Policy and Politics of Nursing


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Introduction to Policy and Politics

Politics has emerged to become one of the leading issues in health and social care (HSC) environment. Today there are a number of such issues in context of politics that HSC organizations are facing today. One of them is that of bed blockers (Mason, Leavitt and Chaffee, 2013). It is a situation that an individual tends to stay in the hospital even when they are medically fit to go some place else like a care home or back to their families. But on the other hand, more and more people nowadays extend their stay in such organizations, which in turn is causing major problems for health care institutes. They are suffering from not only financial losses, but many major operations are being cancelled because of unavailability of beds. This report discusses about ways in which politics in HSC can empower nurses to become autonomous, leaders as well as change agents. Further it sheds light on different political and philosophical principles of health care structure and organization.


Today one of the major issues that HSC enterprises are facing is that of bed blockers. More and more health care organizations are experiencing this problem, as they are suffering major financial losses and cancellation of many operations that otherwise may have been very important for the hospital (Antrobus and Kitson, 2009). Bed blocking is a term wherein patients who though are medically fit to leave, extend their stay, as they believe that they are not yet ready to leave. This blocks bed(s), due to unavailability of which those individuals who are in acute need of medical assistance, do not receive the same. Considering this, the NHS has developed some policies that may help in overcoming the issues of 'bed blockers' with great ease and comfort. For instance, one such policy that NHS has developed in association with the government is to give a time of seven days for bed blockers to leave, or else they will have to face some legal actions. Preparation of this policy will now make the nurses more autonomous and they will be in a position to determine whether an individual stays in the hospital or leaves (Merriick, 2015). The emergence of this policy will enable the nurses to take decisions about health condition of an individual and make changes in treatment(s) that they might be receiving. In this sense it may not be wrong to say that the policy will be very helpful to the nurses.

This is so because of reason that it would help the nurses to closely monitor treatment being given to a patient and change it when they feel that the patient is medically fit and can leave the hospital. Herein it may not be wrong to say that development of this policy largely is very beneficial for the nurses, as it would enable them to prepare a much effective course of treatment for the patients. Furthermore, through this aspect they can act as leaders and change agents, as governing body of the health and social care industry – NHS has devised and implemented this policy (Davies, 2004). Health care institutions will now have to invest heavily upon training and development of the nurses and improving their skill sets so that they can discharge their duties in an easy and effective manner.

In addition to it, government also has taken the decision to integrate physical and mental health and social care services, wherein a single personal care plan would be developed according to individuals (Fenton, 2014). The government is also planning to develop a single point of contact for such people. This way, the nurses can be given more power over treatment of individuals, as they are the ones who would take decision regarding health care services that a person receives and when they can leave the institution. Steps taken by the NHS and the government in this context can be accentuated by stating that better coordination would be developed among various departments such as medical and surgery; as well as funding for functioning of hospitals will also be increased. This will enable the nurses to develop methods to function in a much efficient and effective manner by empowering them and allowing them to act as change agents (Milstead, 2004). In this sense, it may not be wrong to say that this approach will largely be very beneficial for the health care organizations, as it would help the nurses to take decisions on their own and also discharge their duties in such a manner that may help in delivering  effective health care services to the users.


One of the most important aspects of functioning of health care firms is that of the organizational structure that they follow (Jones, 2007). Herein it is imperative for such entities to develop and use an appropriate organizational structure, for it is a basis on which the firm can attain success and fulfill its goals and objectives. It is important for such firms to develop their organizational structure on basis of political and philisophical principles, as it can help in developing a base for the health care firm to attain success and also achieve its goals. The philisophy of health care largely is considered as an indelible component of human social structures. Due to this reason, it is very important for organizations to ensure that such philosophical principles are paid proper attention to, as it form the very basis on which effective services can be provided to care users and their health related issue can be resolved (Connelly, 2004). There are certain philisophical principles which have to be considered in this regard. They have been listed as below:

  • Who requires and/or deserves healthcare? Is healthcare a fundamental right of all people?
  • What should be the basis for calculating the cost of treatments, hospital stays, drugs, etc.?
  • How can healthcare best be administered to the greatest number of people?
  • What are the necessary parameters for clinical trials and quality assurance?
  • Who, if anybody, can decide when a patient is in need of "comfort measures"?

