Health Education England’s chief executive has said he wants to ensure the UK is self-sufficient for nurses and is aiming for a small surplus across all healthcare professions.
Professor Ian Cumming also repeated an earlier announcement that a key focus for the workforce planning body would be improving the retention of staff in partnership with the wider NHS.
“We shouldn’t be relying on other countries to produce our future workforce”
Professor Cumming, who joined Health Education England when it was created in 2013, stated that it was his ambition for the UK to be self-sufficient within the next four to five years.
“We should never be aiming for a shortage of anything,” he said. “In the past we, the system, have aimed to produce the number that we need and we have always fallen short so why don’t we aim to produce a few more? Our desire is to see a small surplus of supply in every clinical workforce group.
“As the fifth or sixth largest economy in the world, we have to be aiming for self-sufficiency in all our healthcare professions,” he said in an interview with Health Service Journal.
“We shouldn’t be relying on other countries to produce our future workforce,” he said. “Let’s get to self-sufficiency but not turn off opportunities that we have got to train people from around the world.”
Professor Cumming added that “the potential was there” for nursing to be self-sufficient in future, with increased training numbers and new routes into the profession.
“I can easily see 4,000 or 5,000 people going through a [nursing] associate training course,” he said, referring to the new bridging role being piloted between healthcare assistants and nurses.
Highlighting another government policy, he said: “We also have the nurse apprenticeship route, which has 1,000 starting this September. We have some large numbers coming, as well as the cohort going through university.”
Hinting at the potential for the future, Professor Cumming said HEE was “right at the bottom” of its predicted supply of nursing staff to the NHS, he suggested.
Meanwhile, he said stemming the growing number of healthcare professionals opting to leave the NHS was the key to ensuring it had enough staff, reiterating comments made last week at a conference for NHS managers.
“If we can take retention of our nursing workforce back to what we were achieving in 2012, the vacancy level goes down to 9,000, which is roughly 3%,” he said. “That is normal turnover.
“Eighty-seven thousand people in this coming period of four years will leave the NHS; 84,000, not necessarily the same people, will come back,” said Professor Cumming.
“What we’re saying is, even if we can improve that by 10,000, it makes an enormous difference, because by 2021 it means we won’t have any vacancies,” he told Health Service Journal.
“We have got to get the pipeline coming through but if you don’t focus on the current staff you’ve got 15 years before new people are in the majority,” he said.
“There is no point in just using the training pathway as the solution, if we are then losing people”
Professor Cumming added: “It’s not production of new staff [that is the problem], they have come off the pipeline exactly as we anticipated. It is around what has happened to the people we have already got – more people at the higher end of expectations have left and we have seen an increase in part-time working. Those are the two main factors driving this.
“There is no point in just using the training pathway as the solution, if we are then losing people from the service or they are not choosing to work full-time in the NHS,” he noted.
Professor Cumming was also asked whether the government’s policy to scrap the student nursing bursary had resulted in an impact on applications for places, in the wake of recent UCAS figures.
- Figures show nursing degree applicants still down by 23%
- Nursing degree applicants fall 23% in wake of bursary loss
- Universities warn of drop in applicants for nursing courses
He said: “We don’t know is the honest answer, and I won’t be able to tell you until October. There are direct applications made to universities and universities will set their own cut off dates.
“We won’t know until we get past clearing and the numbers are released. As we understand it, on aggregate across the country more people have applied for nurse training than there are places available,” he said.
“But we need to be cautious about that. We are expecting some individual peaks and troughs,” he added.
In addition, asked whether he believed pay restraint should be abandoned to improve retention, he said it was not for him to comment on pay, as it was government policy.
“How much people get paid clearly is a factor,” he said. “The people I have spoken to who have returned to practice said their number one issue wasn’t pay but flexibility to fit their work around their family and other commitments.
“Some organisations are giving their staff a huge amount of flexibility over self-rostering while other organisations are still being very command and control,” he added.
On Brexit, Professor Cumming said he believed its impact would be felt more in less well paid staff groups.
- ‘Stark’ decline in EU nurses coming to work in UK continues
- EU nurses leaving NHS, warns RCN ahead of Article 50
- Significant drop in EU nurse numbers ’for first time in years
For example, some European Union staff have been affected by the fall in the value of the pound, as they send money home or save it for returning to their country of origin.
He said: “I am sure, absolutely certain, that we are losing nurses from this country, for various reasons, of which Brexit is one of them. Brexit is a factor we are including in our assumptions.
“What we want to do is look after all our workforce wherever they come from. Retention doesn’t just apply to UK nationals but everyone currently working in the NHS,” he said.
Data released this month shows the number of nurses from the EU registering with NMC has decreased dramatically since last June. The number of EU nurses leaving the NHS in the year to December 2016 rose by a third.
However, while Brexit was initially cited as the major cause, problems with English language testing have subsequently emerged as the more likely main driver behind the trend.
- NMC to assess whether controversial English test is too hard
- Exclusive: Trusts warn NMC test stalling EU nurse recruitment
- Exclusive: English exam stalling nurse recruitment, says agency
NHS in talks with Indian hospital firm over exchange programme
Talks between Health Education England and one of India’s largest healthcare providers could see qualified nurses from the country coming to work in the NHS.
The national education and training body has confirmed it is in talks with the Apollo Hospitals to provide postgraduate training in the NHS to nurses from India for a limited period.
No deal has yet been agreed but HEE and Apollo already have a memorandum of understanding on sharing staff and training opportunities, which was signed in 2015 and has been used to source GPs.
Health Education England chief targets future nurse surplus
HEE chief executive Professor Ian Cumming told Health Service Journal that the negotiations were at an early stage.
He said: “They are looking for registered nurses working for their organisations who are seeking to get further training in paediatrics, ITU, theatres, A&E, etcetera; and they are having a conversation with us on whether the NHS would be able to offer on the job training.
“This would be for a fixed period on an earn-learn-return basis – maybe two years,” he said. “They work as nurses to get that postgraduate experience and training in the specialities we have in this country.”
Professor Cumming said it was too early to say how many nurses could come to the UK and emphasised no contract had been signed with Apollo, but he added: “They are very enthusiastic.”
Any nurse who came to the UK would have to pass English language tests and meet the Nursing and Midwifery Council’s requirements to be added to its register.
The initiative, if agreed, could provide additional nurses for NHS trusts. While he would not be drawn on numbers, Professor Cumming said: “I don’t envisage it being single fingers.
“As a theme, it is something we would like to build on,” he said. “The NHS provides some of the best postgraduate education training for doctors in the world and we also do some pretty good training for nurses and allied health professionals.”
He added: “If there is a way that we can continue to offer that sort of training to other countries around the world, why should we not do it as long as we aren’t substituting our own staff?”
Apollo started in 1983 and is one of the largest healthcare providers in India. It runs 41 hospitals with more than 7,000 beds.