The doctors and allied health professionals grew by 25% and 30% respectively. The NHS sector which increased the most was the Health Care Assistant workforce which almost doubled. Running second is the health care managers at a 68% increase. Figure 1 summarizes data based on whole time equivalents (w.t.e.) or the registered pooled service time of all the nurses.
Although Nursing auxiliaries have the lowest registered growth, they still are three times larger then the population size of HCA's in the year 2004. Within the realm of nursing, there has been differential increase and decrease in specialization. Those with positive growth are the nurse managers sector, first level/ registered nurses and Registered Sick Children's Nurses (RSCN). The midwives and health visitors sector grew with an inconsequential amount while the district nurses and second level nurses showed negative growth. This may have been the result of upgrading of status to 1st level nursing. Figure 2 summarizes the observation.
The figures show that there is indeed a major transformation happening in the health care market. As a rule, whatever is in demand in the market is also the prime choice for employment and study. The rise in healthcare assistants and the nursing profession translates to more people enrolling in those fields because they are assured of employment. As a consequence of this preference, it can be rightly predicted that there would be less people studying in other medical professions.
The Concept of Working Differently
To further complicate matters, there have been a range of policy-led initiatives and external factors that are changing the work definitions of nurses and health care professionals (Buchan, 2005). These involve changes in the roles that nurses and health care assistants are performing, in the skills that they are developing, and in the ways that they work alongside and with other health care staff. The policy initiatives are the following:
Changing workforce programme (O Dowd, 2005)
Extension of nurse prescribing (RCN, 2003)
Implementation of National Service Frameworks in England (RCN 2003)
Establishment in England of NHS Direct (NHS Board, 2003)
Extension of protocol-based care (NHS Board, 2003)
Skills and competency development work supported by the Care Group Workforce Teams (CWGT) in England. ( NHS Board, 2003)
Introduction of clinical networks in Scotland (Health Committee, 2005)
External pressures include dealing with the impact of the European Working Time Directive. (Department of Health, 2004)
The Wanless review, which formulated plans for the improvement of the NHS, forwarded many alterations in the distribution of roles of NHS professionals. The study suggested that nurse practitioners be made responsible for 20% of the work currently under the responsibility of General Practitioners (GPs), physicians and junior doctors. To be fair with the nurses, 12.5% of their current workload will be relegated to HCAs. Instead of a GP working full