NHS managers have been urged to focus on strategies to hold onto nursing staff by the head of a government arm’s length-body, who revealed that, even with increasing numbers of nurses in training, a shortage was still expected in four years’ time.
During a keynote speech at a conference in Liverpool yesterday, the chief executive of national workforce body Health Education England warned NHS leaders that staff retention was the “biggest single challenge” over the next few years in dealing with the workforce shortage.
“Retention; I believe this is our biggest single challenge over the next few years”
Professor Ian Cumming said HEE was expecting around 16,000 nurse posts to be empty in 2020-21, unless trusts helped to reduce the annual turnover of nurses, which he said was currently an average of 9.5% – though in some organisations it was as high as 35%
He noted an increase in training places in recent years would start to take effect from later in the year, when the first group of nurses on expanded courses would graduate.
Between 2017 and 2021, this would result in 69,000 newly-qualified nurses entering the workforce, he said. But over the same period, the NHS was also expected to see 36,000 nurses retire, based on historic trends, he said.
In addition, 87,000 were projected to leave the NHS for other reasons – although 84,000 are expected to return.
“The number one reason for [nurses] leaving… was flexibility”
The number of nurses the NHS needs is also due to increase during that period – to 330,000. Overall, by 2021, this is expected to result in a national workforce of 314,000 nurses, but with a predicted shortfall of 16,000.
“Retention; I believe this is our biggest single challenge over the next few years if we want to improve the positon of workforce shortages in our national health service,” Professor Cumming told the audience.
He said other strategies – such as encouraging former nurses to return to practice – could help improve the situation, but warned that their success was often linked to an organisation being able to retain its staff in the first place.
He noted that around 2,000 extra nurses had taken return to practice courses in the past three years.
“The number one reason for leaving in the first place wasn’t morale, motivation, pay – it was flexibility,” he said. “They said they couldn’t combine their nursing role in the NHS with looking after friends, family, and their other caring responsibilities.”
He suggested other initiatives that could help in the longer term included the introduction of nursing associates and also forthcoming apprenticeships.
“[The cut to CPD budgets] is a massively significant retention issue for nurses”
Following his presentation, Nicola Ranger, director of nursing at Western Sussex Hospitals NHS Foundation Trust, referred to the national cut to continuing professional development budgets made by HEE last year, which saw reductions of between 30% and 50% at most acute hospitals.
“That is a massively significant retention issue for nurses and for other professionals that are non-medical. Not only is it a retention issue, I genuinely believe it is going to be a safety issue,” she said to a round of applause.
“[In my previous role as] chief nurse at Frimley Health, last year that meant, in reality, half the number of nurses doing intensive care courses, half doing emergency department courses, half doing stroke courses etc,” she added.
Professor Cumming said more money was needed for new workforce models and roles, and training for the existing workforce, but that HEE’s budget was constrained.
Critical need to tackle ‘shocking’ nurse retention rates
He said it was important to spend money “appropriately and wisely” and that there was “huge variation” in how this funding was currently being spent, noting at some trusts it had been used for lifting and handling training.
He stressed that the funding should be being used for “workforce transformation”, rather than treated only as a CPD budget, which it had defaulted to in some organisations.
“I want to invest as much as we possibly can in our current workforce…to transform,” he said.
“We do not want to reduce the levels of funding that we give to organisations for CPD, but what we are trying to do is target the limit resource we have got – alongside significant resources put in by employers – into workforce transformation and growing new roles,” he added.
Mr Cumming’s comments follow a call from another NHS leader for trusts to consider offering junior nursing staff affordable housing as an incentive to join the health service.
It is one of the options that must be explored to help make the health service more attractive, especially for young people, according to the chief executive of NHS Employers.
Danny Mortimer said the workforce challenges and low unemployment levels meant the NHS needed to “up its game” in order to attract and retain staff.