21 May 2025
BSR's nurse job planning guidance is making a positive difference to rheumatology specialist nurses, but almost 1 in 4 nurses say NHS pressures mean there isn’t enough time to discuss job planning.
In spring 2024, BSR published new job planning guidance for rheumatology specialist nurses (see below).
Nurse job planning - Rheumatology
BSR in collaboration with the RCN Rheumatology Nurse Forum have published job planning guidance for specialist nurses to enable greater consistency in job planning, and help departments make the best use of staff resources to benefit patient care.
www.rheumatology.org.uk |
One year on, we surveyed our rheumatology nurse members to find out what impact this new guidance is having on their working lives. The questions focused on whether the job planning guidance had led to more nurses having a job plan, as well as more time for Supporting Professional Activities (SPAs), such as education and training, service improvement, and research, which form part of the Four Pillars of Advanced Nursing Practice. Time for these SPAs has often been squeezed out in the past due to workforce pressures.
We received responses from over 50 nurses from all regions of the UK, including the devolved nations. Around 70% worked in adult services, 30% in children’s and young people’s services, and 4% worked in both. Among the key findings of the survey:
- Almost 80% of respondents reported being aware of the guidance.
- Around 50% said they had been able to use the BSR guidance in their workplace and, of those, 90% said they had found it helpful.
Following adoption of the guidance:
- 10% said they now had a job plan for the first time
- 20% said they now had more time allocated to SPAs in their job plan
- 25% said time for their advice line work was now protected in their job plan for the first time
- 52% said it hadn't really made a difference so far
One nurse said, “We have used this to try to add education/research time into our job plan, as according to the guidance our current job plan is 100% clinical.”
Another reported: “It provided a framework to compare our current job plans with – as our job plans are fairly well matched to the BSR job plans, it’s created reassurance rather than altering workload.”
However, it is concerning that of those who hadn’t been able to use the guidance (around 50% of respondents), almost half said it was because there was never any time to discuss job planning at work.
One nurse commented, “I’ve had real problems getting the current guidance to be taken on board by other members of the management team,” while another said, “It doesn’t matter what you write on the job plan; if you don’t have the staff, you still can’t get it done.”
We know that specialist nurses are highly valued by patients, and they represent an excellent return on investment in terms of patient safety and efficiency. Therefore, it is deeply worrying that the workforce crisis in rheumatology means many specialist nurses do not have time to engage in job planning.
Without accurate job plans and an understanding of the current needs of the specialist nurse role, it is not possible to engage in meaningful workforce planning and ensure that there are sufficient nurse specialists to meet the needs of patients.
In our 2021 workforce report, we called for an increase in the specialist nurse workforce to ensure rheumatology departments are adequately staffed, with a specialist nurse-to-consultant ratio of at least 1:1. Alongside developing practical resources like the job planning guidance, BSR will continue to advocate for investment in our specialty and for growing the rheumatology workforce.