Community nursing investment must be Spending Review priority, urges RCN

The Royal College of Nursing (RCN) has demanded ‘urgent action’ to recruit, support and retain community nurses as part of its key asks of the government’s upcoming Spending Review.

The college warned that shortages in specialist community roles, especially school nurses and health visitors, were reducing opportunities to prevent poor health.

In its submission to the 2025 Spending Review (SR) the RCN has also called on the government to ‘increase staffed bed capacity’ to ensure more patients can receive care in the community and be discharged when appropriate.

The union explained how shortages in community and social care nursing were leading to delays and blocks in patient discharge, resulting in overcrowded hospital spaces with staff providing care across corridors and other unsafe settings.

Writing to the chancellor of the exchequer, who will set out public spending plans in the SR on 11 June, the RCN said community and district nurses are ‘essential for expanding care in the community’ despite falling district nurse numbers.

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‘Shortages in specialist community roles, particularly health visiting and school nursing, also reduce opportunities for prevention,’ it said.

‘With demand rising, urgent action is needed to recruit, support, and retain these members of the nursing profession, otherwise plans to shift more care away from hospitals won’t succeed.’

How does the spending review work?

Through the SR chancellor Rachel Reeves will outline the government spending plans for 2026/27, 2027/28 and 2028/29.

The RCN believes the 2025 SR will be ‘particularly significant’ as it will be used to decide how government departments allocate their budgets, in turn shaping their priorities for public service, infrastructure and welfare provision.

Although the early decisions of the SR will directly impact what the government spends in England, these spending levels will also influence the block grants received by devolved administrations in Wales, Scotland and Northern Ireland.

These administrations will later make their own decisions on spending across different areas, depending on their allocations.

What are the RCN’s spending review demands?

The RCN believes this year’s SR is ‘an opportunity’ to tackle some of the challenges facing the UK’s nursing workforce and wider healthcare systems.

It is asking the government to ensure that the SR, the 10-Year Health Plan and the upcoming Workforce Plan for England are all ‘aligned in terms of funding, ambition and planning’.

The RCN has repeated its calls for the government to introduce loan forgiveness for nursing graduates as well as to provide financial subsidies to higher and further education institutions to protect nursing courses.

It is also calling for ‘sufficient long-term funding’ to deliver on additional salaries of new and additional nursing staff, alongside the costs of expanding training places.

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‘Too often we have observed national plans for the NHS fail to be underpinned by sufficient funding, and workforce plans which do not support delivery,’ it said in its submission.

Last month, Nursing in Practice reported on early findings from the Nuffield Trust which found that the number of district nurses working in the NHS in England had fallen by 43% between 2009 and 2024.

In April, Cardiff University paused a proposal to close its school of nursing while an ‘alternative plan’ is being considered following outcries from academics, students and nursing bodies. 

In January, thousands of nurses shared their experience of caring for patients in inappropriate settings including hospital corridors, bathrooms and cloakrooms in a survey published by the RCN. 

And last October, the RCN revealed that the number of people studying to become a nurse had fallen across every region in England, warning that the 10 Year Health Plan could be put at risk. 

A government spokesperson said the government is working to rebuild the health service.  

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‘We value the vital work that nurses do every day, and we are supporting nursing students with a grant of £5,000 per academic year, on top of maintenance and tuition fee loans.

‘We are also committed to improving the working lives of nurses in the NHS, and recently accepted a number of non-pay recommendations which focus specifically on improving nurse career progression,’ they explained.