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NHS trusts report staff shortages worst in specialist roles


Staff shortages in specialist and experienced roles including nursing are being felt across nearly 80% of NHS trusts, despite almost all using temporary workers to try and fill the gaps, according to new research.

The research, commissioned by Unison, found 85% of trusts were finding recruitment “difficult” in general, with 78% struggling to fill higher paid roles, and 60% having difficulty filling posts at an intermediate salary level.

Only 10% had problems recruiting low pay grades.

The report noted this lack of experienced staff was a “particularly serious concern”.

Around two thirds of NHS organisations said they were “unsure” they had enough staff to meet current demand, with 40% saying they had plans in place to recruit more overseas staff than in previous years.

“[Safe staffing guidance and increased demand] have impacted most severely on the financial position and staffing for acute NHS trusts”

Unison report on NHS staffing

Almost all trusts (89%) said they were using agency or bank workers to try and meet staff shortages, with 60% saying they used this approach “a lot”.

The research was carried out by think tank the Smith Institute and involved surveys and interviews with human resources managers at around 30 UK trusts.

It also highlighted that in order to fill vacancies, nearly half were having to recruit people with less skills and experience than they would have done before.

HR managers told researchers recruitment problems stemmed in part from a lack of student nurses being trained.

They also said vacancies has increased mainly due to recently introduced safe staffing guidance following the 2013 Francis report on care failings at Mid Staffordshire Foundation Trust, plus more demand for services.

“It is a fallacy that the same job is being paid [differently] in different trusts around the country”

HR manager at an NHS trust

“These two factors have impacted most severely on the financial position and staffing for acute NHS trusts, with rising, unplanned demand for care in a hospital setting particularly impacting accident and emergency services,” said the report.

Just over half of the HR managers surveyed said they believed the NHS pay freeze for staff had had “some impact” on recruitment and retention, causing staff to consider working for private organisations.

But in interviews they did say pay was an important factor in staff leaving to join other trusts – particular for those in specialist or experienced positions - where the same role could have a higher salary attached to it.

“It is a fallacy that the same job is being paid [differently] in different trusts around the country. There is a huge amount of flexing of Agenda for Change going on, especially where trusts are in deficit,” said one workforce manager.

Unison general secretary Dave Prentis said: “The findings raise some serious questions about the future of our public services in the years ahead – not just in terms of quality of the service and care they are able to provide, but also how safely staff are able to do so.”

He said that capping pay in the NHS and other public sector organisations made them less attractive places to work and called for action to tackle this “emerging recruitment crisis”.


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Readers' comments (9)

  • My concern is the new degree training is putting off a lot of potentially good. caring nurses joining the profession wonder there is a shortage. Degrees don't make good nurses.

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  • It is hardly surprising when year on year newly qualified UK trained nurses have been turned away because they don't have 'experience'. They move onto other jobs, lost to nursing forever.
    Thousands of 'experienced' foreign nurses have been employed regardless of whether their documents are even genuine. The NMC have said that only 8 of their 668 staff deal with verifying ID and qualification of overseas nurses. Hence many have been rubberstamped through. (Chau of Stepping Hill is one case) These qualifications, certificates, references even with graduation photographs can be bought on the streets of many eastern cities for £35 or online for slightly more. These fakes are of the highest quality. If essays are required they are £5 - £10 with a guarantee to pass.
    The degree only nurse training has also taken its toll on nursing numbers Prior to PK2000 there was a 3 year SRN/RGN with an entry standard of 5 A - C GCSE or entry test or 2 year (bedside) SEN training with entry test. Exams in 2nd year were 3 hour anatomy & physiology and 3 hour basic nursing skills (Prelims) where you were expected to demonstrate a thorough knowledge of A & P in the answer. Nurses don't need A&P now.
    The training was rigorous, on the wards combined with nursing schools attached to hospitals. In 3 years of training a total of 9 months of 8 -5 in the classroom with a weekly exam. The lecturers were not classroom nurses but medical consultants and specialists.
    The all dancing/singing degree qualification has robbed the profession of many excellent nurses whose greatest asset was the possession of 'common sense' but they couldn't write a 2000 word essay. They didn't do something because the book said so but because it was the right thing to do. The SEN course didn't include any ward management. Many moved on to become RGN. One case I know was a domestic who became the night superintendent of the same hospital as RGN MA
    Perhaps a modified/extended entry qualification with a 2 or a 3 year training course is the way forward, combining the university training with ward training. This would give good practical nurses with a low dropout rate as students would be exposed to the wards from the start. Nurses would not enter the wards as frightened qualified nurses but as confident professionals with a thorough all round training.

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  • Andrew Dawson

    As a band 4 community assistant Practitioner, I have applied for the NHS fast track nursing course, an 18-24 month training programme designed for my community (or accute if I worked in such a unit) experience to enable me to become a registerd nurse by building on the skills and knowledge I have learnt over the last 6 years of practice in the NHS. For me this is a fantastic opportunity not to be missed. Sounds like the SEN to RGN conversion in different clothing.

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  • "combining the university training with ward training"

    This is the structure of the degree course they have moved classroom ward based learning to university's but clinical exposure starts on the wards from years 1-3 alongside university teaching. The degree programme was introduced to both professionalise nursing and ensure linear externally validated education. Moving simulations, skills acquisition and didactic lectures into universities upholds patient safety preparing students for applying knowledge on their clinical rotations with guidance and mentoring from experienced staff.

    If nurses can not apply scientific knowledge in the medical setting they leave themselves open to erroneous practice, compromising patient safety, poorly communicating with the multidisciplinary team and litigation. A&P is the very basics of what nurses do each day and to say it is not needed promotes an autopilot effect in nursing care through pattern recognition as opposed to critical thinking. Nursing is a science based profession alongside medicine and physiotherapy. The care is provided through knowledge.

    For longterm sustainability nursing perhaps look to other disciplines and countries models in medicine and indeed nursing in other parts of the world two years general experience with further skills acquisition is required before specialisation.

    After working in the NHS many nurses never have career progression meetings with their managers this is a very basic if we are to build nurses experience and guide it the right direction if their long-term interest which gives them experience, routes of access and the knowledge they require to eventually specialise. Many start their jobs hitting the ground running and do in house courses and training and other cpd in their own time. Managers need to invest themselves in nurses long term career goals guide them through this and secure them the appropriate training places. This is not a quick fix but it is the right road to long-term sustainability.

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  • It was interesting to see "It is a fallacy that the same job is being paid [differently] in different trusts around the country" and on the same page an ad that reads "Mental Health Nurses's required
    Salary depends on the area"

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  • Degrees DO make good nurses, but we need a mix. Not everyone can lead, and not all can follow. Bring back the diploma and top up if you want to a degree. We need to be as serious about academia as Doctors.

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  • once again, nurses are being blamed for everything

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  • I'm not sure why people are complaining about degree nurses in this article, if anything most specialist nurses require undergraduate degrees and master degrees. There should be a much larger focus on how difficult it is to climb the clinical ladder in nursing. I've met some very young ward sisters and matrons in my placements, but most CNS's and NPs are above 35. Why is there such a disparity between the ages of management and clinicians?

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  • Anon 6.12pm
    Because you don't have to be clever to climb the greasy pole, you just have to be sly and know whose parsnips need buttering.

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