In this context, it can be said that present organizational structure of health care bodies in the country is depleting at a very fast pace and is turning into a major catastrophe. Due to this reason, it is becoming extremely difficult for health care organizations to provide effective services and resolve health issues faced by people (Goodson, 2010). According to the last philisophical principle of health care, it can be said that these organizations are in serious crisis, as phenomenon of 'bed blockers' is increasing at a rapid pace, which then is influencing the delivery of HSC services to people who really require them. Although health care bodies are developing effective measures through which those persons who are in acute need of 'comfort measures' can be seperated from those whose health needs are so urgent in nature. But because number of cases related to bed blockers is rising at a rapid pace, it is becoming very difficult for health care organizations to provide services to those individuals who are in the need of it (Mason, Leavitt and Chaffee, 2013).

For the same, there can be two viewpoints, one which states that patients should not leave the hospital until they feel perfectly fine and healthy; while on the other hand, some experts on the topic believe that a person, when once declared as medically fit should leave the hospital (Nikolov, 2013). Due to this reason, it can be said that two perspectives can be developed on aspect of ethics in terms of health and social care, which also is a very crucial component of philisophy of health care industry. On basis of philisophy and ethics, it can be said that hospitals must deliver health care services to people until and unless they themselevs feel confident about it. This means that till the time they do not start believing that they are healthy, they must not be asked to leave the premise of the hospital (Ashton, 2010).

Similarly, political aspect is also very important for the health care industry. The UK government is taking steps to remove its interference from working of NHS (National Health Service) in order to make it more autonomus and giving it more power to carry out its functions in an effective manner (Alcock, May and Rowlingson, 2008). Herein, focus of the government is on creating an independent NHS Commissioning Board. Due to this factor there are chances that significant changes will have to be brought about in organizational struture of health care institutions in the country and also the way they function with a view to attain their goals and objectives (Brooks, 2010).


One very important aspects of functioning of health and social care organizations is related to compliance of different regulatory principles and aspects (Bakar and Mustaffa, 2013). It is crucial for firms that they pay significant amount of attention in order to ensure that all legislations related to nursing are followed, so that effective care can be provided to patients and their health related issue(s) can be resolved. If such regulations are not followed, then there are chances that concerned firm may not be able to provide effective health care services and thus might not achieve its goals and objectives. UK government has developed various policies and legislation in terms of nursing and delivering health care services (Fallon and Hausenblas, 2004). In the country aspect of nursing largely is governed and managed by Nursing and Midwifery Council (NMC) which is a statutory body. It was created with an aim to protect the health and well being of publich in the country. Furhtermore, NMC also plays role in developing and implementing different educational standards, training, conduct and performance so as to ensure that nurses are able to deliver high quality services to people and also ensure that they are able to lead a healthy life (Fisher, 2003). This has affected working of the nurses, as they have developed and improved on their skills that has enabled them to provide health care services in a proper manner and as per the guidelines already set.

In addition to it, the NMC also ensures that nurses keep their knowledge upto date and work as per the professional standards. This way, the statutory body pays attention towards developing high quality working standards at workplace, with the help of which health care services can be delivered to individuals in the country. Since 2002, when the NMC was established it has helped nurses and other health care bodies to work in an effective manner due to which health standards in the country have risen substantially (Milstead, 2004). This has happened primarily because of reason that the NMC has paid a lot of attention towards way in which nurses carry out their duties and provide services to public. In a way strict monitoring of the health care industry in accordance with tasks of nurses has helped in motivating them and making them aware about best ways to complete their duties in an effective manner.

The NMC has given precedence towards taking steps to pay attention to performance of nurses and determining ways in which they can effectively carry out their duties, so that goals of the health care firm can be achieved and proper services can be delivered to people who are in the need of it (Curry, Holder and Thorlby, 2015). In this regard, it may not be wrong to say that different policies and legislations which govern the working of nurses, essentially has motivated them in such a manner that they are giving their best performance and are carrying out duties in an effective manner.

Today there are various factors and forces which can be considered as effective drivers of different policies regarding nursing (Moss, 2012). It is due to these facets only that today the profession of nursing has become so very valued and important for the society. One of them is that of constantly changing political and regulatory climate in the country. Aspect of politics and legal have emerged to be major forces on which working of nurses and the health care industry in general is dpendent. If there are any change in these fronts, then this sector specially the nursing department gets affected in a significant manner. Furthermore, economic environment also has a very important role to play in this regard, as it influences the working of nurses in the industry. It can be supported through fact that due to the issue of 'bed blocking', NHS and other such health care organizations are suffering from major financial losses, due to which many times nurses are not being paid their salaries, which then is hampering their performance (Fertman and Allensworth, 2010). In this sense, it can be said that economic and financial aspect has a very significant impact over nursing, as it is, to a great extent dependent on the same.


