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Warning too few nurses are 'migrating' from hospitals to community


Too few nurses are currently moving from the acute sector into community settings to support the future shift towards more out-of-hospital care, workforce planning chiefs have warned.

They said that a “significant effort” would be required by commissioners and providers to ensure more jobs were created in the community and that they were attractive to nurses.

The education and training body Health Education England said such action was necessary to help achieve NHS England’s Five Year Forward View, which includes a series of new care delivery models that place greater emphasis on community provision.

“Unless additional action is taken, nursing in the acute sector may grow at the community’s expense”

HEE report

HEE’s workforce planning team said yesterday that nurses were currently moving at a slower rate than in previous years from the acute sector into primary settings.

It predicted that at least 5,000 clinicians would be required to join the community and primary care workforce by 2020, suggesting that this required an additional 2,000 nurses per year to join the sector in order to meet future demand.

Speaking at a board meeting yesterday, Rob Smith, HEE’s head of planning and information, said: “What we do know is most people find their first placement in a hospital and we rely on people migrating later in their career into the community.

“At the moment, we don’t see that happening in the same way it has in the past,” he told the meeting.

He said that while it was not necessarily within HEE’s power to rectify the problem on its own, it would consider looking at how to equip nurses with the skills to feel confident in community roles.

“We rely on people migrating later in their career into the community”

Rob Smith

HEE’s 2015-16 workforce plan, also unveiled yesterday, said: “Forecasting indicates that unless additional action is taken by commissioners and providers, nursing in the acute sector may grow at the community’s expense.”

Meanwhile, HEE noted there had been recent increases in hospital nurses following the Francis report, but questioned how sustainable it was if international recruits were to go home and if nurses returning to practice had shorter careers than their newly-qualified counterparts.

For these reasons, HEE said it would fund an additional 555 training places for adult nurses – which will supply both the acute and community settings – in 2015-16, a 4.2% increase from last year.

Overall, the workforce plan will see increases in nurse education places across all four nursing branches, resulting in an extra 827 qualified nurses, a rise of 4% from last year.


Readers' comments (4)

  • As previously mentioned, the Francis Report had highlighted large numbers of nurses are needed to ensure safe care in acute settings.

    Also feels there is little or no support given to clinicians in community settings. Too many stories of about lack of support, development and resource issues. These get reported back to colleagues who were thinking about moving to community settings.

    The additional numbers being recruited from overseas, would primarily mostly go into acute sector, as they would have more challenges to face when working in the community.
    They would have to learn how to commute around their neighbourhood, understand local issues and concerns, population demographics, language/slang issues to learn, as well as knowing that advice, support and backup are just a bit further away.

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  • Here we go again. Part of the problem is that community nursing has been taken over by social enterprise organisations in some areas of the country, and they don't all offer the nhs pension, or only allow nurses to stay on the scheme for a year before they have to transfer onto a less favourable one. An experienced hospital nurse with quite a few years in the nhs pension is much less likely to want to work in the community with a lot less favourable pension plan. Some social enterprises are realising this and doing something about it but most are not. Wake up if you want to recruit more staff onto the community.

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  • one of the problems with recruiting practice nurses is the lack of pay structure and conditions. Although able to remain in the NHS pensions practice nurses are not NHS employees and, mostly, GP employers do not use AfC. As a PN with 13 yrs at the same surgery I have 5.5 weeks annual leave, 3 months sick pay and no annual pay review. However I do enjoy my job and lots of things make up for the above, weekends and BH's off, but a job in a GP surgery often means a pay, conditions and annual leave cut for a hospital nurse wanting employment.

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  • There are personal financial aspects to consider: years back we tried to poach a couple of E grade staff nurses (a blast from the past for Alphabetty Spaghetti fans!) for G-grade CPN posts...One compared her take home (shifts, nights, etc) with mine (G-grade with a few weekends) and laughed...It took me until I was a H-grade to catch up with where I had been financially as a top E-grade on shifts and nights...

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