Academics and unions have called for an urgent government response to latest figures confirming that fewer nurses are joining the NHS than leaving it.
The comments were made in response to NHS Digital figures that showed one in 10 nurses were leaving the NHS in England each year, with more than 33,000 leaving last year.
“Each time the strain ratchets up again, they are the ones who bear the brunt of it”
Covering the period 2012-13 to 2016-17, the data showed that leavers outnumbered joiners by 3,000 last year, according to the BBC, which collated and analysed the figures.
It adds to warnings made throughout the second half of last year, after it was revealed in July that more nurses and midwives were leaving register than joining it for the first time in recent history.
The Nursing and Midwifery Council’s register shrunk in size from 692,556 registrants in March 2016, to 690,773 in March 2017, and 20% more people left the register than joined it.
A survey conducted by the NMC at the same time identified working conditions, including issues such as staffing levels, as the main driver for nurses to leave the profession.
Further figures, published in November, showed nurses and midwives were continuing to leave the profession at a greater rate than they were joining, highlighting “major” staffing challenges.
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Responding to today’s stories on the BBC, the Royal College of Nursing warned of a “dangerous and downward” spiral, and described the NHS Digital figures as “disappointing, but not surprising”.
Janet Davies, RCN chief executive and general secretary, said: “Most patient care is given by NHS nurses and, each time the strain ratchets up again, they are the ones who bear the brunt of it.
“We already know there are 40,000 unfilled nurse jobs in England and things continue to head in the wrong direction,” she said, citing figures collected last year by the college.
The RCN called on the government to “urgently” give nurses a meaningful pay rise above inflation this year, increase training place numbers and support career development.
Meanwhile, Unison head of health Sara Gorton noted that the pressure on the NHS was “at an all time high”, with trusts struggling with a lack of beds, staff and flu cases over the past few weeks.
“New recruits are quickly realising that the demands placed on them are unrealistic and overwhelming,” she said. “More experienced nurses are also leaving due to heavy workloads and the ongoing pay restraint.
“The government needs to ensure nursing is an attractive career option by supporting new recruits, and rewarding those currently doing the job,” said Ms Gorton.
Nurse educators responded to the figures by both calling for the reinstatement of the student bursary and also funding for new routes into nursing and continuing professional development.
“This is an issue that needs to be urgently addressed”
David Willett, corporate director at the Open University, said the focus should be the development of nursing degree apprenticeships that are set to be funded through a tax or “levy” on trusts.
He said: “With a significant fall in the number of applications to universities for nursing places down 23% since the introduction of student loans and Brexit threatening the supply of workers from overseas, this is an issue that needs to be urgently addressed.
“As the biggest contributor to the apprenticeship levy, NHS leaders need to ensure the funding is used effectively,” he said.
“It offers the opportunity to address the shortfall, if they use their levy to fund new nursing degree apprenticeships, which could help to ease the strain by developing new nurses and increasing retention rates,” he added.
Brian Boag, associate dean of Salford University’s school of health, said: “The number of nurses leaving the NHS presents the issues that are facing modern nursing in a very stark way.
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“Once a nurse qualifies, there is a range of careers available and nurses are now taking on more and more extended roles that improve the quality of care provided,” he said. “They are working in a much more collaborative way and increasing their skills and talents way beyond the traditional image of nursing.
“We hope the government recognises this and reviews the current lack of funding they provide to nurses who wish to enhance their skills, as nurses taking on differing roles can only lead to improved outcomes for the most vulnerable and sick in our society,” he said.
He added: “Nurses need the opportunity to develop and feel valued in their work as this can only increase the amount of staff who wish to stay in the profession.”
In November, responding to ongoing concerns about staffing, health secretary Jeremy Hunt announced plans for a new national workforce strategy designed to help secure the long-term supply of nurses and doctors for the NHS.
The “robust, co-ordinated workforce plan”, due to be revealed and in place this year, will be the first time there has been an over-arching workforce strategy for the NHS since the early 2000s.