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”
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”
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.
Status of EU NHS staff needs protection post-Brexit
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.
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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.”