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NHS facing potential nurse workforce crisis, study warns


A government-commissioned report has revealed the NHS could be crippled by a shortage of nearly 200,000 nurses in just three years’ time, Nursing Times has learnt.

The major study makes predictions on changes in healthcare demand and the supply of registered nursing staff in the NHS in England between 2011 and 2016.

The report, compiled by the Centre for Workforce Intelligence, is not yet in the public domain but has been submitted to the Department of Health and is understood to have been read by ministers.

In the worst case scenario, the gap between supply and demand will grow year-on-year, leading to an overall shortage of around 190,000 registered nurses by 2016, the report predicts.

Under this scenario, demand for registered nurses will rise from 600,000 staff in 2011 to 700,000 in 2016, but the supply of nurses will fall from around 570,000 to around 510,000 over the same period.

Nursing Times revealed last year that the number of nurse training places at universities had been slashed by 2,500 places – a drop of 12.7%.

Meanwhile, 57% of respondents to a Nursing Times survey earlier this month described their ward or unit as already sometimes or always “dangerously understaffed”.

The new report is aimed at informing workforce planning in the NHS to help meet future needs. It is also understood to project nursing workforce demand and supply beyond 2016 as far forward as 2030.

In the best case scenario, the report will suggest there could be enough nurses in 2016, but only if demand remains at 2011 levels – unlikely given current trends in patient acuity driven by the country’s ageing population.

Peter Sharp, chief executive of the Centre for Workforce Intelligence, told Nursing Times the worst case scenario figures did not necessarily mean there would be an actual staff “shortage”.

“It’s only a shortage if someone is willing to employ someone and can’t,” he said. “We can see there will be greater demand – how that demand is met is another question.”

He said the NHS needed to find new ways of re-engaging and motivating existing staff, pointing out 65% of the staff likely to be working in 2030 would already be working now.

In particular he highlighted how healthcare assistants were used (see opposite). “In the past the use of HCAs has frankly been poor; poor in training with little or no regulation, but just because that’s been the case it doesn’t mean it should always be that way.

“We have to find ways of improving the existing workforce with new and different ways of working to help meet the rising demand,” he said.

If there is a shortage, the NHS may need to recruit nurses from overseas, as it has done in the past.

But this will be more difficulty in the future given new, tougher immigration rules and the fact the UK has signed up to a World Health Organization commitment to be self-sufficient in securing its own healthcare workforce.

Howard Catton, director of policy at the Royal College of Nursing, said it was good to highlight the potential shortage of staff, noting also the Mid Staffordshire Foundation Trust public inquiry report published this month by Robert Francis QC.

“The Francis report has shone a spotlight on having the right numbers of nurses and the link between that and high quality care,” he said.

“There is absolutely a numbers issue and we need to see the supply line stabilised. We can’t afford to keep cutting the number of pre-registration training places. We also need to work much harder to keep people in the profession.”

Health Education England, along with Local Education and Training Boards (LETBs), will take on responsibility for the training and education of all healthcare professions from April.

A spokeswoman from HEE said there were limits to the predictions in the centre’s report, but it was a “contribution” to the debate on future staffing needs.

She added: “We will work with LETBs to produce robust workforce plans based upon the information they will have from local providers – as well as different forecasts of the future that various commentators have made – to ensure the NHS has staff in the right numbers, with the right skills and the right values and behaviours to meet the needs of patients.”

A Department of Health spokesperson said: “It is important that the NHS has the right staffing in to deliver high quality care to patients.

“The role of the Centre for Workforce Intelligence is to consider and  report on a wide range of scenarios based on a number of factors; including whether the education and training of health care professionals planned will meet future demand.”   


Readers' comments (75)

  • Chickens coming home to roost maybe?

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  • this is just what the tories want, they can then move more private companies in

    more profit for thier rich friends at the expense of the ill..well done cameron..

    we will cut the nhs not the deficit

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  • Anonymous | 19-Feb-2013 10:13 am

    Ok we all understand where you stand politacally

    Any thoughts about where the Tories rich friends are going to recruite nurses ?

    The point of the article is to highlight the potential lack of nurses ! If such a shortage occures it will affect all sectors of the health care economy !

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  • No s--t sherlock; we've known for a long time that the registered nurse population was going to decrease dramatically, partly due to a lot of middle aged nurses retiring, but those nurses are leaving earlier than planned because of what is happening to the pensions. Also nurses are really fed up and leaving to do something else. This country prefers to deal with crisis management rather than careful planning and looking after the staff they have. Its so crap!!

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  • Well said Jenny.

    Is there really any surprise in this? The working conditions, rubbish pay, decimated terms and conditions, constant attacks, criticism and blame,etc etc etc, has had a devastating effect on moral.

    So many current nurses are leaving the profession now or at the very least wish they could, fed up with the way they are treated and the conditions they have to put up with.

