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Nurse shortages 'likely to worsen' as result of workforce 'perfect storm'

  • 27 Comments

Nurse shortages in the UK are likely to get worse and could put patient safety at risk, unless governments take immediate action to tackle recruitment and retention problems, the Royal College of Nursing has warned.

A “perfect storm” of problems now face the profession including rising demand, an ageing workforce with more nurses closer to retirement, insufficient number of trainees and potential threats to international recruitment from the UK’s decision to leave the European Union, it said.

“The trends indicated in this report add up to a perfect storm of risks to the future supply of nursing staff”

Janet Davies

In addition, the decision by the government in England to remove bursaries for students risks deterring people from applying to become a nurse and could also lead to an uneven distribution of trainees across regions and specialties, compounding shortages further, said the RCN.

There are already “mixed fortunes” for staffing across different nurse specialisms, according to the RCN, which carried out new analysis of NHS data that revealed “sizeable falls” in learning disability and community nurse numbers, in particular.

Official data in England from NHS Digital shows that, despite the small 1.6% increase in the overall size of the NHS nurse workforce, the number of learning disability nurses reduced by 23%, from 4,667 in 2011 to 3,577 in 2015.

The size of the community nursing workforce also dropped by 11% over the same time period, from 40,281 to 35,726. In addition, the mental health nursing workforce declined by around 8% from 39,024 to 35,671.

“By making nursing like any other degree… the government has made it less appealing”

Janet Davies

Meanwhile, the RCN noted that health visitor numbers had begun to fall for the first time in recent years, coinciding with the end of the UK government’s pledge to boost the size of the specialism.

In Wales, learning disability nurse numbers reduced by around 4% and in Northern Ireland there were also 7% fewer learning disability nurses in 2015, compared with 2011 – at the same time as an almost 4% reduction in district nursing numbers. Comparable data for Scotland was not provided.

The analysis – prepared both for an RCN report on the UK nursing workforce and its annual submission to the NHS pay review body, which advises UK governments on salary increases – also warned about the ageing workforce.

Royal College of Nursing

Status of EU NHS staff needs protection post-Brexit

Janet Davies

In England half of the nursing workforce was now aged 45 or over – compared with around a third 10 years ago – and were now within a decade of being able to take early retirement, which is also similar to other UK countries, according to the RCN report, called Unheeded warnings: health care in crisis.

The RCN urged governments in all UK countries to tackle the problems by improving recruitment and retention strategies, including providing NHS wage increases of above the 1% cap planned in England.

A survey carried out as part of the RCN’s workforce report found 3% of NHS nurses were actively looking for another job at the time, with the most commonly cited reason being that they were unhappy about their pay.

In addition, the union highlighted years of pay restraint for NHS nurses. It pointed to data from the Office for National Statistics that showed nurses’ weekly earnings had dropped by 14% since 2011, taking account of inflation.

Meanwhile, employers were failing to use local retention and recruitment premia to hold onto staff, which could stop them from moving over to agency work, said the RCN.

In the absence of using premia, recent cases of trusts offering staff higher rates of pay in exchange for sacrificing pension’s contributions were likely to be copied by other NHS organisations, warned the union.

Janet Davies, chief executive and general secretary of the RCN, said: “The trends indicated in this report add up to a perfect storm of risks to the future supply of nursing staff. Many of these risks could have been avoided, and now immediate action is required.

“The government has largely ignored the crisis facing the nursing workforce. Its only action so far has been to change the way nurse training is funded, introducing loans which mean that future nurses will be expected to take on debts with little prospect of fair pay when they graduate,” she said.

Ms Davies added: “By making nursing like any other degree, even though a nurse’s salary is £8,000 less than the median graduate salary, the government has made it less appealing and created more uncertainty.

“Patient safety will be at risk without immediate action to secure the future supply of nurses,” she said. ”This crisis requires a coordinated, long-term strategy to train more nurses and an above inflation increase in pay to help our current staff make ends meet.” 

  • 27 Comments

Readers' comments (27)

  • michael stone

    Is it just me, or is Janet Davies defending nursing much more publically (or publicly if you want) than Peter Carter used to ? If so, I approve of her more robust and open-to-view defence of nursing.

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  • At no point does this article mention the influence the overpriced NMC and their latest buzz policy "revalidation" are having on nurses decisions as to whether to leave the profession
    Personally whilst we have a regulator that hates our profession and introduces silly hurdles at every opportunity I will continue to aim to retire as soon as possible!!

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  • Revalidation is a huge problem I am certainly debating whether to continue after next year when when I will be 59 and my revalidation is due. I feel I still have a lot to give but the current process of revalidation is a huge burden on our unpaid time.

