New analysis from the Royal College of Nursing today exposes the inadequacy of the government’s political target to recruit 50,000 nurses to the workforce to tackle the crisis facing the NHS.
The figures from the RCN make clear that the NHS continues to face dangerous staff shortages. In England, patient demand has far outstripped modest growth of the NHS workforce. Since the pledge in 2019, the patient waiting list for elective care has grown over four times faster than the number of nurses recruited. There has been a 16 per cent increase in nursing staff, whilst patient waiting lists have grown 70 per cent since the target was set.
The official tally of nurse vacancies released by the NHS itself has fallen by little over 100 in the four years since the pledge was made – with 43,339 roles still unfilled in England’s registered nurse workforce compared to 43,452 at the time of the pledge.
The Long-Term Workforce Plan announced in the summer this year must be given adequate funding to support its level of ambition.
A Downing Street letter to the Department of Health in February 2020, released to the Covid inquiry, shows the early stated policy intention to rely on “notable additional international recruitment” to hit the target. Almost half (48%) of new joiners to the official NMC nursing register are now internationally recruited as a direct result.
Large-scale international recruitment is expensive, unsustainable, and unethical given global nursing workforce shortages. Many internationally educated nursing recent recruits having come from 'red list’ countries which the World Health Organisation has warned face dangerous and pressing health care worker shortages and therefore should not be recruited from.
The government must do more to support people to come forward to study nursing domestically - this year, UCAS recorded a 12 per cent fall in the number of people expected to take up nursing courses in England. On average nursing students take on £50,000 of personal debt to cover the cost of their education.
Widespread regional variation across England means there is a postcode lottery for patient care with some areas having significantly fewer nurses. There are just 47 Nurses per 10,000 people across NHS services in Leicestershire, North Yorkshire, and Cornwall compared to 79 across North Central London.
Royal College of Nursing Director for England, Patricia Marquis, said:
“Not a single nurse will say that it feels like there are more staff now – they say the very opposite. When patient numbers and demand is so high, staffing levels become dangerously inadequate. It is unsafe for patients and professionals alike when one nurse cares for 10, 15 or more patients at a time and beds are put in corridors or other inappropriate places.
“The government’s political target was not based on calculation of patient needs and the international reliance shows they reached for short-sighted and unethical means rather than sustained domestic growth in nursing.
“The Autumn Statement is just days away. The new Health Secretary must secure urgent investment in the nursing workforce now, to keep the staff we already have and recruit a new generation. This means abolishing tuition fees for nursing students and paying staff fairly. Only then will there be enough nurses to give patients the care they need and deserve.”
Ends
Notes to editors
NHS recruitment
Data shows the government recruitment figures since 2019. The below shows the number of nurses working in Hospital & Community Health Service and GP settings between 2019 and 2023.
|
Sep-19 (FTE) |
Aug-23 (FTE) provisional stat |
Difference |
Number required to hit 50k target |
|
300,904 |
348,182 |
Increase of 47,278 |
2,722 |
Patient waiting times
For every nurse the government has recruited since 2019 in England, there are now an additional 68 waits for non-urgent NHS treatment in England. This is based on the growth of the waiting list – which increased from 4.4 million (source available here) in September 2019 - when the government committed to recruiting 50,000 more nurses (source here) - to 7.8 million in September 2023 (source here). The increase of 3.4 million was divided by 50,000 for a total of 68 more waits for non-urgent NHS care for each nurse the government has promised will be recruited.
The regional variation data is based on data showing the projected population size covered by an ICS for 2022/23 and calculates the number of NHS FTE nurses per 10,000 population. The data showed there are around just 47.0 nurses per 10,000 inhabitants in NHS Leicester, Leicestershire and Rutland ICB, NHS Humber and North Yorkshire ICB, and NHS Cornwall and the Isles of Scilly ICB compared to 78.5 in the NHS North Central London ICS. In England, there is an average of 56.6 registered nurses per 10,000 population. Source: NHS England. Allocation of resources 2022/23.
UCAS data
The latest UCAS clearing data shows a 12% fall in the number of acceptances onto nursing degree courses at universities in England (from 21,490 in 2022 to 18,870 in 2023).
NMC data
The Nursing and Midwifery Council register shows the proportion of internationally educated nurses who joined the nursing register between April 2019 and March 2020 was 14.2%. This increased to 31.8% between April 2022 and March 2023.
