The current approach to workforce planning in England is fragmented and incomplete, with no clear national accountability for ensuring that nursing staff with the right skills arrive in the right parts of the health care system at the right time, according to a new report from the RCN.
Left to chance: the health and care nursing workforce supply in England sets out the scale of the current crisis in the nursing workforce: 27% more nurses are now leaving the profession than are joining, the historical bursary for nursing tuition has been removed and, despite the intention to increase the number of student places, numbers have actually dropped. Applications for 2018 entry into nursing have already fallen by 13% since the same time last year, and are down 33% on January 2016.
Simultaneously, Brexit is threatening to cause further instability by ‘throttling’ the EU recruitment pipeline.
The RCN says Health Education England’s recent consultation document on a first long term workforce strategy contains ‘huge gaps and does not set out what workforce is actually needed or how we might get there’.
The College says the Government ‘must intervene now to increase the numbers of applicants to training places.’
While nursing degree apprenticeships are welcome, they do not present a solution to the nursing workforce crisis because the Government has not provided additional funding. New routes into nursing and the new support roles have not been planned strategically to meet population needs, and there has been inadequate consideration given to the clinical practice elements required as part of the new schemes.
RCN chief executive Janet Davies commented: ‘If we were to label today’s approach to workforce planning as a patchwork, we risk overstating its elegance or overlooking where the quilt has become threadbare. So piecemeal and disjointed are the attempts to address workforce issues that the pieces are barely stitched together at all. This must change with the first strategy, expected in the summer, from Health Education England. It must address the lack of accountability in current arrangements and, in coherent and detailed terms, explain how Government will reconcile demand with the supply of nursing staff needed for safe and effective care.’
In a paper submitted to the Department of Health and Social Care and the Treasury in 2017, the RCN points out that there are approximately 40,000 unfilled nursing posts in England, while a leaked DH workforce model predicts that this will increase to 42,000 post-Brexit. In the meantime, England is currently training around 20,000 nurses a year. The RCN proposes practicable approaches to incentivise growth in the ‘home grown’ workforce, including:
- Grants for placements for all healthcare students
- Investment in healthcare education through employers
- Means-tested grants
- Targeted support for parents and carers to support students with caring responsibilities