The Need for Nurses: What the U.S. Can Learn from the U.K.’s Reforms

By Lathan Liou (PO ‘19)

On October 3, 2017, the U.K.’s National Health Service’s (NHS) Health Secretary Jeremy Hunt announced grand reforms to increase nurse training capacity and improve working conditions for nurses. The NHS states that it will allocate enough funding to add 5,170 nurses who will be certified in 2018. In addition, the NHS plans to financially support the increase of a new nursing career route – the nursing associate, which allows those who are unable to pursue a nursing degree full-time but can still obtain a nursing license through a work-study route. To accommodate the need for better working conditions, the NHS plans to support flexible working schedules, institute a system of staff banks, and implement a “Homes for Nurses” plan which grants 3,000 NHS staff the right of first refusal on NHS-owned affordable housing. These measures to increase and retain nursing staff are crucial in addressing the medical pressures in the near future as the majority of the population begins to age and in facilitating social mobility within the health sector by creating job opportunities.

The availability of nurses is becoming increasingly important as the burden of disease, especially chronic, age-related diseases, continues to grow. A widely cited study published in the British Medical Journal found that nurses had on average longer consultation periods with patients than doctors, similar if not better reported quality of care compared to doctors, and patients overall reported higher satisfaction of care with nurses. It appears that the increase in nursing stuff would positively benefit the ability to provide care for a growing population in need.

As in the U.K., nurses are crucial in the U.S. Approximately 600 million patient visits are made to nurse practitioners (NPs) each year in the U.S., which clearly represents an important aspect of healthcare access at a time of physician shortages. The adaptability of NPs has also allowed for the expansion of the number of community health centers and private clinics which serve as other avenues for healthcare besides the hospital system. Similar to what the NHS recently declared, increased public subsidies are needed to increase the number of training slots available in graduate nursing programs in the U.S..

This becomes all the more important in today’s world in the context of healthcare. The overarching problem is described quite aptly by Nobel Laureate in Economics Angus Deaton: “the American health care does a poor job of delivering health, but is exquisitely designed as an inequality machine, commanding an ever-larger share of GDP. and funneling resources to the top of the income distribution”. Healthcare is one of the most polarizing issues facing the United States, and at the crux of the problem is who has access to healthcare. An increase in nursing stuff, especially in community health centers and low-income clinics, will be able to better meet the growing need of healthcare.

In order to deal with the nursing shortage, companies such as Avant Healthcare Professionals have been trying to hire international nurses, from countries such as the Phillipines, but according to Shari Dingle Costantini, CEO of Avant Healthcare Professionals, “the delays we are seeing with government agencies since the change in administration [Trump] are dramatic. They are truly creating a hardship for many healthcare clients in critical need of nurses.” The Trump Administration has introduced the Emergency Nursing Supply Relief Act of 2017 in an attempt to address the nurse shortage by granting special immigration privileges to nurses, but it still remains to be seen whether that will be passed.



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