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Scottish care home sector experiencing nursing workforce ‘crisis’

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There is an ongoing recruitment and retention “crisis” among the nursing workforce in the independent social care sector in Scotland, a report has warned.

Pay inequity, the lack of younger nurses and Brexit uncertainties have contributed to the challenges faced in the care home sector, according to the report published by Scottish Care.

“We will see even more care homes close and more of our vulnerable older citizens stuck in hospitals”

Donald Macaskill

The organisation’s Independent Sector Nursing Data 2018 report contains latest survey findings based on responses from 121 care providers between September and October this year.

The annual survey, the third of its kind, found nearly a fifth of all care home nursing posts to be vacant.

Scottish Care said the biggest problem identified to be contributing to the shortfall was an inequity in pay, conditions and esteem in comparison with nurses working in the NHS.

The survey revealed 91% of respondents thought the sector was struggling to recruit nurses due to conditions of the service and because of “better conditions” in the NHS, including those relating to holiday and sick leave.

This was followed by 48% of respondents who claimed that there are too few nurse applicants due to better pay in the NHS.

Another issue highlighted by the survey was a lack of younger staff working in the sector, where 64% of nurses in care homes were reported to be over the age of 45.

In addition, 54% of respondents believed that recruitment was affected by insufficient applicants coming from college and university.

In its report, Scottish Care branded the volume of older nurses as a “major challenge” for the sector.

It added that one reason for this could be that younger nurses were more likely to seek employment within the NHS, where it reiterated that there are better terms and conditions.

“This report shows the scale of the nursing challenge facing Scotland’s care services”

Theresa Fyffe

The survey also found around 12% of care home nurses originated from the European Union outside the UK and, as a result of Brexit, uncertainties the report warned this could mean further challenges for recruiting nurses.

It explained of the potential impact of losing nurses to fill gaps left by European staff within the NHS, the decision of some European nurses to leave the care sector and the challenges of undertaking any new recruitment in Europe.

Among the organisations surveyed, the report was also found that for 2018 the average annual turnover for nurses was 38%.

However, it also noted that for some smaller to mid-sized organisations they saw a turnover of all their nurses within a one-year period.

Scottish Care wrote in its report that this is “extremely concerning” for the negative impact of continuity of care, and also for the morale of colleagues within a care home.

In terms of recruitment, it was found that the average length of a vacancy would appear to be between six and eight months.

Though some respondents indicated that it was taking them between one and two years to fill nursing posts.

Scottish Care

Donald Macaskill

Donald Macaskill

The report goes on to explain that to ensure safe staffing levels are met they are turning to a high-cost solution of agency staff, where it revealed costs varied between £300 and £1200 for an overnight shift.

The survey indicated that only 29% of organisations were not using agency nurses, with 41% saying they were using agency nurses regularly and 7% turning to them all the time.

Chief executive of Scottish Care, Dr Donald Macaskill, said the findings showed that the sector “continues to be in a period of real criticality in relation to nursing care”.

He noted that the challenges surrounding the recruitment and retainment of nurses in social care settings had “worsened” in comparison to last year.

“The nursing care home sector in Scotland cannot continue to rely on dedicated staff giving above what is reasonable, managers on a constant conveyor belt of recruitment, and the inequity of nurse terms and conditions in commissioned social care in care homes compared to those available in the NHS,” he said.

“We urgently need to identify an increased resource in early 2019 to support this highly vulnerable workforce,” he added.

“Faced with this existing recruitment crisis together with Brexit’s uncertainties, we will see even more care homes close and more of our vulnerable older citizens stuck in hospitals unnecessarily as a result,” he said.

Theresa Fyffe

Theresa Fyffe

Theresa Fyffe

Royal College of Nursing Scotland director Theresa Fyffe said: “This report shows the scale of the nursing challenge facing Scotland’s care services.”

In particular, she flagged findings on the 20% vacancy rate, that 64% of nurses were over the age of 45 and 91% of providers were struggling to recruit nursing staff.

She said: “One of these issues would raise significant concerns but taken together they paint a very troubling picture for nursing and the care sector.”

Ms Fyffe called for the care sector, decision makers and nursing leaders to “work together to ensure that nursing in the care sector is an attractive career”.

“This must include addressing historic low pay and assuring clear career pathways which include the opportunity for professional development,” she added.

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