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GWH moves to improve nursing skills and fill vacancies

The Great Western Hospitals NHS Foundation Trust has started to recruit nurses from Scotland, Ireland and Portugal. It has at present fifty-seven whole time equivalent nursing vacancies across the Trust.

Of these twenty-one are on wards at GWH Swindon and thirty-six are in its community hospitals and Neighbourhood Teams across Wiltshire.  But it is not just a matter of numbers that Hilary Walker, GWH's Chief Nurse, wants to rectify.

During a review of staff just after she joined GWH last year, it became clear that the mix of nursing skills was not quite what the hospital required as the kind of treatments and balance of patients’ needs were changing.  They were employing fewer registered nurses than they now needed.

To redress the balance between auxiliary and registered nurses the Trust has committed £1.1 million for a recruitment campaign and additional salary costs – adding more nurses to its basic establishment.

The campaign began in April with its own website and events bringing interested nurses to see the hospital.  It has been showing some successes.  But, Ms Walker told Marlborough News Online, “We have not yet broken the back of the new posts.”

So they are now looking beyond England with Portugal chosen because it teaches English as the second language in its schools – it is, after all, known as ‘Britain’s oldest ally’.

GWH’s work on improving its nursing staff anticipated the calls in the final Francis Report on the Mid-Staffs hospital scandal for better nurse training and better ratios of nurses to patients.  At the end of last year it adopted a plan across the Trust’s premises and services: “Nursing Together – a strategy for improving patient care”.

The government’s instant response to the Francis Report was to call for all nurses to serve time as auxiliaries before they started their training.  This was supposed to prove those wanting to nurse were committed to caring for patients and with their nursing degrees were not, as some politicians would have it, ‘too posh to wash’.

Hilary Walker, Chief NurseHilary Walker, Chief NurseMs Walker is doubtful this would help: “I would be interested to know why the government think it’s a good idea. Training currently focusses on bedside care – I’d be interested in learning what additional benefits we’d get from that.”

Ms Walker’s has two strands in her work to bolster standards of nursing at GWH.  The first is to concentrate on the leadership skills of senior nursing staff.  They are spending a quarter of a million pounds on leadership training and stressing the importance of talking not just to patients but to relatives too.

“We’re doing the things we think are important.”

Secondly they are paying much more attention when they recruit new nursing staff to values and behaviour and attitudes – ensuring that recruits have caring characters and can show empathy. As Ms Walker says “Society doesn’t value social behaviour until it’s needed.”

Hilary Walker admits that nationally “It is safe to say we have not been the best planners in the world – our workforce planning was not perfect.  But it never will be – you’re trying to anticipate what you will need in five years’ time – that’s not an exact science – it’s a very long way from it.”

And locally there is some evidence of moving targets.  The new Wiltshire Clinical Commissioning Group (CCG) is currently working with GWH to upgrade the services provided under the contract for community care.  

This centres on the eleven neighbourhood teams one of which is based at Savernake Hospital. The CCG plan to employ Care Coordinators to improve the teams’ work: “GPs and the staff recognise there’s a lot more they could do particularly for people with a lot of health problems – the complex cases.”

Above the current contract costs, new investment is being made – some of it in kit so that the neighbourhood nurses can file their records to base from their cars.

The contract has been extended until June 2015.  However, whatever happens to the community services contract for Wiltshire, other services operate at Savernake Hospital which is now owned by the GWH Trust.  

After his recent visit to GWH and Savernake Hospital, Dr Peter Carter, the General Secretary of the Royal College of Nursing, told Marlborough News Online: “I was very impressed with what I saw during my visit, and very much enjoyed meeting hard-working staff. Although Savernake is clearly a very busy hospital, the standard of care I saw was extremely high.”



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