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National nursing shortage could continue beyond 2020

  • 15 Comments

The shortage of nurses across England will continue beyond the turn of the next decade if provider trusts fail to reduce demand for services, it has emerged.

It has been revealed that Health Education England’s commitment to close the gap between the demand and supply of adult nurses is based on providers reducing demand, as outlined in the NHS Five Year Forward View.

“The position is set to get increasingly difficult”

Cheryl Clements

HEE has confirmed that it will not be able to supply the health system with enough nurses if trusts cannot cut activity. Without that reduction in demand, HEE has said trusts will continue to struggle to fill vacancies every year to 2020 and beyond.

However, trusts are planning for activity growth above what is envisaged in the forward view – meaning there is a gap between the number of nurses set to be supplied by HEE and the amount trusts believe they need.

The education and training body said growth in demand for nurses following the 2013 Francis report led to 24,000 whole-time equivalent nursing posts being created between 2012 and 2015, an 8.1% increase – much higher than trusts had been forecasting. In 2015-16, trusts predicted a further growth of 8,000 FTE nursing posts.

Details of a potential gap between supply and demand, identified in a HEE report, emerged last month in a board paper from The Rotherham Foundation Trust.

The HEE report said: “Such expansion [in demand for nurses] appeared to be inconsistent with the assumptions in both the [2015] spending review and the Five Year Forward View.”

Forecast demand and supply for adult acute nurses 2011-2020

hee trust demand forecasts adult nursing 2015

The report included a graph (reproduced above) which shows the potential gap between trusts’ forecast demand for nurses and the potential supply from HEE.

Rotherham workforce director Cheryl Clements said in a report to the trust board that the HEE graph showed “the challenging position regarding the recruitment and retention of qualified adult acute nurses in England”.

The Rotherham Foundation Trust

National nursing shortage could continue beyond 2020

Cheryl Clements

She added there was already a gap between nurses in post and the numbers required prior to 2013, but this had since been aggravated by the need to ensure safe staffing levels following the Francis report.

Ms Clements said even HEE’s best case scenario for nursing supply is below the level trusts believe they will need, and it assumes trusts increased their nursing numbers in line with their plans last year, which was “unfeasible due to the spending review”.

She said: “Therefore, the position is set to get increasingly difficult and means that Rotherham will be competing with the other trusts for a decreasing supply of nurses, including a potential reduction in new qualifiers.”

HEE told Nursing Times’ sister title Health Service Journal that the situation described by Ms Clements reflected the tension between the Five Year Forward View, the NHS’s funding settlement in last year’s spending review, and the need for more efforts in retention and efficient use of the existing workforce.

HEE said it remains confident it will close the supply and demand gap, but only if trusts made changes in line with those outlined in the Five Year Forward View.

“We are training more people to enter the system than those leaving”

Rob Smith

Rob Smith, director of strategy and planning at HEE, said: “HEE set out its position clearly in its latest workforce plan, outlining proposed commissions for 2016-17. This has not changed.

“We again increased the overall volume of education and training with nearly 40,000 new opportunities for nurses, scientists and therapists,” he said.

“Our forecasts of future supply show that we are training more people to enter the system than those leaving in every profession, with an additional 80,000 staff across a range of professional areas potentially available to be employed by the NHS by 2020,” said Mr Smith.

“In nursing and midwifery alone, we are forecasting an additional 47,000 in available supply,” he added.

Diane Abbott, Labour’s shadow health secretary, said: “These revelations are an outrage. We have an ageing population and a health and social care sector that’s been decimated by cuts. By any measure, the Tory’s approach is a false economy.”

