The NHS needs more nurses. Estimates suggest that there could be 40,000 vacancies, and the signs are that figure could grow. Worryingly, the latest update from the Nursing and Midwifery Council (NMC) suggests a vital pipeline for recruits is starting to run dry.
It’s not just that the number of European nurses and midwives who left the register rose to more than 4,000 in the year to September – an increase of 67 per cent compared to the previous year.
We also saw a dramatic decline in those making that big life-and-career decision to bring their skills to the UK. New registrations fell to just over 1,100, a drop of nearly 90 per cent.
We represent 98 per cent of NHS trusts, including mental health, community and ambulance services as well as hospitals, so we get a strong sense of what is happening on the NHS front line. They are telling us that losing valuable staff in this way is the very last thing that the health service can afford.
It’s true that as an overall proportion of nurses and midwives registered with the NMC, the fall is modest. But there are two key points to remember here.
First, the NHS has come to rely more heavily on that EU “pipeline” in recent years. Now it’s becoming clear that the uncertainty surrounding Brexit is taking its toll. Some nurses and midwives are heading home. We know there are many more who are considering their options.
And there is growing evidence that those who were planning a move to the UK to benefit from the experiences and opportunities of a career in the NHS are finding reasons to think again.
That matters. NHS trusts are struggling as never before to recruit and retain nurses and midwives. They are working to ensure their European staff feel engaged and motivated, and will carrying on recruiting overseas, but there is only so much they can do by themselves.
Just a small drop off in NHS nurses from the EU will make a bad situation worse. And when trusts can’t cover gaps in rotas it affects the quality of care. Patient safety is always the top priority, but this becomes more difficult when staff are overstretched.
The other important point here is that when it comes to staffing the NHS is running to stand still, because demand for care is going up and up. Yes, there are more clinical staff in the health service than ever before, but the increases in GP referrals, accident and emergency attendances, emergency admissions and diagnostic tests are far greater. This is a bad time to be losing European nurses and midwives, whose skills are at such a premium.
And let’s be clear this is not just in hospitals. The pressures on mental health and community services and paramedics have also risen through the roof. There are around one in 10 vacancies in mental health nursing alone.
NHS nurses and midwives can not give the quality of care they want to if they are run ragged. We can not keep on expecting them to go the extra mile, time and again, especially when pay has been held back for so long. And let’s face it: payments in pounds sterling are hardly the currency of choice at the moment if you come from the Eurozone.
It should be no surprise that if the pressures are intolerable and the money falls short, eventually people will vote with their feet. That’s what is starting to happen now.
It’s going to take a long time to turn this round. But we could make a good start by assuring EU nurses and midwives working here that they will have a right to remain. We need an immigration policy that will allow trusts to fill vacant posts while we train up more nurses and midwives in the UK. And beyond that there should be a clear coordinated plan to create the health and care workforce this country will need in the years to come.
Saffron Cordery is the director of policy and strategy for NHS Providers, a trade organisation for the NHS acute, ambulance, community and mental health services.
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