NHS reforms have no chance unless recruitment is sorted out, top nurses say

Top nurses have said planned government health reforms “don’t stand a chance” if recruitment and retention problems in the profession are not addressed.

They warned as new figures show the number of registered nurses and midwives in Britain has risen to a record high.

However, experts say the workforce is “increasingly inexperienced”, faces worrying shortages and is still heavily dependent on candidates from abroad.

Policymakers have been urged to consider measures, such as student loan forgiveness schemes, to ensure there are enough domestic workers.

The latest half-yearly report from the Nursing and Midwifery Council shows that there was a record number of 841,367 professionals on the register at the end of September, an increase of 14,949 on the previous six months and 22% higher than March 2017.

The NMC said growth over the past seven years had been underpinned by “two pillars”: a “stable pattern” of domestic recruitment and a “significant increase” in the number of foreign workers.

The figures show that 14,780 UK-trained professionals joined the register between April and September, a decrease of 1.8% compared to the previous six months, while 11,569 UK-trained workers left the register, 1, 6% higher than the figure reported in the six months to date. September 2023.

Meanwhile, the NMC said international recruitment “could start to slow”.

The data shows that there were 12,534 internationally trained newcomers on the register in the six months to September, which is 16.6% fewer than the same period last year. Approximately 2,573 international employees also left the register, an increase of 33%.

Kuljit Dhillon, interim director of strategy and insight at the NMC, said: “Nursing and midwifery are among the most trusted professions in Britain, so as we head into another harsh winter we hope there is little comfort in the growth from our register. to a record number of 841,000.

“At the same time, there are signs of caution in our data around international recruitment, which has been a mainstay of workforce growth in recent years.

“We have seen a decline in the number of internationally trained entrants and an even greater proportionate increase in the number of leavers, although it is important to view leaver data through the lens of a growing register.”

Nevertheless, Prof Nicola Ranger, general secretary and chief executive of the Royal College of Nursing (RCN), called the figures ‘bad news for patients’.

She said: “Nurse recruitment is slowing, the number of new starters is falling and we are witnessing a devastating increase in the number of people leaving within five years of joining. At a time of widespread vacancy, these trends are incredibly worrying for our NHS and the people who rely on its care. In health and care services, international recruitment was used to fill roster gaps, but we are now seeing thousands of foreign workers choosing to go elsewhere.

“This comes as the number of student nurses in Britain has fallen significantly again this year, showing that even worse years lie ahead. As demand for care rises, ministers across the UK must recognize this as a perfect storm for patient safety and take action to improve patient recruitment and retention.

“Working for low pay, in understaffed and under-resourced shifts, is taking its toll, with burnout pushing highly skilled nursing staff out the door.

“Across England we urgently need a loan forgiveness scheme to boost domestic recruitment into the profession. The Government’s NHS reforms have no chance of success if these fundamental issues are not addressed.”

Dr. Billy Palmer, senior fellow at think tank Nuffield Trust, welcomed the growth in the register but said staffing levels were facing shortages. He also described the figures as “a chronic symptom of a domestic clinical education system that is not fit for purpose”.

Palmer said: “The UK nursing and midwifery workforce is increasingly inexperienced and facing very worrying shortages in key areas, while the numbers of nurses with learning disabilities are still lower than five years ago.”

A Department of Health spokesperson said: “Nurses have been overworked for years, leaving them burnt out and demoralised. That is why we have accepted the recommendations of the independent pay review bodies to award them and other NHS staff a pay rise above inflation.

“We will work with staff to rebuild our healthcare services and give the NHS the stability and certainty it needs.”