    The majority of nurses I personally speak to all say that if they had their time again they would never have entered in the first place.

    And how are they going to attract new recruits to the profession when they see all this? Low pay for a degree and a lot of sacrifice, awful working conditions, no real prospects (that is if they are lucky to actually find a job!)constant attacks, criticism and so on in the media, who would willingly choose that?

    And they wonder why there will be a staff shortage?

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  • wouldn't a little common sense and foresight have helped to predict this as well as the lack of provision of community services, care of the elderly and other vital public services? it seems all of these demographic problems have been known for a very long time by everybody else except the government who ignore the problems which affect the daily lives of British citizens and keep themselves far too occupied with more trivial priorities of their own.

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  • The debate is philosophical and political so the twain can not be separated. The response to the crisis is to cut nurse training places by 12%. The solution is to go for the cheap option usually sourcing of nurses from third world. This is now not guaranteed due to a racist immigration policy. Nurses can now go to other countries that guarantee them security and a friendly environment.

    Its important to reinforce that for those with money these things do not matter much as their wealth can cushion the rich. They may not all be Tories. Those who will suffer are the poor and marginalised groups.

    Training HCA is a must' For the task we need good education services. A happy workforce will deliver better care . The narratives about staff leaving show all is not well at the workfloor.

    To play games with people's health would be a major mistake. Clearly these issues need open and democratic debate which would try and generate some consensus.

    There is a democratic deficit in how things are now done in the UK and we should all be politial.

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  • Nursing is struggling now. The profession is failing to attract academically able young people

    The recruiting ground is now amongst people in their late twenties /thirties and in some cases even older.

    Many of these recruites enter uni via some kind of access scheme. Something like 20%+ fail to complete.

    Some site family pressures others cannot cope with the academic demands of the course. Many find themselves in financial difficulty or have problems with child care.

    Many problems have to be addressed before we can be assured of the professions future.

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  • Jenny, I agree but that is only the start of the problems.

    I think the start of the solutions is to offer nurses a starting pay that a) isn't an insult, b) recognises the degree plus level quals, skills, and training nurses have, (as well as the work we do), and c) is stable and not constantly under attack.

    That is how to begin, and I stress that word, to attract decent people.

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  • No surprise the shortage will get worse.
    More nurses retiring, some especially before pension changes take effect. It is a physically + mentally exhausting job. How many people in Parliament have fallen asleep during sessions, and that's nowhere near as physically exhausting (mentally, I'll fall asleep listening to all that babble) and that does not involve dealing with concerned patient's + relatives a lot of the time. If they fall asleep in the middle of the day, chances of they people 'look after' dying are also unlikely.
    Lower number of places to train nurses at universities. If in-house only training is great, then why is it hard for a lot of nurses to secure funding, training + development for courses, time off the ward for the programmes, protected time with their mentors to properly assess, develop and supervise training needs, and to meet concerns and areas for development.
    Also to meet the requirements and demands of enabling future nurses to have both excellent knowledge and practical skills, courses have both high theoretical and practical elements, incorporating university and hospital/community and other placements on degree-level programmes are now necessary; cannot just use workbooks or only focus on one or other side (ie no good if its purely hospital training). Why should students go through this very difficult nursing training, when they can find easily other degree programmes, probably similar effort and stress, can offer better rewards and working conditions when they qualify and take a lot less flak in their jobs.
    Less people would want to become nurses, due to all the negative publicity in the press, media and from existing nurses who find their working conditions extremely difficult and demoralising. Odd bits of good news is not enough to change this culture of attacking nurses.
    Caring and compassionate nurses will leave, due to the constant feelings of being battered and not listened to at work. More importantly, its people who create these policies for changes in the first place, are not listening and only promoting their own agendas, which is having this domino effect of poor care right through from strategic management to frontline delivery and allied support services.
    Cuts will affect public, private and voluntary sectors; private companies will also find it more difficult to poach nurses from public sector when the shortages gets worse.
    Much easier for skilled and experienced nurses to leave their jobs/roles to use their skills elsewhere locally or abroad, wherever their skills and attributes are valued and respected. Yes, its an employers market picking up which excellent nurse they want to hire and/or which poor nurse they want to fire. It doesn't help recruitment of excellent staff if there's less to choose from and doesn't help retention if staff want to leave to find better prospects elsewhere.
    Anyone given a choice of jobs, would take the one offering better remuneration packages, overall working conditions and environment where they are not subjected to any abuse from anyone.
    People will only realise what they've lost, when its too late and find that they need more good nurses. When people are ill, it doesn't matter if you're very rich or poor, you'll need help and staff to deliver it. But do people think about how we let the care services get into such a state when their fit and well, or only bring it up when it directly affects them and by then its late for changes to really help them.

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