Nursing and midwifery leaders have singled out retention of healthcare professionals as ‘crucial’ to addressing the workforce ‘crisis’ facing the NHS.
Speaking at the health and social care (HSC) committee on 24 May, RCN president Dr Denise Chaffer and RCM chief executive Gill Walton said keeping nursing and midwives in their roles is among the most important ways to tackle workforce shortages.
They also called for a long-term workforce strategy to be published, while HSC committee chair Jeremy Hunt agreed Health Education England (HEE) must calculate and publish the numbers of healthcare professionals needed to meet patient demand in the long-term.
Also speaking to the HSC, Dr Navina Evans, chief executive of HEE, said HEE was publishing Framework 15, which she said will look at ‘what the population needs’, what services are needed and ‘what work needs to be done’ over the next fifteen years.
‘It won’t tell us exact numbers, but it will tell us how we need to think about and what will be required as a continuous, iterative process,’ she explained.
Mr Hunt countered: ‘I am deeply sceptical of publishing a framework – that’s like saying we’re going to publish an algorithm, but not an answer…
‘Isn’t it actually basically useless to publish a document on the biggest crisis facing the NHS if it doesn’t give a simple answer that the public understands on whether or not we’re actually training enough doctors and nurses for the future?’
Retention in nursing
Dr Chaffer highlighted a ‘huge’ retention ‘problem’ in the nursing profession, which she said is contributing to 39,652 vacancies – equivalent to 10% of the workforce – as of December 2021.
She pointed to NMC figures published last week showing that while the number of nurses, midwives and nursing associates registered to practise in the UK has grown, so has the number of people leaving the register, increasing by 13% on the year before.
Dr Chaffer continued: ‘I think the retention issue is probably the most critical – really understanding why nurses are not staying… Not only is that really difficult for all of the nurses working across the fields of nursing, but it also impacts on safe staffing levels.
‘Nurses that are not able to give safe care is very bad news for patients… We have to focus on the fact we’re losing nurses. We cannot afford to lose one single nurse.’
Dr Chaffer stressed that the Government must also work to reduce student nurse attrition – where trainees drop out of courses – and ensure nurses ‘are provided with the support they need to continue’ once they enter the profession.
She added: ‘That requires – in addition to the support to be able to practise safely, have enough staff to supervise and ensure there are safe practices – but access to further education as well.’
In addition, she argued nurses – who she said are sometimes not able to pay rent, afford the petrol need to get to work amid high fuel prices or get a mortgage – need to be paid fairly. The RCN is currently calling for a pay rise at 5% above inflation.
However, Dr Chaffer warned against ‘relying’ on international recruitment to plug workforce gaps and voice concerns over unethical treatment of overseas staff.
She said: ‘We have some international recruitment, but we need to look after those international recruits when they arrive in this country – so they are not subject to poor conditions, having to pay additional fees and that they are supported in the workplace.’
‘I also think we need to provide better support for training for the staff we have got – so they have access to training, many are paying for their own further education training, and also being released from backfill for training is incredibly complex.’
This comes after the NMC this month said it is considering accepting employer English language references, after research found hundreds of internationally trained nurses who have lived in the UK for years cannot work as a nurse because they are struggling to meet English language requirements.
Retention in midwifery
Speaking on behalf of the RCM, Ms Walton said the ‘midwifery workforce is very fragile’, with the organisation estimating a shortage of over 2,000 midwives in England alone.
She continued: ‘Retention is a really important thing. How are we going to keep the midwives that we have whilst we are recruiting more?’
‘If I was to pick a key thing that could make a massive difference, I would choose flexibility in terms of working in maternity services – so that’s the flexibility of being able to plan your work. The other thing is pay obviously, valuing midwives for the work they do…
‘It is a tough job – and the complexity of maternity services and the focus on it is increasing… The supply needs to be looked at as well as retention, that’s key.
‘It’s a vicious cycle: If you are short of midwives and you can’t deliver quality safe care, you feel anxious and then you leave. There’s also people who retired early – how do we attract them back to support particularly junior midwives in practise?’