The Ward Round: A ticket to work

Starting a new job is never easy. The simplest task takes twice as long and there is usually an unfathomable amount of bureaucracy to contend with. For the NHS, this pain is amplified and more frequent because of the rotational nature of certain jobs.

Last week NHS chief people officer Prerana Issar announced this was about to change. A new ‘NHS passport’ has been launched, which according to NHS England and NHS Improvement would enable staff to move “seamlessly” between sites, take on new roles and “plug gaps” in staffing.

The national regulator urged all hospitals in England to sign up to the new passport agreement, which it also said would cut admins cost and the need for “up to two-day inductions” when staff move between organisations.

Ms Issar stressed this is an example of the delivery of the pledges made in the long-term plan to increase flexibility in the NHS and make it a more attractive place to work.

I’m yet to speak to a junior doctor who hasn’t bemoaned the never-ending cycle of admin and mandatory training and the British Medical Association has also been lobbying for more efficient record-sharing when junior doctors move between employers.

However, the doctors’ union cautiously welcomed the NHS passport and junior doctors committee chair Jeeves Wijesuriya warned against employers not using these changes to redeploy staff to unknown areas outside their training programme at short notice and without agreement.

The idea of staff being deployed to a trust far from their usual place of work sounds a little far-fetched, but with the current emphasis on integration and ever-present service change in some specialties, it may not be wildly off the mark. Trusts and systems often raise the potential benefits of sharing workforce, so the leap to system-wide collaboration could be on the cards.

In the announcement itself NHSE/I said the passport could be used to “plug gaps”, but this raises the question of patient safety. It’s unreasonable to expect staff to safely adapt to a new place of work without proper induction.

NHS E/I is trusting that organisations will sign up to the scheme but they must also ensure the passporting system does not result in unsafe deployments in the cause of filling rota gaps.

More streamlining

The workforce crisis in the NHS and the looming threat of Brexit has prompted the Home Office to streamline the process for doctors, nurses, dentists or midwives coming to the UK to work.

The new application process was launched this week and healthcare professionals who have secured sponsorship to come to the UK will have to sit one English language test set by their professional body (for example, the General Medical Council), rather than two tests.

The government said this will enable NHS employers to “access the staff they need” more quickly but also added as the UK leaves the EU a new points-based immigration system will be introduced built around the talent and skills people have. (Not to mention the major staffing and wage concerns in the social care system).

The NMC also announced further measures to ease recruitment of EU and international nurses, which include an online application system.

Streamlining the recruitment of both domestic and international staff is undoubtedly important but new research by the Health Foundation and Nursing Standard magazine has shown one in four nursing students are suspending their studies before graduation.

There are of course a multitude of financial and personal factors behind this but NHS trusts and other organisations offering clinical placements need to ensure their offer is good enough to keep future nurses in the system.

Boosting the domestic pipeline of nursing students is a crucial part of making a dent in future vacancies and rota gaps. The newly announced personal development budgets are welcome as they could make the NHS are more attractive place to work, but the benefits of flexibility and streamlined recruitment will be lost if nurses are dropping out before they even start their NHS career.