A workforce in jeopardy: identifying the challenges of ensuring a sustainable advanced HIV nursing workforce

Abstract

Introduction HIV services in England face substantial challenges arising from financial pressures and changes to commissioning. A sustainable HIV specialist nursing workforce will be vital to enable them to respond to those challenges. This paper examines the current workforce situation in HIV services across the country. Methods This mixed method study involved semi-structured interviews with 19 key stakeholders and with 44 nurses / physicians from 21 purposively selected HIV services across England. Data were interpreted using a framework analysis approach. Findings 'Building a career in HIV nursing' identified problems associated with retention and recruitment. Changes in commissioning are disrupting common career routes from sexual health to HIV nursing and a perceived lack of clear career pathway was seen as a barrier to recruitment. 'Developing a specialist workforce' explored professional development of the current workforce which was hampered by poor access to funding or study time for advanced study, and the absence of an HIV-specific advanced nursing qualification. Conclusion The HIV nursing workforce, which provides an increasing proportion of HIV care, is facing serious recruitment and retention challenges. A strategic approach to workforce 2 development and training is essential to overcome systemic barriers and secure the next generation of skilled practitioners. Key messages • The role of the HIV specialist nurse needs to develop and expand to deliver advanced community based HIV care • The separation of commissioning for sexual health and HIV threatens the main career pathway for specialist HIV nursing. • A more robust training programme is needed to prepare HIV nurses to deliver advanced specialist care across settings • A strategic approach to workforce development is needed to ensure a sustainable workforce, capable of delivering high quality care.

Between delivering chronic care and answering patients' burdens: Understanding HIV specialist nurses' experiences in the age of treatment

“…In line with chronic care models, both for HIV and other (non‐communicable) diseases, a higher workload is attributed to the fact that patients, with the current treatment options, remain in care for much longer (Dave, 2004). In addition, political and policy‐related decisions concerning spiralling health care costs as patient‐centred chronic care is provided lead to increasing responsibilities with limited core and support staff (Piercy et al., 2018; Temmink et al., 2000).…”

Avaliação da assistência de enfermagem referida por pessoas vivendo com HIV

“…A assistência de enfermagem às PVHIV é fundamental, com vistas a promover um cuidado holístico e efetivo (Piercy et al, 2018). Assim, há a necessidade de atendimento personalizado às PVHIV, que integre a prevenção e o manejo de comorbidades (Heer et al, 2022).…”