- There is a dire shortage of nurses
- The NHS needs a plan for how to address the challenges it is currently facing
- NHS Improvement is being honest about the problems and we need to saw more of this
- We cannot fix the challenges
My exposure to nursing has been pretty brief compared with some of the nurses I meet. I’ve been editor of Nursing Times for just over six years, so when I say that it feels like the NHS is under the greatest pressure in my experience, it may not sound especially significant.
“It is refreshing to hear a senior nurse leader being honest about the challenges”
However, today, Ruth May, executive nursing director at NHS Improvement, has openly admitted that this is the “toughest” she’s ever known it – and she has way more exposure to the healthcare system than I.
There is a shortage of nurses, exacerbated no doubt by the uncertainty for nurses from the EU who might have considered joining the NHS, and the long-running regime of pay restraint and real-terms budget cuts that deters people from staying in - or joining – the profession.
It is refreshing to hear a senior nurse leader being honest about the challenges the system has to cope with – all too often we hear whitewash from the Department of Health or NHS England. For example, I’ve lost count of the number of times the Department has responded to similar stories with variations on “We expect all parts of the NHS to make sure they have the right staff, in the right place, at the right time to provide safe care.”
“I know chief nurses who have had to roll up their sleeves and help out”
I’m sure we’d all support that as an aspiration, but as an expectation? If you can’t recruit the staff you need because they don’t exist, or caps on agency spending prevent you from staffing your wards how on earth can you meet it?
I know chief nurses who have had to roll up their sleeves and go back to their wards or A&E departments to help out, and while it may be good for these senior nurses to keep in touch with the front line, that should be something they do in a planned way or in short-term exceptional circumstances, such as a critical incident. The fact that they are doing it repeatedly to plug gaps shows how serious the situation has become, while diverting those nurses from their management and leadership responsibilities does nothing to solve the situation in the longer term.
“This situation is completely untenable”
And how attractive does it make a chief nurse role if you can’t provide safe care because you can’t recruit enough nursing staff, yet will be in the firing line when things go badly wrong as a result of the shortage?
This situation is completely untenable. More than that, this is a crisis. Yes, the nursing associate role will help provide much-needed care for patients - eventually, but while in training those nursing associates in the pilot sites should be supernumerary, and with the system under such intense pressure that will be difficult. In any case there are only initially 1,000 nursing associates, rising to 2,000. This is not going to fix the problem, when as Janet Davies, chief executive at the Royal College of Nursing, points out, there are 20,000 nurse vacancies across the country.
Pieces of paper and strategies and frameworks will help in the long term, but isn’t it time someone did something big right here, right now to tackle this problem? The starting point is being honest about the situation, and for that, I thank Dr May, deputy chief nursing officer for England, for her candour. Because we will never fix the problem unless we are honest about the size and scale of it first.