presented at the 9th International Medical Workforce conference in Melbourne, in November 2005.

The paper was written by: Rob Webster, Debbie Mellor & Becca Spavin,
Department of Health, England.

The paper had the following disclaimer:

This is a discussion paper only. It is not a statement on Department of Health policy.

Nevertheless, the document gives clear insight into the thought processes behind MMC.

It is the first documentation The Witch Doctor has found that suggests the medical profession will be fully integrated at various levels into the “Practitioner” career framework for the NHS that underpins the structures and principles in “Agenda for Change”

Here is where the Doctors in the Grades they held in 2004 were placed.

LEVEL 9
Doctors: Consultants (27914), Directors of Public Health (228), Associate Specialists(2029).

LEVEL 8
Doctors: Registrar Group (8056)
Allied Health Professionals: Consultant Therapists (126)
Health Care Scientists: Consultant Clinical Scientist – Grade C (433)

LEVEL 7
Doctors: Registrar Group (8056), Staff Grade (4943)
Nurses: 5% of All Qualified Nursing, Midwifery and Health visitor Staff (20125)
Allied Health Professionals: Managers (265)

LEVEL 6
Doctors: Senior House Officer (20283), Hospital Practitioner/Clinical assistant (1164), Other CHS Staff (442), Other CDS Staff (1083).
Nurses: 30% of All Qualified Nursing, Midwifery and Health visitor Staff (120751)
Allied Health Professionals: Manager (2312), Manager (265), Instructor/teacher (4118), Tutor (89), Qualified Ambulance Staff (16587), Assisstant Practitioner (557)
Health Care Scientist Clinical Scientist – Grade A and B (2776), Advanced Practitioner Biomedical Scientist (342)
Admin Senior Manager (11365)

LEVEL 5
Doctors: House Officer/Dental House Officer (4259).
No Doctor appears below Level 5.
Nurses: 40% of all qualified Nursing, Midwifery and Health visitor staff….
etc etc…………..

The Witch Doctor has three questions:

1. Where do the doctors really sit on the Skills Escalator?

2. Who exactly will be doing what used to be called basic nursing care?

3. Is this, or is it not, a stupid government?

She thinks she knows the answer to all three questions.

Do You?

a red apple ……………………

The Witch Doctor – Link to a random page

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LINK TO UK MISSING KIDS WEBSITE

LINK TO MISSING PERSONS WEBSITE

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