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Nursing fails to make it onto government's shortage occupation list


Government advisors have recommended against nursing being added to the list of occupations in short enough supply that they can be “sensibly” filled by overseas recruits from outside Europe.

The Royal College of Nursing responded by saying its evidence to the advisors had been “misrepresented” and that it was “deeply disappointed”.

The Migration Advisory Committee, which offers independent advice to ministers on migration issues, was asked to carry out a partial review of the shortage occupation list in September.

It was sparked by the government identifying a small number of occupations where it thought there might be a case for inclusion from the list since the committee’s last full review in February 2013.

These occupations included graduate occupations within the health sector, including consultant roles, nurses and training grades.

“The health sector told us that, nationally, they do not need any jobs in nursing to be on the shortage list”

David Metcalf

However, following its latest partial review, published yesterday, the committee said nurses were not recommended for inclusion, as it “did not receive evidence of a national shortage”.

The committee based its judgement largely on evidence from the Centre for Workforce Intelligence, which it said “essentially distilled” workforce information from relevant organisations such NHS providers, unions and the Department of Health.

It said the evidence suggested that nurse vacancies were largely caused by recruitment freezes and redundancies due to budgetary pressures. As a result, including adult nurses on the shortage occupation list “would not be effective at reducing the number of vacancies”.

Instead, it suggested better use should be made of existing mechanisms to fill nursing vacancies, such as Health Education England’s return to practice campaign.

“We are deeply disappointed that the Migration Advisory Committee has significantly misrepresented the position of the RCN”

Peter Carter

Additionally, it noted that 96% of campaigns aimed at recruiting overseas nurses were focussed on countries within Europe – particularly Spain, Ireland and Portugal – indicating that the numbers of nurses entering the UK from elsewhere were a “very small proportion” of the nursing workforce.

Likewise, GPs did not make it onto the list, though the committee noted that it been “particularly difficult to determine whether or not to include them”.

As part of its review, the committee also recommended that specialist nurses working in neonatal or paediatric intensive care units who had previously been on the list should now be removed.

However, it said paramedics and various medical roles in clinical radiology, paediatrics, psychiatry and emergency medicine should be added.

As well as the health roles, low voltage overhead linesworkers and senior jobs in digital technology are also set to join the list. In total, the committee recommended 10 jobs be added.

Committee chair Professor Sir David Metcalf said: “The health sector told us that, nationally, they do not need any jobs in nursing to be on the shortage list but we agreed with their assessment that there is presently a shortage of skilled paramedics.”

But Peter Carter, chief executive and general secretary of the RCN, said: “We are deeply disappointed that the Migration Advisory Committee has significantly misrepresented the position of the RCN in order to claim that there is no shortage of staff in the nursing profession.

“We will be contacting the committee about this as a matter of urgency and would urge them to reconsider their position in the light of this misinterpreted evidence,” he said.

“Let us be very clear: we provided detailed, extensive and unambiguous evidence of the shortage of nurses in the UK and the effect this was having on patients,” he said.

He added: “Recruiting from overseas is not a sensible long-term solution to a profound nursing shortage, but…today it is absolutely necessary. This means recruiting and retaining nurses from outside the EU as well, given the projected shortage of half a million nurses across Europe over the next five years.”



Readers' comments (9)

  • HCSW

    “did not receive evidence of a national shortage”. Honestly speaking, in the past 10 years I remember only two shifts when one (the same one!) RGN did not turned up. Money does miracles, all of the other shifts were always covered.

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  • I am glad,if and a big if we are short why not train more nurses in the uk...redeployment of some existing staff would help some area,s and as HCSW has said it is very rare in my experience that a shift is not covered.

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  • This is a non-story. There are thousands (literally) of RNs in our Trust. The real problem is the rate of attrition vs training capacity. Address those, and we won't be short.

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  • There are plenty of them trained but not working, so the report is correct.

    There are lots of shortages due to poor pay and working conditions; and arbitrary and nonsensical caps on the number of staff who can be employed, -so people just want to do different jobs instead.

    Also, there is an endless supply of them from EC countries with high unemployment.

    In effect, the shortages are manufactured to save money.

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  • yeah right , pigs fly, it would seem being over stretched and under staffed is a figment of imagination, if only there was a shortage of mps

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  • I can reflect back on the days when working on certain wards in a support role with maybe Ward Sister on duty with a Staff Nurse and a couple of Enrolled Nurses (EN's). EN's predominantly worked at the beside, rendering patient care, undertaking clinical duties and coordinating the Auxiliary Nursing staff. This freed up the Ward Sister, who were occasionally hands on in those days along with Staff Nurse to perform more clearly defined Registered Nurse roles.
    This worked well until EN's were used to fill the gaps due to RN shortage and some of them proved worthy in their undertaking, which eventually led to conflict about the role.
    A certain party recommended the possible re-introduction of SEN's. Maybe, this would be a solution in retaining good beside, practical Nurses'. Besides, our government were keen to phase them out and the skill mix has been problematic ever since. With good academic provision and ward based training, this surely would solve the skill crisis, providing they are not exploited as they were previously.
    There are Band 4 Nursing Assistant Practitioners out there, that have had a an excellent foundation programme and with further branch modular placements could quite easily fill the gap.
    In no certain terms, should it perceived as a threat, but a welcome relief to remedying the current shortfalls being experienced.
    In context, this would resolve the issues around basic care provision and ensure that our patients are nourished, hydrated, comfortable and kept under constant trained/ skilled observation.
    Too much procrastination with deliberating on possible solutions and fear of developing roles exists in health care, which is not solving the needs of our patients in the short term.
    I honestly believe that until we can start to get things back in to perspective; taking command of a good service with the respect of our patient population, only then will I feel positively rewarded as a Nurse.

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  • If there's no shortage, how come the NHS is spending so much on agency nursing staff? (registered and non-registered)

    Not surprised some people are topping up with agency work, as the normal rate of pay is low in relation to levels of skills and knowledge, and also with what needs to be done.
    Supply + demand will only drive up agency pay.

    Maybe more MPs will roll up their sleeves and help out on the wards and in their constituencies when more patients needs assistance.

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  • HCSW

    andy | 27-Feb-2015 3:06 pm

    'If there's no shortage, how come the NHS is spending so much on agency nursing staff? (registered and non-registered)'

    Several reasons:
    a) Wards cannot employ more staff than they need. but there is a catch, everybody is entitled to holidays.. So roughly speaking one moth per year is lost straight away, and has to be covered by agency or overtime.
    b) Agencies pay well or at least, better than the NHS for a permanent posts.
    c) There is no real shortage of nursing staff, there is a problem of keeping them working on permanents posts, under stress, on poorly managed wards.

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  • HCSW | 28-Feb-2015 3:54 am


    Also agency staff take the higher pay and sacrifice employers' pension contributions (which staff won't see until retirement and some staff are unaware what employers put aside for staff pensions)
    A lot of permanent staff work flat-bank rates and at their substantive increment rate, or more preferably on overtime rates (if working above 37.5hr).

    Probably what's also taken into account is nurses have transferable skills, which means quite a lot can be moved from one department into another (for short term/emergency cover) when needed. Also on most people's contracts now it's likely to say 'to work where asked to'

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