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Mind the nursing workforce gap

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The NHS will need to deal with an ageing workforce The NHS will need to deal with an ageing workforce

Research by the Institute for Employment Studies has revealed the scale of challenges facing the NHS nursing workforce. In line with much of the broader evidence, we found that demand continues to outstrip supply and that the reported vacancy rate across healthcare providers was around 10%.

The report identifies three key causes of the current nursing shortage:

  • The government have not funded enough student nursing places (despite demand for these places far outstripping supply).
  • The workforce is ageing. There are not enough nurses entering the system to fill the gap that will open up when one third of nurses reach retirement age in the next 10 years.
  • Since the Francis Report, safe staffing levels and the increasing workload of the NHS have pushed up the demand for nurses, while at the same time Trusts have faced financial constraints that have made recruiting nurses more difficult.

This poses an urgent question for the NHS: who will fill this gap in the workforce? There are three realistic possibilities.

First, they could recruit from outside the European Economic Area (EEA). Nurses from countries such as India and the Philippines have always played an important role in the NHS, making up 8% of the total nursing workforce in England. In March 2016, the Migration Advisory Committee recommended granting up to 15,000 visas over the next three years to non-EEA nurses. This will ease the immediate to short-term nursing shortage in the NHS but it is questionable whether this will be enough to make up for the loss of a third of the nursing workforce over the next 10 years.

Second, it is possible to recruit more nurses from the EEA. They constitute 4.5% of the total nursing workforce in England (up from just over 1% in 2009). But with uncertainty around the status of EEA workers in the UK, post Brexit, the recruitment pipeline from Europe is likely to be hit hard.

Lastly, the government could act now to ensure that we have a ‘homegrown’ supply of nurses. This will require sustained investment, but is the most sensible way of addressing a potentially gaping hole in our future NHS staff. For too long, there has been a lack of strategic thinking here. Workforce planners have known for several years that the ageing nursing workforce is a problem, and yet very little has been done about it.

Having recently scrapped the student nurse bursary, the government will now need to monitor the impact of this decision in case it reduces the pool of new recruits.

One last sobering thought: this issue is not just about numbers. Workforce planners need to consider the years of experience, skills and expertise that retiring nurses will take with them. Replacing that will be a far more challenging task.

Dr. Rachel Marangozov, senior research fellow, Institute for Employment Studies

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