Change is one of the crucial aspects of every industry, as it is directly associated with the way that sector performs and carries out its numerous functions. In health and social care industry, change is all the more important and also a very important part of functioning of different organizations in the sector (Wimbush and Watson, 2000). If changes are not brought about in the sector, then there are chances that it might negatively influence functioning of companies in the industry and also their chances of attaining their goals and objectives. In recent times there have been numerous changes at international, national and local level in the health and social care industry, which then is influencing performance of nurses.

Global changes

One of the major chanege that has been brought  about at international scale in terms of health and social care can be seen in terms of introducing long term insurance in prder to cater the aging population. This policy has been introduced by Japan in order to reduce the rate of excessive hospital utilization in the country (Anderson and Keller, 2002). It is now being considered by countries all around the world as a very good approach through which they can tackle the problem of bed blocking but also provide highly effective health care services to the users. This is influencing aspect of nursing in a significant manner as well. Herein, it can be said that by implementing the policy of long term insurance to aging people, load on nurses to care for large number of people can be reduced significantly. It is due to this very reason, the nurses can perform their tasks in a much effective manner and pay attention towards the aspect of quality (Calladine, 2006). Therefore, due to this change, the nurses can discharge their duties and maintain high levels of professional standards in their working.

National changes

In the UK, recent times have experienced significant changes, which are influencing the very aspect of nursing in the country in a significant manner. The UK health and social care industry has not been able to match pace with rapidly changing demographic environment. In addition to this, public expectations from the health and social care industry have increased and changed dramatically, which further is influencing the way this sector performs (Fawcett and et. al, 2000). This has resulted in extreme pressure over the nurses, due to which they are not conducting their duties in a proper manner. This is leading to catastrophic results in the sector. It can be supported through fact that performance of nurses in the country has deteriorated, as they are not giving high quality work. On the basis of it, nursing is being influenced in a negative manner, that ultimatley is influencing the health and social care industry in a negative sense on a general point (Cozens, Firth and Booth, 2003).

Local changes

In London health and social care authorities have initiated various campaigns in order to provide better and effective services to the users and enable them to lead a much healthier life. Different projects have been started with a view to bring about a major change in health care landscape in the city. This has put more pressure on nurses, as now they have to perform a lot many functions in order to provide effective health care services to public (Mumby, 2012). In this context since local support centers asre being established all over the region, work pressure on the nurses has increased by manifolds. This, on many instances is negatively influencing their performance and also their ability to provide appropriate health care services to people. It is due to this very reason, dedication of nurses is diminishing at a rather very rapid pace (Campbell and et. al, 2000).


Policies and politics have a very significant impact over working of the health care industry, in particular the nursing aspect of it. During the present study, it was observed that bed blocking is oneo of the major issues in UK health care industry, as bodies like NHS are suffering from major financial losses, while many hospitals have had to cancel many very important operations due to this very reason. Further philisophical and political principles are crucial for the sector, as they determine efficiency and effectiveness of delivery of different health care services. Further, there are various drivers as well which are driving various policies which govern working of the health care industry and subsequently the nursing aspect of it. According to the study, they can be determined to be political, legal and economic climate of the country. Therefore, it can be said that the concept of bed blocking is proving to be very dangerous for the health and social care industry which essentially is eroding effectiveness of the industry.


Mason, D. J., Leavitt, J. K. and Chaffee, M. W., 2013. Policy and Politics in Nursing and Healthcare-Revised Reprint. Elsevier Health Sciences.
Milstead, J. A., 2004. Health policy and politics: a nurse's guide. Jones & Bartlett Learning.
Davies, C., 2004. Political leadership and the politics of nursing. Journal of Nursing Management. 12(4).pp. 235-241.
Antrobus, S. and Kitson, A., 2009. Nursing leadership: influencing and shaping health policy and nursing practice. Journal of Advanced Nursing. 29(3).pp. 746-753.
Jones, P. A. R., 2007. Nursing Leadership and Management: Theories, Processes and Practice. F.A. Davis.
Mason, D. J. Leavitt, J. K. and Chaffee, M. W., 2013. Policy and Politics in Nursing and Healthcare-Revised Reprint. Elsevier Health Sciences.
Milstead, J. A., 2004. Health policy and politics: a nurse's guide. Jones & Bartlett Learning.
Alcock, P. May, M. and Rowlingson, L., 2008. The Student’s Companion to Social Policy. 3rd ed. Blackwell Publishing.

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