  • 15 Comments

Readers' comments (15)

  • Demand, efficiency and funding are (according to the NHS forward five year plan) the three 'fronts' that require action to 'sustain' the NHS. The idea to reduce demand by making people more responsible for their own health sounds great but has not worked out too well, and planning to care for people out of hospital is fine providing they have someone who can 'care' for them at home. Of course there is always the 'controversial system efficiencies' that we probably don't want to know about, but are all aware that the greatest 'efficiency' would be to make sure nursing staff are paid the minimum they have to be, which means a continual pay freeze. Any reference to ' funding' just means there is no more money!


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  • We should go back to the days of schools of nursing, it worked fine, students paid to work, students that were compassionate and caring, not necessarily with 3 A levels. 12 weeks learning on a unit, 2 weeks in school.
    Also bring back the enrolled nurse.

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  • So, shortage of nurses to continue beyond 2020. Could this possibly be linked to headline in same e-mail "Pay restraint for NHS nurses to continue to 2020"?? Just a thought!! If pay continues to erode it makes no sense for nurses to stay in the job, they can earn as much elsewhere with much more pleasant working conditions. Oh, and what about the cutbacks to Learning Beyond Registration? Hardly an incentive when nurses are denied the opportunity to increase their knowledge base and professionalism. Nursing used to be described as a profession - no, it's now just a job - b***s on seats - well, not seats exactly as we never have time to sit down.

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  • I like how Anon 5:43PM brings up ye olde nursing, because the article could be talking about any aspect of nursing and someone will still find a way to bring up the old nursing ways. I trained in the late 60s in Birmingham and learned the old fashioned ways of hospital corners and sterilisation. We had an intake of about 30 with only 2 leaving. When you hear about attrition rates nowadays it makes you think if we should go back to how it was before. Then you hear BCU takes in about 300 students a year and Birmingham about 100. Hospitals don't have the capacity to teach the way they used to and would never be able to anywhere near this number under the old nursing school ways. The variety of skills that nurses take on is amazing. I remember the first time I saw a nurse take bloods in the 70s, I was totally gobsmacked, and now taking bloods is a minimum nursing requirement in some area's. Oh, and what I remember from EN's they were used and abused and taken for granted.

    Reasons for shortages have always been the same. Even in my day poor pay and conditions, NO progression, unsupportive management and ever increasing demands were the main reasons for leaving. There needs to be a major cultural shift in the profession if you really want things to get better.

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  • Re Pippi 6.45 p.m. The clue is in the word "profession" - it just isn't a profession any more. Nurses have no respect from anyone, and Dept of Health thinks we will carry on year after year with no pay increase and no career progression. I frequently mentor students and often ask if they are happy with their choice of course - the majority say no, so I advise them to get out if it is not too late, or failing that, continue with the nursing course, get the qualification as a fallback, and consider something where they can use their talents properly. Sad!

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  • There are so many qualified nurses from the Philippines who works in the Uk as a Senior health carers. It will help to fill up the shortage of nurses if NMC reduces the required bond score of IELTS OR abolish it. Just give a 3-6 months refresher training to those licensed Filipino nurses and the problem will be diminish.

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  • Funny that I see this today. I was on duty on Saturday and as we all do we have those rare moments when we sit and discuss the profession. I told one of my colleagues that I would not advised anyone to go into nursing. It is not worth it, the politics, lack of support, poor pay progressions system (you have a band 7 earning less than a band 6 but with more stress), cliques, nepotism, no funds for futher education and the list goes on. I am not surprised that the nursing shortage will continue.

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  • @ Mary Vales Apologies, but if they cannot fulfil a reasonably simple IELTS requirement (I've got an overall bAnd 8 and I'm far away from being excellent in every aspect of the English language) they should not practise as RGNs.

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  • I want to see how theresa mae reacts to this. I don't think she'll ever wake up to her senses no matter how many times she may be slapped with this reality. She is narrow minded and has a hardened heart. Continue to remain stubborn at the expense of the British people who certainly deserve better. Cameron has already fallen, now let us see this old lady fall and follow her master.

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  • Its sad that policians do not see or want to see what is happening (or want to), I can't see anything getting better.

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