Debate: Recruitment and retention

This resolution passed 

It appears clear that there is a shortfall between the number of nurses in employment and the number of nurses that are needed to deliver safe and effective care. For every unfilled nursing post there is a patient not getting the full care they are entitled to.

Following the decision to remove the student bursary in England, the number of applicants for nursing courses has reduced. NHS pay policy over the last few years has ensured that nurses’ pay fails to keep pace with inflation.

In NHS Scotland over 2,500 WTE nursing and midwifery posts are vacant, and posts vacant for three months or more continue to increase (NHS National Services Scotland – Information Services Division, 2018). Only 27% of nursing and midwifery staff responding to the Scottish Government iMatter Health and Social Care Staff Experience survey reported that there are enough staff for them to do their job properly (Scottish Government, 2018). The RCN in Scotland continues to lobby the Scottish Government to better reflect nursing workforce pressures within core policy documents, such as the Four Day Public Holiday Review and the new National Workforce Plans.

According to Nursing and Midwifery Council (NMC) registration statistics (NMC, 2017a), 506 nurses resident in Northern Ireland left the NMC register during the first half of 2017, from a workforce of 20,868 by headcount as at 31 March 2017. In addition, the Department of Health Northern Ireland has confirmed that 1,513 registered nursing posts within the HSC remained vacant as at 30 June 2017, with a further 315 nursing assistant posts also vacant (DHNI, 2017). The RCN estimates that a similar level of vacancies exists within the independent sector in Northern Ireland.

The UK Government’s pay freeze for nurses in recent years, along with a sharp reduction in public spending, has impacted on the funds available for public spending in Wales, and has had a detrimental impact on nursing morale, career trajectory and retention.

Figures from NHS Improvement in England (2018) reveal one in 11 positions remain unfilled. The data, which covers the last three months of 2017, shows the NHS in England had 100,000 vacant posts, including 35,000 nurses and almost 10,000 doctors. NHS Improvement said the shortage of staff contributed to the winter pressures faced by the NHS. About 5.6 million people visited A&E in England in the last quarter of 2017 and almost half a million people were admitted to hospital in December alone.

The age profile of the current nursing workforce also poses a challenge. We know that a third of nurses are over 50 and could retire in the next decade. NMC registration figures (NMC, 2017b) show there are now more nurses leaving than joining the register, with the total number of nurse registrants 5,047 lower in 2017 than 2016. The number of EU nurses has seen the largest drop, with a reduction of 96% of EU nurses joining the register following the Brexit vote.

The impact of the ageing workforce and the failure to promote nursing effectively amongst the postmillennial generation is already being felt widely across the four UK countries. Attention must be paid to both recruitment and retention to ensure a nursing workforce for the future. 

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