Party pledges to increase nurse numbers following the general election lack clear financial planning or robust recruitment strategies to back them up, policy and workforce experts have claimed.
They told Nursing Times that promises made to ensure, in some cases, tens of thousands of additional nurses were recruited over the next five years had failed to address the funding or infrastructure required.
The academics also warned that pledges made for the largest workforce increases – promises of 20,000 more nurses made by Labour and the UK Independence Party – may only just be enough to comply with minimum staffing requirements.
One professor said it was still unclear what effects recent nurse staffing guidelines published by the National Institute for Health and Care Excellence would have on workforce numbers, and hinted that efforts may be required to recruit even more nurses above this “safety net”.
“I’m not convinced any party so far has a funding envelope that means it can continue to care for our ageing population in the way that nurses would want to care for them”
A leading health think-tank, meanwhile, warned that parties that had committed to extra funding for the NHS – estimated by its leaders as needing to be £8bn a year by 2020 – had failed to explained how that would pay for more nurses.
Candace Imison, director of healthcare systems at the Nuffield Trust, said the extra funding – in addition to £22bn annual savings expected by 2020 – might maintain the NHS, but it was not apparent whether the money could be used for more staff.
“Nobody has translated that £8bn into actual staff numbers,” she said. “The key thing for nurses is going to be the NHS having a funding envelope that means it can continue to care for our ageing population in the way that nurses would want to care for them.
“I’m not convinced that any party so far has a funding envelope that does that,” she told Nursing Times.
Beccy Baird, policy manager at the King’s Fund think-tank, warned that Labour and UKIPs’ pledges for 20,000 more nurses were “quite big promises that require a lot of infrastructure”.
“That is 150 more places per university – that is also finding practice placements for all of those nurses, and all those people would need to be guaranteed that the hospitals will be able to pay for them as well,” she said.
Professor James Buchan, from Edinburgh’s Queen Margaret University, said no party had supplied any clear recruitment strategies for boosting the workforce when options were “relatively limited”, particularly in the short term.
He also said improving nurse retention looked set to become “highly problematic”, as nurses who postponed retirement during the recession might now look to leave as the economy improved.
The pool of nurses able to return practice was both “ageing” and “dwindling”, he added. “That leaves us with the international recruitment ‘quick fix’, which has already been significantly ramped up over the last couple of years.”
Anne Marie Rafferty, professor of nursing policy at King’s College London, said the introduction of NICE guidance on nurse safe staffing could lead to more demand for nurses to cover shifts.
“One might argue that these party pledges made about extra nurses are only going to fill the vacancies and the positions that are needed to implement a safe staffing policy,” she said.
She added that 20,000 extra nurses could “just cover the base of what’s actually needed” to create “some kind of minimum safety net for staffing, rather than being a world class high-calibre service”.
In response, a Labour spokesman said it had a “fully-funded rescue plan” for the NHS, which would be paid for with £2.5bn a year from money raised from its proposed tobacco levy, “mansion tax” on properties worth over £2m and action to tackle tax avoidance.
“Labour’s plan to recruit 20,000 extra nurses will allow hospitals to break the hold of the staffing agencies and get their finances into better shape,” he added.
A UKIP spokesman said the party’s NHS staffing plans were “very clear” and all costs were based on Health Education England’s 2015-16 workforce plan. “All UKIPs spending plans are fully costed and independently verified,” he added.
Meanwhile, Liberal Democrat health minister Norman Lamb said his party would work with “experts in the NHS and nurse leaders to plan properly for the right levels of nurse staffing”. “We will retain nurses by marking an end to pay restraint and increasing nurse pay in real terms over the next parliament,” he told Nursing Times.
A Conservative spokesman said: “We are committed to spending an additional £8bn a year by 2020 to ensure we can continue to employ enough staff in the NHS to meet growing demand.”
- Find out more about what our experts thought about the party’s pledges on the NHS and nursing: Do election pledges on nursing and the NHS stand up to scrutiny?