The NHS will experience a chronic shortage of nurses within the next three years as demand for services continues to pile on pressure.
This is the dire warning from the government-backed Centre for Workforce Intelligence, which has predicted the NHS is likely to have 47,500 fewer nurses than it needs by 2016.
The analysis will make bleak reading for members of the profession who have already been reporting growing staff shortages in their care settings, as trusts seek to trim paybills in an effort to balance their books.
It also comes shortly after fresh concerns that the health service is failing to provide more care into the community and is experiencing unsustainable demand on accident and emergency departments as a result.
The CfWI looked at a range of projections and likely scenarios over the next three years, based on factors such as the number of nurses due to retire, the number of students being educated and expected demand for services.
“Employers have a real challenge to plan and sustain the supply and demand of the future nursing workforce at a time of financial constraint,” the CfWI report warned.
It concluded that the most likely scenario would see a 47,545 shortage of registered nurses by 2016, created by a 5% drop in the supply of nurses and a 3% increase in demand.
Although this was considered the most likely outcome, the centre noted a range of possible scenarios based on its predictions. These ranged from a nursing shortage of 0.6% by 2016 to one of 11%.
This 11% worst case scenario would see a shortage of around 190,000 nurses, as we revealed in February when some of the initial findings from the research were shared with Nursing Times.
|Projections of supply and demand of nurses 2010-2016||Source: CfWI|
|Shortage||0 (0%)||47,545 (8.31%)|
Howard Catton, head of policy at the Royal College of Nursing said: “We are going to have a nursing shortage; the question is what the scale of that shortage will be. There is now no excuse for inaction and people won’t be able to say we didn’t have the warning.
“The impact this will have on both current nurses and the quality of care and safety for patients is extremely worrying,” he said.
He called for a “step change” in the way services were delivered and staff trained, but cautioned that it was already too late to head off the impending shortage that the centre had predicted. “It’s just not plausible that these changes are going to happen by 2016,” he said.
The CfWI report highlighted the financial pressure on the NHS as a key factor on its conclusions, with providers interviewed for the research saying “the decrease in demand for nurses is financially driven”.
However, the centre noted there should be smaller reductions in nurse posts than in the 1990s, when full time equivalent posts fell by 1% a year for five years.
Across England nurse headcount has reduced in virtually all regions covered by the former strategic health authorities between 2009 and 2011, the report revealed. The exceptions being London and the South East Coast, which both saw an increase (see boxes below).
Nursing Times revealed last year that across the old SHA regions the number of training places for nurses has been cut by 2,500 over three years.
While in the past the UK has looked to bring in foreign nurses to address nursing shortages, the CfWI report noted this was more difficult now due to stricter immigration controls on non-European Union nurses. The UK has also signed up to a World Health Organization commitment to reduce recruitment of foreign health workers.
The report also highlighted the NHS’ overall failure to successfully move away from expensive acute settings.
A number of managers told the CfWI they were planning to redesign services and develop community pathways, but it added: “There was a view expressed from most SHAs that the shift of care into the community continues to be a challenge and is not happening on the scale required”.
Dean Royles, chief executive of the NHS Employers organisation, said the report should be used for a “mature and evidence based discussion” about the challenges and how to ensure safe patient care.
He added: “As the largest part of the NHS workforce it is right to look at nursing numbers but we must also take a multi-professional and multi-disciplinary approach if we are to find sustainable solutions.”
But a spokesman for Health Education England described as “early work from one source”, and that its investment decisions would be based on the forecasts of local education providers.
He added that HEE’s forthcoming national workforce guidance would be “designed to help ensure the NHS has the right people, with the right skills, values and behaviours, in the right place at the right time and in the right numbers”.
In a statement, health minister Dr Dan Poulter said: “The authors of these reports are clear that their projections are early work and more needs to be done to check their accuracy. But they do highlight that the NHS will come under increasing pressure from the demands of an ageing population.”
The news was more positive for midwifery, however. A separate report from the CfWI said there was an overall increase in NHS midwife headcount from 2009-11 of 4% and predicted there was likely to be a surplus of 3,425 midwives by 2016.
“However, our work indicates midwifery supply and demand is finely balanced, and slight changes to either supply or demand could tilt the balance between slight oversupply and undersupply in the period up to 2016,” it cautioned.
The report also reveals the latest data on the nursing workforce by region:
|Ratio of nurses to HCAs||2.66||3.11|
|East of England||2009||2011|
|Ratio of nurses to HCAs||1.75||2.07|
|Ratio of nurses to HCAs||1.69||1.94|
|Ratio of nurses to HCAs||1.72||1.87|
|Ratio of nurses to HCAs||1.75||1.88|
|Ratio of nurses to HCAs||1.84||2.07|
|South East Coast||2009||2011|
|Ratio of nurses to HCAs||1.56||2.10|
|Ratio of nurses to HCAs||1.65||1.98|
|Ratio of nurses to HCAs||1.78||2.03|
|Yorks and Humber||2009||2011|
|Ratio of nurses to HCAs||1.48||1.86|
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