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Mr Hancock… we have a workforce problem

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Two articles that have made Nursing Times headlines in July together offer a powerful warning about the future of the nursing profession. It is not a new warning but it is one that has been growing in significance. 

Nursing Times reported last week that more than 250,000 people had signed a petition calling for student nurses to be paid a minimum living wage, following the scrapping of the bursary in 2017. The number of signatures has now passed 280,000.

It was started by student nurse John Worth at the beginning of July. He pointed out that, unlike other students, those studying nursing faced the additional pressure of having to complete 2,300 unpaid hospital-based clinical hours to join the Nursing and Midwifery Council’s register.

In launching the petition, Mr Worth was clear about his commitment to nursing but said that student nurses felt they were providing “free labour for the NHS” and were being forced to take on other jobs to cover their living costs.

He cited the strain on the mental health of student nurses from the heavy work load of study and placements, combined with financial uncertainty, since the removal of the bursary for pre-registration student nurses in England.

Meanwhile, earlier this month, latest available university data showed that nursing course applications had continued to plummet in England, crashing by one-third in two years.

A total of 35,260 people from England have applied to study nursing at university next year, compared with the 40,060 who had applied by the same point in 2017.

Our report on the fall in applications faithfully follows a clear and alarming trajectory in news headline travel since the removal of the bursary. In February 2017, Nursing Times reported: ‘Nursing applicants fall 23% in wake of bursary loss’.

Then in July that year, our headline read: ‘University applicants for nursing courses remain down by 23% at final deadline’. And by December it was: ‘Student nurses fall by 2.6% in England, official figures reveal’.

These two articles on student nurses raise serious questions about the pressures under which we are asking them to train and they provide strong indications of the consequences such pressures will have on future recruitment to the nursing profession.

Their message is ominously underlined by the fact that the backdrop against which the health service operates is already known to be dominated by workforce shortages.

“People who want to join the nursing profession are passionate about their chosen career”

Delivering care demands clinical competence, but it also demands empathy, intuition and emotional connection – all of the time.

People who want to join the nursing profession are passionate about their chosen career. They are people who want to – and feel they will be able to – deliver clinical competence with compassion.

They have skills and qualities that the NHS needs. They should not be required to overcome huge financial hurdles to be allowed to train in this vital role. They have a right to see their skills developed in supportive and nurturing training conditions.

As Mr Worth says: “I’m a student nurse – I love what I do. But, in all honesty, being a nurse is a real struggle, and being a student nurse, having to work 37.5 hours a week and paid nothing, is even harder.”

Of course, there are precedents for financing work and study combinations that are already in operation. The new apprenticeship route entitles trainees to be paid the National Minimum Wage, for example.

There are many other arguments surrounding the apprentice idea and whether it represents part of the solution to the workforce problem or a step back in time.

However, it was good to see Matt Hancock put workforce as a number one priority in his first speech as health and social care secretary last week.

His message was a positive one. “I value you. I admire you. I will fight for you and I will champion you,” he said, adding: “I want to ensure training is organised and funded so that everyone can reach their full potential.”

“It is vital that he and his department get a grip on the workforce issues”

He also promised to launch a consultation exercise on workforce issues and called for “everyone who gives their lives to this amazing vocation” to respond with their views.

It is vital that he and his department get a grip on the workforce issues they learn about in their promised consultation, while taking a serious look at the vital student pipeline should be a priority already. He can expect a letter from Mr Worth on the matter very soon.

Announcing the consultation, Mr Hancock stated: “In both health and social care I want your voice to be at the heart of government.”

The NHS and patients need the nursing voice to be heard. We all need that voice to be at the heart of government – where it belongs.

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