Wales chief nursing officer discusses future of workforce

Sue Tranka, chief nursing officer (CNO) for Wales, opened the annual CNO summit in Cardiff today with a discussion of her priorities for the coming months and years, and praised nurses for tackling the difficulties the profession faces “head on”.

“We have a lot more work to do”

Sue Tranka

Ms Tranka began that she was “humbled” to be entering her third year as CNO, and acknowledged that there “continues to be hard, hard challenges” for nursing in Wales.

“There is so much negativity about the profession, you only have to open social [media] or a newspaper to know that there is an overwhelming negative rhetoric about this profession,” she said.

“I say we all have a responsibility to ensure we don’t continue to perpetuate the danger of that single story.”

She pointed to the recent NHS in 10+ Years document, published by the Welsh Government, which showed the projected challenges of the health service in the coming decade.

Ms Tranka said it set out a “compelling argument” for needing to continue innovating in the profession, and for the continued stepping up of nurses to become leaders. She welcomed nurses joining leadership programmes and encouraged those in attendance to follow suit.

The CNO said her five priorities for 2022-24 remain unchanged, being: leading the professions; workforce; making the professions attractive; improving health and social care outcomes; and professional equity and healthcare equality.

She said that, while they all occupied equal importance, workforce “remains our biggest challenge”.

As a result, she said improving preceptorship for newly registered nurses, and mandating clinical supervision for nurses, were two things she was focused on particularly.

Ms Tranka said she was happy about progress made in the last year on nurse pay and working conditions, with a new deal secured.

“We have had a turbulent year, haven’t we,” she said.

“As a profession we have been calling for better reward and recognition, but I’m pleased to note the efforts are making a difference and that’s important.”

Official national data on Welsh nurse vacancy numbers were published for the first time recently, in a move welcomed by Ms Tranka.

She said: “All Wales vacancy data is now live and will be updated bi-annually. It is not enough but it is a start.

“We have reduced [vacancies] marginally. It’s nothing to celebrate, but it’s resetting us to where we need to be – we have a lot more work to do.”

She continued that she was working to improve retention in the workforce, and that she hoped to work alongside colleagues in Health Education and Improvement Wales, which recently published a series of recommendations to that end.

Ms Tranka said work continued in improving the training rates for nurses, both in the number applying for nursing courses, and their retention on them.

Latest data from the Universities and Colleges Admissions Service showed student nurse acceptances onto courses in Wales for 2022-23 are down 13% from the previous year, with similar declines in England and Scotland.

Meanwhile, the CNO said that the environment was something she wished to put more of an emphasis on than before: “I want to turn our attention to climate change as a health emergency.

“I can’t talk about securing our future as a profession, or securing the health of our nation, without thinking about the next health emergency on our doorsteps.

“As nurses and midwives we are part of the problem on climate change, but also absolutely part of the solution; good planetary health means good public health.”

She said it was the “moral duty” of all Welsh nurses and midwives to question their practice, in order to bring about improvements in the sustainability of the health service.

“I think we can show, in Wales, the contribution nurses and midwives can collectively make and what we can achieve to reach a green future,” she said.

“To support this, I have commissioned a report on how we can contribute to achieving our goal in Wales of net zero by 2030.”

She further mentioned the need to improve on wellbeing, tackling discrimination and the frameworks for nurses to whistleblow on poor practice.

Finishing, Ms Tranka said: “Whilst recognising what we’ve achieved so far, my observations are that the challenges ahead are still really great and when the resilience you have shown continues to be tested we must do all we can to ensure the positives will be captured in our work.

“We have to enact the change we want to see, so I hope that these achievements I share with you today, the focus on your wellbeing, centring you at the heart of the delivery of care, will really inspire you to look towards our future for nursing and midwifery in Wales.

“Friends, colleagues, I am under no illusion: we remain the heartbeat of healthcare.

“It is strong and it remains strong for each and every one of you. That’s not rhetoric, I am really clear: having received care not so long ago in a hospital, you remain the heartbeat of healthcare. You kept me alive.

“It remains strong, our health system, and so does each and every one of us despite everything that is thrown at us.”

The conference also received a pre-recorded message from World Health Organisation (WHO) CNO Dr Amelia Latu Afuhaamango Tuipulotu, who spoke about the importance of improving wellbeing support and working conditions for nurses.

Amelia Latu Afuhaamango Tuipulotu speaking at the CNO Wales conference

“[It] is ever so important now, and for the long term, in order to ensure that the professions are highly motivated and have the job satisfaction that they deserve in order to deliver safe and quality care for the people of Wales, supporting universal health coverage and the sustainable development goals,” Dr Tuipulotu said.

“This week, on the 10th of October, we celebrate World Mental Health Day reminding us that mental health is a universal human right.

“The WHO director general advocated for caring for our nurses and midwives, making sure they have decent pay and working conditions.

“It is important that nurses and midwives feel and know that we care for them, including fair pay as they rightly deserve.”

The WHO chief nurse echoed Ms Tranka’s comments about the need to encourage nurses to seek leadership opportunities, and added: “I wish you success in all your deliberations to ensure wellbeing is a priority with supportive systems to better support the professions to continue to deliver safe and quality care for the people of Wales and the UK, ensuring health for all.”