NHS reforms stand no chance if recruitment issues are not tackled nurses warn

Top nurses have warned that planned Government reforms for the health service “stand no chance” if issues with recruitment and retention in the profession are not addressed.

It comes as new figures show the number of nurses and midwives registered in the UK has grown to a record high.

However, experts claim the workforce is “increasingly inexperienced”, while facing worrying shortages and still relying heavily on candidates from overseas.

Policymakers have been urged to consider measures such as student loan forgiveness schemes to ensure there are enough home-grown staff.

The latest mid-year report from the Nursing and Midwifery Council (NMC) shows there were a record 841,367 professionals on the register as of the end of September.

The figure is an increase of 14,949 compared to the previous six months and 22% higher than March 2017.

The NMC said growth has been upheld by “two pillars” in the past seven years.

These are a “steady pattern” of domestic recruitment and a “significant rise” in overseas joiners.

The figures show 14,780 UK-educated professionals joined the register between April and September, a fall of 1.8% compared to the previous six months, while 11,569 UK-educated staff left the register, some 1.6% higher than the figure reported in the six months to September 2023.

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

Its data shows there were 12,534 internationally educated joiners on the register in the six months to September, which is 16.6% fewer than the same period last year.

Some 2,573 international staff also left the register, an increase of 33%.

Kuljit Dhillon, interim executive director of strategy and insight at the NMC, said: “Nursing and midwifery are among the UK’s most trusted professions, so as we head into another tough winter, we hope there is small comfort in the growth of our register to a record 841,000.

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

“We’ve seen a fall in internationally educated joiners and an even higher proportional rise in leavers, although it’s important to view leavers’ data through the lens of a growing register.”

However, Professor Nicola Ranger, general secretary and chief executive of the Royal College of Nursing (RCN), called the figures “bad news for patients”.

“Nurse recruitment is slowing, the numbers of new starters is falling and we are witnessing a devastating increase in people leaving within five years of joining,” she added.

“At a time of widespread vacancies, these trends are incredibly worrying for our NHS and the people that rely on its care.

“Across health and care services, international recruitment was utilised to plug rota gaps, but we are now watching as thousands of overseas staff choose to go elsewhere.

“This comes as the number of student nurses in the UK dropped considerably again this year, showing worse years seem be ahead.

“As demand for care soars, ministers across the UK need to recognise this as a perfect storm for patient safety and take action to improve recruitment and retention.

“Working for low pay, in understaffed, under-resourced services takes its toll with burnout pushing highly-trained nursing staff out the door.

“Across England, we desperately need a loan forgiveness scheme to boost domestic recruitment into the profession. The government’s NHS reforms stand no chance of being delivered without addressing these fundamentals.”

Dr Billy Palmer, senior fellow at think tank Nuffield Trust, welcomed the growth in the register but warned the workforce is facing shortages.

He also described the figures as “a chronic symptom of a domestic clinical education system that is not fit for purpose”.

“The UK’s nursing and midwifery workforce is increasingly inexperienced and facing deeply worrying shortages in important areas, with learning disability nursing numbers still lower than five years ago,” Dr Palmer said.

“Concerningly, the number of nurses and midwives with over 10 years’ experience is falling, and 28% of staff have five years’ experience or less – echoing similar trends seen in the latest registration data for doctors.

“This shift to less experienced staff may affect productivity and put a strain on those who train, mentor and supervise them.”

He added: “We have warned the NHS is failing to attract homegrown nurses, with new domestic joiners having previously fallen by more than 6,000 over two years.

“Now, the heavy reliance on overseas joiners continues, with nearly half of new nursing and midwifery registrants educated outside of the UK.

“Policymakers and educational leaders cannot stay blind to these trends. They need to be bold – considering measures like student loan forgiveness schemes – to ensure UK nursing and midwifery has enough domestically trained, experienced staff to sustain the NHS workforce for the future.”

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

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

Published: 02/12/2024 by Radio NewsHub