Cynulliad Cenedlaethol Cymru | National Assembly for Wales
Y Pwyllgor Plant, Pobl Ifanc ac Addysg | Children, Young People and Education Committee
Blaenoriaethau ar gyfer y Pwyllgor Plant, Pobl Ifanc ac Addysg | Priorities for the Children, Young People and Education Committee
CYPE 47
Ymateb gan : Coleg Nrysio Brenhinol
Response from : Royal College of Nursing
|
Question 1 – Within the remit set out above: what do you consider to be the priorities or issues that the Children, Young People and Education Committee should consider during the Fifth Assembly? |
|
The Royal College of Nursing is the world’s largest professional union of nurses, representing 430,000 nurses, midwives, health visitors, health care support workers and nursing students, including over 25,000 members in Wales. RCN members work in a variety of settings including the NHS and the independent sector. The RCN works locally, nationally and internationally to promote standards of care and the interests of patients and nurses, and of nursing as a profession. The RCN is a UK-wide organisation, with its own National Boards for Wales, Scotland and Northern Ireland. The RCN is a major contributor to nursing practice, standards of care, and public policy as it affects health and nursing.
We have several issues which we believe should be considered by the Children, Young People and Education Committee for the Fifth Assembly term.
Children’s Nurses – an area of high concern within the workforce Children’s Nurses are one of the four fields of nursing (adult, child, mental health and learning disability). Children’s nurses work with people from birth to the age of 16 or 18 if the young person has a disability.
Currently there are not enough children’s nurses in Wales to meet demand.
Children’s nurses work in a variety of areas including neonatal units, acute children’s wards, emergency units, out-patient departments, safeguarding, looked after children, child and adolescent mental health services, school nursing, community settings which include special schools and continuing care teams. Children’s nurses are a small group within the wider fields of nursing and often it is assumed that any registered nurse is sufficiently prepared to care for children and young people.
We also provide below reasons why we consider Child and Adolescent Mental Health Services and Sexual health services to be priority areas for investigation by the Committee.
|
|
Question 2 – From the list of priorities or issues you have identified, what do you consider to be the key areas that should be considered during the next 12 months (please identify up to three areas or issues)? Please outline why these should be considered as key priorities. |
|
Children’s Nurses – an area of high concern within the workforce There are now historically low numbers of children’s nurses in Wales. While adult nursing, mental health nursing and other health professions have seen a welcome increases in pre-registration training places in Wales children’s nursing education has remained static and does not support the future workforce requirements. Current workforce planning for children’s nursing across Wales does not take into account the number of potential registrants due to retire or the reconfiguration of services.
The shortage of children’s nurses is particularly damaging in neonatal nursing and in the community. Traditionally children’s nurses worked in the hospital on children’s wards. When children were very sick they were cared for in the hospital environment. Today advances in technology and medicine allow more children to be cared for in the home and for children and young people to live more independently with chronic conditions. This requires support from children’s’ nurses based in the community yet very few children’s nurses are based in community nursing teams.
Children’s Nurses, rather than midwives are also increasingly making up the neonatal nursing workforce. (Neonatal nursing qualifications are post registration specialist qualifications). In July 2016 Bliss published a report in Welsh neonatal services in Wales. Bliss’ research shows that services for premature and sick babies in Wales are facing critical staffing shortages, leaving many neonatal units unable to meet national standards for safe, high quality care. Eight out of ten units did not have enough nurses to staff all of their cots, leading to nearly a quarter of all emergency transfers taking place due to a shortage of staffed cots rather than heath need, putting babies at unnecessary risk and adding to families’ stress and worry.
Investment and leadership from the Welsh Government will be essential to tackle the staffing shortages that have left neonatal units falling far short of the All Wales Neonatal Standards. This must be directed towards a significant increase in the number of child branch nurses, which is essential to close the neonatal nursing gap that exists in Wales.
Child and adolescent mental health services The current pressure on child and adolescent mental health services in Wales is a concern. There needs to be clear workforce development strategy (including education) strategy for mental health nursing that will meet the future mental health needs of children and young people.
Residential and inpatient services also need investment. The pressure on a limited number of places can mean that children and young people are inappropriately placed either in adult areas or sometimes out of Wales all together. Living areas are sometimes inappropriately mixed gender resulting in strategies for dealing with sexual harassment or assault being flawed or unable to be implemented.
Sexual health services
Good sexual health is part of a healthy and fulfilling life. Sexual health services provide information and advice related to healthy sexuality, contraception, treatment of sexually transmitted infection and termination of pregnancy. Nurses and other healthcare professionals based in these services help prevent the spread of sexually transmitted infections, as well as work to safeguard against and identify issues of sexual exploitation. These services are essential in ensuring good sexual health for the children and young people but too often receive a low priority when Government considers public health.
Accessing sexual health services is not only about the geographical availability, it includes ensuring young people can access the right type of service at the right time.
Young people may be particularly likely to need a location accessible by public transport for example or confidentiality may be a concern. Some health professionals can be mobile, working in a school for example whilst others may need a well-equipped clinic. Access to long-term contraception methods can be variable particularly in primary care. Equitable access to abortion services, particularly in North Wales, is also needed.
The RCN believes that education in relation to making safe and informed choices about health and welling should be improved for the young. Sexual health is part of a broad curriculum to enable young people to develop personal responsibility for their own health. This forms part of the prudent healthcare agenda. There should be a statutory requirement for schools to deliver sexual health education via professionals specifically educated and trained to do so. Resources should be bilingual in relation to education and service provision throughout wales. |