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Cynulliad Cenedlaethol Cymru |
National Assembly for Wales |
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Y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon |
Health, Social Care and Sport Committee |
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Ymchwiliad i wasanaethau Endosgopi |
Inquiry into Endoscopy Services |
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HSCS(5) E08 |
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Ymateb gan Goleg Nyrsio Brenhinol Cymru |
Evidence from Royal College of Nursing Wales |
The Royal College of Nursing Wales is grateful for the opportunity to respond to this consultation and would like to raise a number of points in relation to the inquiry:
I. The Royal College of Nursing welcomes the introduction of any form of screening that increases the simplicity and accuracy of testing, thereby increasing uptake. As is acknowledged by the Health Committee in the inquiry’s background information, there are concerns about the capacity of existing services to cope with demand, and the RCN echoes these concerns. We are aware of shortages within the nursing and endoscopist workforce and this will undoubtedly impact the ability to deliver services in the face of increased demand.
II. The Royal College of Nursing also maintains the introduction of a new screening initiative should be accompanied by a public awareness campaign, with appropriate promotion and explanation of what is involved. A certain amount of stigma and sense of taboo still surrounds tests of these kinds, and the public needs to be assured of the effectiveness of the tests and for any myths or concerns to be dispelled via an appropriate marketing campaign, alongside ensuring that professionals with the right skills are involved in the delivery.
III. There needs to be significant investment and expansion of the current workforce and nurses can play a central role in this. For example, Advanced Nurse Practitioners (ANPs) and Clinical Nurse Specialists (CNSs) with competencies in the area of endoscopy are able to perform endoscopic procedures without the supervision of other health or medical professionals are can therefore be invaluable in expanding services. These competencies are set out in the All Wales Endoscopy Nurse Competency Framework. Opportunities for ANPs and CNSs for further education and development in the area of endoscopy should be made available to those wishing to pursue these skills.
IV. The Royal College of Nursing recommends that Health Education & Improvement Wales (HEIW) works with Health Boards and Higher Education Institutions to develop and implement a strategic plan to ensure that sufficient education opportunities are available for those wishing to undertake endoscopy training, ensuring that the funding is available for these courses and also that the necessary backfill is available to enable staff to be released to undertake the courses. As more of these nursing roles emerge, it is vital that the funding is made available centrally. Health Boards should also ensure that plans around endoscopy services are reflected in their Integrated Medium Term Plans (IMTPs).
V. In areas of high deprivation where uptake of screening programmes is known to be poor, targeted action can help to improve uptake and improve outcomes. As acknowledged in the Welsh Government’s Cancer Delivery Plan, this is important for helping to support a reduction in inequalities of health outcomes. The Royal College of Nursing recommends that the introduction of the FIT test must include targeted action of this kind in order to ensure the initiative helps to reduce health inequalities whilst also fitting in with the objectives of the Cancer Delivery Plan.
VI. Also important for improving the uptake of the bowel screening programme is ensuring that the appropriate staff with the right skills are deployed in the right areas to encourage uptake. Many patients will, in the first instance, be seen by a Practice Nurse, and it is essential therefore that the nursing workforce is engaged with and involved in any promotion activities related to screening. Ensuring that staff are engaged with on different initiatives, will help to ensure that patients and the general public have access to the right information, and is likely also to help to dispel some of the stigma around the screening tests and help patients to feel more confident in the process.
The RCN is the world’s largest professional union of nurses, representing over 430,000 nurses, midwives, health visitors and nursing students, including over 25,000 members in Wales. The majority of RCN members work in the NHS with around a quarter working in 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. The RCN represents nurses and nursing, promotes excellence in practice and shapes health policies.