Nurses have played a “vital” role in caring for people during the COVID-19 outbreak despite nearly 40,000 unfilled nursing post vacancies which had already put staff and services under strain.
The Government has committed to 50,000 more nurses by 2025, but in a report published today, the Public Accounts Committee says the Department for Health & Social Care (DHSC) does not understand the nursing needs of the NHS and does not know how many nurses are needed, or where and in what specialism.
The NHS is relying on a substantial short-term increase in overseas recruitment as part of meeting that commitment for 50,000 nurses, but the COVID-19 outbreak is just the latest illustration of the risks and problems inherent in this strategy.
Even before the pandemic, the NHS’ own numbers show tens of thousands of their nurses were leaving the profession every year, and in evidence to the Committee the NHS acknowledged that there are worrying signs of stress and burnout amongst NHS staff since the COVID-19 outbreak.
A Royal College of Nursing survey showed a huge 36% of respondents considering leaving nursing in the next year, up from 28% before the pandemic. When asked about why they are considering leaving, two thirds cited low pay; while almost a half of respondents cited low staffing levels, the way nursing staff had been treated during the pandemic, or lack of management support.
However, rather than addressing this emerging crisis in nursing, there are “worrying indications that the NHS has reverted from long-term planning to short-term firefighting. This is not good enough for the over-stretched NHS workforce”. The pace of progress on increasing the number of NHS nurses was already “too slow”, with efforts to increase the numbers in undergraduate nursing degrees – which anyway take years to come to come to fruition - having “signally failed”.
It is vital that the NHS protects the mental health and well-being of nurses who have contributed so much during the COVID-19 outbreak, and the Committee is also concerned that the necessary safeguards being put in place to protect Black, Asian and minority ethnic staff, who are disproportionately affected by COVID-19, restrict their work experience and career progression.
After a highly critical PAC report earlier this year, when the Committee Chair said care homes had been “thrown to the wolves” in the pandemic, today’s report finds “the nursing needs of social care remain an unaddressed afterthought for the Department of Health & Social Care.” Vacancies for nurses in social care increased from 4 % in 2012-13 to 10% in 2018-19, while the number of registered nursing posts in social care has fallen by 20% since 2012-13.
Meg Hillier, Chair of the Public Accounts Committee, said:
“The picture from the front line of nursing in the NHS and care homes is not good. I fear with the strain of a huge shortage of nurses and the worrying reports of low morale and huge numbers considering leaving in the next year, we are facing an emerging crisis in nursing.
“We fully recognise that the NHS is reeling under the strain of Covid-19, with staff unsure how they will cope with the second wave that it seems clear already upon us. But it must not take its eye off the ball and allow a slide back into short-term, crisis mode. It must press on with coherent plans to get the nursing workforce back to capacity, under the kind of working conditions that can encourage hard-won, hard-working nurses to stay in our NHS and care homes.”
Sarah Gigg, Director of Nursing at Sue Ryder, said:
"The coronavirus pandemic has proven how vital a strong nursing workforce across health and social care is in tackling a public health crisis.
"Challenges facing the nursing workforce are not isolated to the NHS. Like many independent providers, Sue Ryder struggles to recruit and retain the workforce needed to provide expert end of life and neurological care to people across the UK as there simply aren't the nurses available.
"A sole focus on the NHS nursing workforce is detrimental and naive. Skilled and trained nurses deliver expert care in all settings, without which ultimately serves to add significant pressure to the NHS. If services offered by Sue Ryder and other healthcare organisations are unable to maintain a workforce, we could see services closing, with patients becoming reliant on an overburdened NHS for their care and simply falling through the gaps.
"The government must now take action at both a national and local level to overcome the future shortfall of nurses across the health and social care sector."