Devolution and nursing workforce policy and planning in the four countries of the United Kingdom 1997-2009
Milne, P. (2013) Devolution and nursing workforce policy and planning in the four countries of the United Kingdom 1997-2009, no. 376.
This thesis examines how political devolution in the UK impacted upon nursing workforce policy and planning by investigating the following research questions: What has been the impact of devolution on nursing workforce policy and planning across the four countries of the UK (1997-2009)? How and why have the approaches to nursing workforce policy and planning changed across the four countries of the UK (1997-2009)? The research methodology used was a mixed methods approach which included semi-structured interviews with 30 stakeholders from the fields of nursing, healthcare policy or workforce planning across the UK. A purposive sampling strategy was adopted and the distribution of interviewees was England (11), Scotland (7), Wales (6) and Northern Ireland (6). A realist review approach to inquiry was taken which involved establishing what works for who, in what circumstances and why? The qualitative data from the interviews was supplemented by analysis of quantitative data on nursing workforce trends and information from the analysis of health policies from the four countries. The key findings include: changing patterns of power and influence in the devolved administrations; continued cycles of ‘boom and bust’ in nursing workforce supply; variable growth in the nursing workforce across the UK; the unwillingness of England to ‘let go’ and the perception by interviewees that some national nursing policies were unimportant. The conclusions were that although devolution enabled greater freedoms in terms of policy and workforce flexibility, just under half of the interviewees reported that devolution had a positive impact upon nursing. There was reluctance from senior nursing leaders to share and learn from good practice across countries and despite the rhetoric from numerous reports around the need to improve nursing workforce planning, there was little evidence of lessons being learned which would have improved the effectiveness of planning the future nursing workforce.