    It is also pretty insulting that at the same time, associate nursing is being rolled out and they appear to have none of the legal responsibilities that RGN's have and will be paid not much less than a band 5 nurse. What is the point ?

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  • Can I get this message across I've said it before there is not shortage of nurses: 1. Operating Theatre scrub or Anaethetics is not nursing. Endoscopy is not nursing, Bed managers, too many matrons not really nursing get these people back to what they were trained to do. Not hand instruments to a surgeon and clean endoscopes all day long.
    Wake up NHS

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  • Again I think Michael Stone is right, this lady is more vocal, but surely it's about time, if we can't strike at least we can be a thorn in the governments side.
    As for the two comments referencing revalidation as a possible reason for retiring, I feel that the hours required don't make revalidation onerous, the time required isn't much over 3 years. Perhaps this is just the last straw for some after years of overwork?

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  • firstly ... to work in an operating theatre scrub or anaesthetics you have to be a qualified nurse ...
    Can someone correct me if I'm wrong ... did I read the other day from the (not fit for purpose NMC) that there are no issues/shortage of nurses... esp now (defending their crappy) revalidation ..

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  • I tend to agree with a previous poster some jobs that are indeed done by qualified nurses could be given over to people qualified in that job alone . Make it a scrub assistant or theatre assistant and put those nurses back into nursing whilst allowing someone else a job role. Why do the aforementioned posts require a qualified nurse? I also agree with posters who are unhappy with the new onerous revalidation process. I'm over 60 and found the whole thing daunting, not least because it isn't relevant to my line of nursing (OH) and I am self employed and only work two days. I have had to be very creative in gaining free training online and attending lectures which luckily my local university do for free, however I have to do it in my free time. This is no so for other professionals who get free training whilst working. As always nursing appears not to have moved on from Florence.

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  • I agree with Janet Davies, chief executive and general secretary of the RCN, due to the following reasons:

    - 29,000 WTE shortage of RGNs within the NHS in 2016 as these are the amount of jobs that have been advertised via the NHS that still remain unfilled… HOWEVER…. The NHS are paying nearly double rates for agency nurses / HCA`s that are offered no training and are not consistent within placements. Agency nurses/ HCA`s will not apply for permanent jobs as their pay will be halved or substantially less…… If bursaries were to remain in place, then the RGN`s should repay this by working for the NHS or private domain within the UK for another 2 years under contract, rather than working for agencies for increased incomes or choosing to move abroad.

    - NHS temporary staffing are trained and the pay is (rightly) based upon the NHS banding… HOWEVER… when the NHS advertises for permanent posts, these are normally focused upon internal temporary staffing as they have obviously received the training and are familiar with their job roles, but they should also advertise nationally irrespective of internal temporary staff.

    - Agency HCA`s/ Nurses are not familiar with individual personalised care and are not consistent within placements but are paid nearly double by the external agencies that the Government has to fund due to staff shortages.

    - Quick fix on use of external agencies has ultimately failed

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  • May I also add that many nurses seem to be moaning about the introduction of the NMC “Revalidation” …..BUT…. This is an excellent idea due to a number of reasons:

    - Any whistleblowing NMC registrant that raises concerns against their managers` or employers will have already had their 5 of some of the 5 case studies overlooked and signed by the relevant manager.

    - “Revalidation” takes into account: “CPD, Feedback Log and Reflective Accounts” (that is crucial which will inevitably confirm that any nurse/midwife is either performing their duties and NMC CoP correctly or are failing).

    - Therefore many NMC registrants will have the ultimate proof of performing their NMC CoP correctly in accordance with the “Revalidation”…..

    - An average rate of 45% of employers refer nurses/ midwives to the NMC that seems to be the predominant highest rate of referrals in comparison to other segmented reasons for referrals.

    - Therefore, if managers & employers have subsequently supported the “Revalidation” process by signing and supporting the NMC registrant….. Then, the NMC referral rate should decrease considerably

    - This in turn should reduce the amount of NMC Fitness to Practise (FtP) hearings, especially against the ones that have whistleblown…..

    - “Revalidation”’ will prove NMC registrants’ whistleblowers` innocence against vexatious allegations.

    - ALSO…., all NMC “Registrants” will empower their own knowledge, so what is the problem?

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  • Lol for 1 revalidation is definately too subjective and just because someone's done 5 case studies doesnt mean A=B and so C wont happen, that is indeed poor logic. Revalidation doesn't near enough cover a plethora of roles, including OH. 2 Revalidation can include tell tale and tall stories. 3 revalidation is too easy a tool to control and manipulate staff. Revalidation might be good for good times, but were now in the mire - desperate times call for any means to keep hold and retain experienced hands.

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