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Nursing workforce ‘in crisis before pandemic’

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Nursing workforce ‘in crisis before pandemic’ Nursing workforce ‘in crisis before pandemic’

Shortages in the nursing workforce were compromising patient care even before the COVID-19 pandemic, a report by the RCN has found.

The report, which shares data not previously released by the RCN, shows that Going into the COVID-19 pandemic, in January 2020, 73% of nursing staff surveyed by the RCN said staffing levels on their last shift were not sufficient to meet the needs of patients safely and effectively. More than half (57%) felt patient care was compromised. The report states that nursing staffing levels weren’t acceptable to staff or patients then and this won’t have improved given that demand has continued to build.

‘The past two years have revealed the extent of how ill-prepared the UK was for the additional pressures on the health and care system during the pandemic,’ said RCN General Secretary and Chief Executive Pat Cullen.

‘This mounting pressure continues to present grave risks to patients. However, the risks to nursing staff - and to recruitment and retention as these pressures continue - must not be underestimated.’

The report also found that one in five nursing registrants are 56 years of age or over and due to retire in the next few years, perhaps earlier given the intolerable pressures they’re facing.

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Only 56% of new people joining the UK nursing register in 2021 were educated and trained in the UK, exposing a longstanding over-reliance on international recruitment potentially at a cost to other countries needing to retain their workforce.

In addition, the report shows the swelling in numbers of registered nurses in the UK during the pandemic is starting to drop. Before last year the number leaving the Nursing and Midwifery Council register was decreasing year-on-year. But the data shows a change in direction in 2021, with 11.3% more people leaving the register than in 2020.

‘We expect governments across the UK to take these risks to patient safety seriously,” added Ms Cullen.

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‘They must take decisive action to significantly grow the domestic nursing workforce. Robust policy and investment measures are needed as a matter of urgency. As a minimum, every country in the UK must have accountability for the health and care workforce enshrined in legislation, and a government-funded health and care workforce plan, including fair pay for nursing staff.’

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The Secretary of State for Health has commented that since the start of the pandemic the number of applicants for nurse training, or at least, the number of 'expressions of interest' has increased. Without a doubt this is welcome news for succession planning. There is however a significant flaw, as cited, the NMC reports a drop of 11% in 2021 of registrants leaving the register. This combined with 1 in 5 registered nurses being aged over 55 years, and due to retire in the next few years will result in additional severe pressures on the NHS. As the UK emerges from the pandemic the country is faced with managing a national backlog of around 6 million patients on NHS waiting lists as well as the relentless rise in providing urgent and emergency care for an aging population. If the 'expressions of interest' translate into nursing students it will be about 2028-30 before anywhere near sufficient numbers of registered nurses are in post. In the meantime all efforts must be made to retain the existing experienced and skilled workforce for as long as possible.

Mike Paynter
Consultant Nurse
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