The impact of Brexit and a growing older population could combine in some areas to exacerbate the severe nurse shortages already being felt by many hospital trusts across the country, warns researchers.
Analysist from the Institute for Employment Studies, a leading UK centre of research and consultancy on human resources, said they had identified “vulnerabilities” in the nursing workforce that may leave it exposed to some of unintended consequences of Brexit.
“The ongoing uncertainty around Brexit poses serious questions for NHS workforce planners”
In particular, they predicted trouble ahead for trusts that have also recruited heavily from overseas due to the current nursing shortage and that have older populations, which are most likely to make intensive use of services.
They said that, for the first time, their report brought together analysis to map the regions and trusts most vulnerable to the associated risks of Brexit and population growth.
They noted that the NHS in England was already short of nurses and the current workforce was ageing, with one in three nurses projected to reach retirement age in the next 10 years.
Added to this had been the recent increase in demand for nurses, caused by the emphasis on safe staffing following the Francis report and too few nurse training places having been commissioned.
As has been extensively reported over the last few years, this so-called “perfect storm” has led to increasing dependence among some NHS trusts on recruiting nurses from the European Union.
The authors of the new analysis – Beyond Brexit: Assessing key risks to the nursing workforce in England – identified two models where trusts were most “vulnerable” to further changes sparked by Brexit and population factors.
Firstly, there are those that have very high reliance on EU nurses and higher-than-average growth in the over-85s population. Secondly, there are those with very rapid population growth among the over-85s and above-average employment of EU nurses.
The researchers suggested trusts in London and the South East were especially vulnerable to any post-Brexit disruption to the recruitment pipeline, while the trusts most “at risk” from demographic changes were spread across the regions.
Examples of trusts with “very high proportions” of EU nurses and above average elderly population growth included the Royal Brompton and Harefield NHS Foundation Trust, where 20% of nurses were from the EU in 2015, and the Queen Elizabeth Hospital King’s Lynn, with 18%.
Meanwhile, those facing very rapid elderly population growth with above average employment of EU nurses included Milton Keynes University Hospital NHS Foundation Trust, Burton Hospitals NHS Foundation Trust and Wrightington, Wigan and Leigh NHS Foundation Trust.
In their report, the analysts stated: “The analysis presented here is intended to be a starting point for discussion within the NHS, in the light of the Brexit vote, rather than as the ‘final word’ on the subject.
Brexit and ageing patient combo to ‘worsen nurse shortage’
“That said, analysis of these two projected trends alone reveals that Brexit and population growth may be two of the greatest challenges to many English NHS trusts in meeting growing demand for nursing resources,” they said.
“Our analysis indicates where and to what extent Brexit could squeeze the supply of EU nurses in the NHS in England, and a growing population of those aged 85 and over will increase healthcare demands on already pressurised NHS resources,” they added.
Lead author Dr Rachel Marangozov said: “The ongoing uncertainty around Brexit poses serious questions for NHS workforce planners, who need to act now to reduce the impact of ‘worst case’ scenarios.
“This will be particularly important given that the NHS already faces funding challenges, increasing demand for its services and a rapidly ageing nursing workforce,” she said.
Last month, the government announced a wave of new nursing degree apprenticeships and confirmed further details on the new nursing associate role, which is set to act as a “bridge” between nurses and healthcare assistants.