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Nursing workforce could shrink by 100,000 over next decade

  • 19 Comments

The NHS nursing workforce could crash by up to 100,000 over the next decade due to a combination of spiralling cuts to posts, falling student places and a retirement bubble, academics have warned.

Research commissioned by the Royal College of Nursing reveals that even if current trends remain steady, the NHS nursing workforce in England stands to shrink by nearly 43,000 over the next 10 years.

The research forecasts what will happen to the current NHS workforce of 352,000 qualified nurses, midwives and health visitors based on a number of different scenarios.

In the worst case scenario, a quarter of the nursing workforce is lost, leaving just 253,000 staff in post by 2021-22.

For this scenario to occur, inflow of newly-qualified nurses would need to fall by 31% – as occurred in the last major downturn in training commissioning between 1991-92 and 1994-95 - all nurses over the age of 50 would retire over the next 10 years, and the number of nurses leaving the service for other reasons would rise by just 0.5% a year.

Under a different scenario, the NHS stands to lose 56,000 registered nurses if the number of newly qualifieds remains at current levels but there is an increase in nurses leaving for reasons other than retirement – for example through a rise in redundancies or post cutting.

In a further scenario, the workforce falls by 61,000 even if cuts to posts and training places are halted. The scenario envisages a significant rise in nurses retiring, potentially in order to beat the introduction of the unpopular pension reforms.

The researchers warn that their projections “highlight the vulnerability” of the NHS nursing workforce to policy changes.

“For example, if reforms to NHS pensions lead to more nurses remaining in employment for longer, the nursing workforce could, despite a lower intake from education, shrink comparatively little (2.6% over 10 years).

“Conversely, if these reforms result in a short-term rise in the numbers taking retirement then the NHS could face a rapidly diminishing nursing workforce and staffing shortages.”

Lead author James Buchan, professor of health sciences at Edinburgh’s Queen Margaret University, said: “The scenarios we have set out are all possible futures – where we are in 10 years will depend on decisions made now by policy makers about numbers of new nurses to train and retention policies.”

He suggested the sectors likely to see greater demand in coming years could also be worst affected by workforce shrinkage, due to retirement patterns.

“The sections of the workforce with the highest proportions of nurses reaching retirement age are in the community nursing area and in nursing homes,” he told Nursing Times.

Professor Buchan warned that the service might attempt to remedy any significant drop in registered nurse numbers by employing more lower band staff or looking overseas.

He said: “We have over-relied on massive scale international recruitment in the past as a quick fix, and this could very well happen again – but there will also be cost containment pressure to shift skills mix by making more use of assistant practitioners and healthcare assistants.”

RCN general secretary and chief executive Peter Carter said “urgent and immediate action” was needed. He said: “One clear first step must be to stabilise the numbers of registered nurses and reverse decisions to cut student nursing places by 10% by 2012.”

The bleak forecast follows warnings from the Department of Health about “worrying signs” in the way some trusts were planning to make savings through its quality, innovation, productivity and prevention (QIPP) programme.

Speaking to Nursing Times’ sister title Health Service Journal last week, DH national director for improvement and efficiency Jim Easton said some were making financial efficiencies through improving quality and productivity, but warned others were just making staffing cuts instead. 

He said: “There are two ways of achieving changes in staffing. One is that you do something like productive ward work and you redesign the way nurses and support staff on a ward work in a way that delivers quality, and gains productivity.

“The other is that you just take your off-duty rosters and take 3% off them. The first is delivering QIPP, the second of those is not.”

The research forms part of the forthcoming RCN Labour Market Review 2011, which will be published later this year.

The most recent previous forecast of the future nursing workforce – carried out in June 2009 by the NHS Workforce Review Team – projected a decline in headcount from 382,496 in September 2008 to 340,116 in September 2020. 

  • 19 Comments

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Readers' comments (19)

  • But none of that matters does it? The idiots at the top are only concerned with saving money right now, this instant.

    That is of course until they realise that the health service isn't functioning and everyone is dying because there are no Nurses left to look after them.

    So the whole process of mass recruiting from foreign countries and shoving as many people through uni as possible, etc etc etc begins again.

    Until that is they realise that they actually have to god forbid spend a bit of money on maintaining the workforce, so the cuts begin again!!!

    And round and round in circles we go.

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  • it really is extraordinary thinking (non-thinking) and false economy. where is the logic. If the nursing workforce becomes so depleted and then it is discovered after this vast 'experiment' that it needs replacing the costs would be so astronomical and probably totally unafordable.

    A totally illogical vicious circle!

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  • afterthought to my comment above - this then equals privatisation and pay for yourself and your care and the nursing workforce.

    a bit slow but it took a further second for the penny to drop!

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  • Two things are happening here - the short-term political objectives of the people in charge, and the legacy we inherit from past generations of nursing unions - ie easy targets. If the political masters want to save money, then they take aim at the section of the workforce which rolls over easily and has the largest numbers.

    This is against a backdrop of an increasingly elderly population placing more and more demands on the NHS.

    Two things need to happen: the unions need to wake up and start acting as unions, and the NHS needs to be freed from the idiots in charge like Mr Lansley who have only one agenda: their own!

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  • as long as the country as such a divisive system of government, how can life and services in the UK ever improve. there is no political, economic and social stability and what seems like a very limited measure of democracy. how can this insure a fair and just society?

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  • If there are going to be that many less nurses surely our pensions and terms and conditions should be protected!

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  • Anonymous | 18-Jul-2011 12:33 pm:
    It can't and it isn't. Neither might I add do the present govt intend it to.

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  • As I keep saying, nothing has changed except the pace. Our NHS is intended to be privatised for the benefit of the profiteers not the patients.
    Aneurin Bevin predicted that the NHS will only survive where there are those with the faith to fight for it.

    http://m.guardian.co.uk/society/2011/jul/19/nhs-services-open-to-competition?cat=society&type=article

    I am one.

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  • Adedapo Haastrup

    Why would'nt these happen when most of the time the Unions and the NMC which are supposed to fight on behalf of Nurses and for Nurses in most cases seem to turn their backs on Nurses despite all the monies paid towards subscriptions and re-registeration over the years.

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  • Natalie Jewell

    Yet it's predicted the numbers of people needing nurses will increase over the same decade. Increasing elderly population as well as increasing numbers of premature babies surviving.

    Mind you we knew in 1998 that a large proportion of health visitors were going to retire within 10 years. Nothing was done about it and now we have the new HV Implementation Plan because things have become so bad. Another reactive rather than proactive initiative.

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