The recent publication of Recognising the responsibilities and contribution of registered nurses within social care was an important release from Skills for Care. It provides the first statement of role for nurses working in the sector and should support us in facing up to the challenges within the system.
The report highlights the varied and multifaceted role of nursing in adult social care, including nurses’ roles in providing person-centred and relationship-based care, managing complex chronic health conditions, enabling independent living and preventing hospital admission, co-ordinating care across multidisciplinary teams, operating within a complex regulatory framework and providing leadership to others. It is a long and varied list.
The 42,000 nurses that work in adult social care form only 3% of the entire workforce and yet the role they perform is vital. The purpose of Skills for Care’s statement is to raise the profile of the specialty whilst promoting understanding of the utterly essential contribution that social care nurses make to our health and care systems.
Providing person-centred care across a number of different health and care systems is extremely difficult. Those with multiple, chronic diseases will be working with a number of different professionals across different disciplines. GPs, hospital clinicians, pharmacists, social workers, occupational therapists and physiotherapists all have a role to play in helping people to live independently. Co-ordinating these resources is difficult and it is often social care nurses who provide the joined-up thinking required for a positive experience for those using services and their families.
Unfortunately, as it stands, the role of nursing within adult social care is poorly understood amongst the wider healthcare community. There are preconceptions that it is one dimensional, minimally specialised and low-skilled. These attitudes are incorrect and likely due to a lack of understanding and exposure to the sector.
At the highest-pressure interfaces between health and social care – the A&E department and discharge lounges – the misunderstanding can be severe. Hospital nurses may have little insight into the unique responsibilities of their counterparts in the community. The pressures of working in a sometimes under-supported environment are far different from those experienced by the large, multidisciplinary teams within hospitals. Clinical decision-making in the community is often done solo and without the diagnostic tools and knowledge that exist within hospitals.
This disconnect exists from the get go; placements in adult social care are an unusual component of undergraduate degrees, whilst preceptorships are rarely performed in the community. This lack of exposure means that many nurses do not have a chance to adequately consider a career in adult social care.
If we are to tackle the recruitment and retention crisis within adult social care nursing, we must recognise the unique skillsets required to work in adult social care and build a narrative that will encourage nurses to see it as an aspirational career choice.
There should therefore be two main audiences for this report: frontline nursing staff and leadership within the sector. For each audience the benefits are clear. For nurses, this statement of role raises the profile of the sector and will impact on morale, retention and recruitment.
For industry leaders and Government, this statement presses home the point that social care nurses are the glue that holds our society together. The line that is drawn today between health and social care creates massive challenges for the system as a whole. For leaders and legislators, it is important to realise the role that adult social care nurses play in joining up these two silos.
This statement of role comes at a time when the pressures on our health and care systems are at a peak. The squeeze on resources and the ongoing workforce pressures are set against ever-increasing care requirements of the ageing population.
Overcoming the organisational disconnect between health and social care is a difficult but essential task if we are to create a person-centred and cost-efficient framework to care for our ageing population. This is highlighted well within the statement and it is important that this message is pressed if we are to encourage a collaborative approach between the two.
This resource from Skills for Care should be eagerly adopted by the sector.
Care providers should use it as a framework to assist in hiring and professional development, whilst decision-makers should reflect on its conclusions and ensure that nursing staff are recognised for the invaluable, highly-skilled and ultimately irreplaceable role that they play in caring for us all.