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Tagged In:  Allied health, Nursing

Could dual training of those in nursing jobs and other healthcare professionals be the answer to increased pressures and staff shortages in the NHS?




A healthcare provider in Norfolk recently announced that it would be 'dual training' nurses as both health visitors and school nurses. Cambridgeshire Community Services Trust is concerned that primary school children fall through the net because health visitors tend to concentrate on under 5s and school nurses are focused on secondary school pupils. A total of 10 nurses will have completed the dual training and taken up their new roles by September this year.

"This will plug the gap we have had among the 5-11 year olds where there are already potential concerns, " said Andrea Graves, Clinical Lead for Norfolk's children and young people's services, in an interview with Nursing Times. "So it is about early intervention and about supporting those families before they become teenagers and get to a crisis point."

The idea of dual training of healthcare staff is not new, but it's one that has gained traction in recent years. In its 2015 report, Workforce Planning in the NHS, the King's Fund talks about building a more flexible workforce with a breadth of skills and knowledge:



As we discussed in this previous blog, in 2016 a major review of nurse education recommended a new training model that enabled nurses to spend more time studying both physical and mental health before specialising. 

A number of educational providers offer dual registration degree courses enabling graduates to work as an adult nurse and mental health nurse or as an adult nurse and child nurse. In April 2016, City University's School of Health Sciences became the first to offer a master's level degree that would lead to dual registration as a mental health and general nurse. Associate Dean Julie Attenborough explained the thinking behind the new course to Nursing Times: "From the point of view of East London NHS Foundation Trust, in an acute ward in a London hospital, where you might have to bring in an agency nurse to work with someone who has mental health problems who happens to be on a cardiac ward, being able to employ somebody who already has those skills is very attractive."

Dual training has been traditionally been available to certain other health professionals. Doctors can complete dual Certificate of Competency Training (CCT) in two specialities, for example anaesthetics and intensive care medicine or cardiology and general internal medicine. Psychiatrists can jointly train in combinations such as forensic psychiatry and medical psychotherapy or psychiatry of leaning disability and child and adolescent psychiatry.

In January, the American Journal of Hospice and Palliative Care published an article entitled The Case for Dual Training in Geriatric Medicine and Palliative Care, which argues that joint training in palliative care and geriatric medicine could better prepare doctors to manage an ageing population with complex long-term conditions.



"The changing needs of the population demand a more flexible and adaptable clinical workforce," says the King's Fund workforce planning review. "Retraining the current medical and nursing workforce could be simplified even further through a more comprehensive assessment of skill-mix. This can include current initiatives to relieve pressure on the GP workforce by using pharmacists for medicines management or review, or greater involvement of allied health professionals in the management of patients with long-term or chronic conditions such as musculoskeletal disorders."
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