The NHS has failed to drive recruitment to increase its community nursing workforce, despite repeated government rhetoric on moving care out of acute settings, a Nursing Times investigation can reveal.
Workforce figures obtained from eight of England’s 10 strategic health authorities show that the much-heralded shift of care from hospitals into the community has so far failed to gather momentum - nearly three years after it was first announced.
Only one SHA, West Midlands, appears to be looking at recruitment to shift its workforce in line with the government’s intentions to provide more community care nursing - first announced in early 2006 in the white paper Our Health, Our Care, Our Say.
The SHA had 3,114 fewer acute whole-time equivalent (WTE) posts in 2008 than in 2007, while community WTE posts had increased by 3,330 over the same period.
Most other SHAs are still increasing their acute nursing workforce at a greater rate than their community nursing workforce. Within NHS North West, NHS South Central, NHS South West the increase in acute WTE nurse posts between 2007 and 2008 was around double that of the increase in community posts.
However, NHS London increased its acute workforce by a massive 2,044 posts but its community nursing posts by a meagre 202. NHS North West in fact reduced its community nursing workforce by 54 posts and increased its acute by 852. Equally problematic is NHS South East Coast, which cut both its acute and community nursing workforce, but shed more from the community.
Caroline Waterfield, acting deputy head of employment services for NHS Employers, admitted transferring services and staff from acute to primary care had been slower than anticipated.
‘We don’t think it has happened as quickly as people thought, some organisations are only looking at it now,’ she said. ‘It’s a slow drift across, which will continue to happen across the next few years.’
But she suggested the NHS Next Stage Review would ‘really focus commissioners’ minds around where their services are being provided - it’s the lever we needed to make the change happen’.
The NHS Workforce Review Team’s latest summary of the nursing workforce, published in October, warned that employers would need to respond ‘specifically in preparing to work in settings outside of hospital and in public health roles’.
Dr Angus Forbes, senior lecturer in primary care nursing at the Florence Nightingale School of Nursing, added: ‘There does need to be a shift if they are going to meet the agenda.’
He suggested part of the reason the move had not taken place was lack of training. ‘You need a workforce which is trained to provide care in the community and the traditional training as it is, is not geared up for that,’ he said.