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‘Haemorrhaging’ of community nurses being tackled, claim CNO and system regulator

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Nurse leaders have sought to reassure community nurses that the “haemorrhaging” of staff is not going unnoticed at a national level and that work is underway to address the problem.

Community nurses attending the Queen’s Nursing Institute conference in London on Monday warned that “colossal” workloads and cuts to ongoing training were contributing to high turnovers of staff.

“Over the years we’ve always had ups and downs around real pressures and real stress”

Jane Cummings

Both chief nursing officer for England Professor Jane Cummings and Professor Mark Radford, a director of nursing at NHS Improvement, faced scrutiny on workforce issues at the event.

Official data analysed by NHS Improvement has revealed annual turnover rates for nurses at community trusts in England were just over 14% in 2016.

This level of turnover was a “significant challenge” for community providers, noted Professor Radford, who is nursing director for improvement at the system regulator.

Speaking separately at the QNI event, both nursing leaders referred to NHS Improvement’s new retention programme as a way for employers to reduce the number of nurses leaving.

The programme was launched in July with 20 acute and community trusts, and 20 mental health trusts.

Meanwhile, the CNO was asked by a nurse lecturer from Essex whether the “haemorrhaging” of nurses from community services in “many, many places”, due to an increasing focus on tasks and “colossal” workloads, was visible at a national level.

“We need to look into some of the perhaps more innovative ways we can deliver CPD going forward”

Mark Radford

Professor Cummings said the problem was recognised and being tackled through NHS Improvement’s programme – but that a more positive image of nursing also needed to be promoted, rather than just the negatives.

“Yes, people are working incredibly hard, yes everybody says [the conditions] have never been worse, but over the years we’ve always had ups and downs around real pressures and real stress,” she said.

“So, for me it’s about the image. And, actually, when you meet frontline staff they are very positive and upbeat about what they are doing and about the impact they are having – at the same time as acknowledging that they have never worked harder,” she said.

NHS Improvement

Senior nurses appointed by national regulator

Mark Radford

In addition, she told delegates that it was important for staff working in other roles – such healthcare assistants or new nursing associates – to help free up nurses’ time.

“This is not about denuding registered nurses of the role they must do – because we know the impact of graduate nursing is significant – but we have to think differently,” she said. “More of the same won’t work.”

Later, Professor Radford was asked by a community nurse what action was being taken to address cuts to funding for continuing professional development training, which was contributing to staffing problems.

He acknowledged there were challenges due to national funding cuts, but also suggested that employers could be doing more to develop some training in-house.

In future, more needed to be done to influence how workforce funding for local sustainability and transformation partnership (STP) plans could be diverted towards professional development training, he said.

“All of us have described some of the challenges associated with CPD – particularly with CPD in terms of the central funding position,” said Professor Radford.

“However, when I go to visit trusts I always look at the offer they have for staff and thinking about the expertise that sits within their own organisation and the flexibility around professional development that exists by doing things differently within the organisation – and using that expertise to set up courses and frameworks,” he said.

“With the funding challenges that remain, we need to look into some of the perhaps more innovative ways we can deliver CPD going forward,” he added.

A recent report from recruitment company Hays recommended that trusts should focus on boosting training opportunities and improving working culture in order to attract and retain nursing staff.

“Results show that healthcare professionals place value on the entirety of the job offering, with culture and professional development key areas of focus outside of pay,” said the report.

To coincide with the conference, the QNI revealed survey findings indicating that almost all district nursing course providers had “major concerns” about the future funding and viability of their programmes.

The institute also said it was concerned that recent increases in the number of students on such courses appeared to have now “reached a plateau”.

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