The health select committee is calling on the Government to restore nurse CPD budgets, among other measures, to boost falling retention rates.
The health committee wrote in its nursing workforce report, published today, that ‘too little attention has been given to retaining nurses’, which has resulted in more nurses leaving the register than joining it.
‘There are many causes for this shortfall, including workload pressures, poor access to CPD, pay and a general sense of not feeling valued,’ the committee said.
The committee heard from nurses and executives during its inquiry that access to CPD plays an important role in retention, but that the budget for it has fallen over £100m in four years. The report therefore said that Health Education England (HEE) ‘must reverse cuts to nurses’ CPD budgets’.
They also called for funding allocated to trusts for nurse CPD to be ringfenced for that purpose, and for ‘specific funding’ to be made available to support CPD for nurses working in the community.
The committee have also instructed HEE to assess the sustainability and transformation partnership and accountable care system workforce plans in a ‘timely and transparent’ manner, with the aim of looking to ‘redress the shortages in community nursing’.
The report added: ‘We expect HEE to supply us with a report of its scrutiny of STP workforce plans when they have been completed’.
It also recommended that further assurances be given to EU nurses working in the NHS that they will be able to remain in the UK with their families after Brexit.
Nursing should remain on the shortage occupation list for an extended period.
About education, the committee noted ‘early warning signs of emerging problems’ from the withdrawal of the student nurse bursaries in England.
‘The Government needs to closely monitor the impact of the removal of nursing bursaries,’ the report said. ‘The committee is concerned about the emerging indicators of the impact of bursaries on mature students. Action should also be taken to address high attrition rates from degree courses and the level of variation.
‘We were particularly concerned to hear that 30% of nursing undergraduates do not complete their course, and we would like further assurance from HEE that attrition rates have been taken into account in future workforce projections.’
In November, Dr Sarah Wollaston, a GP and chair of the committee, hosted two focus group sessions with nurses from a variety of different areas, organisations and specialties. The nurses said that their colleagues often left because of burnout and workload.
‘There was agreement that there is an urgent need for “more hands on deck” right now, even if it is HCAs rather than registered nurses, as there are simply not enough nurses to go around,’ the report said.
The committee welcomed the new nursing associate role but said that the Government needs to ensure that nursing associates have a clear professional identity, which the public understands and recognises.
Dr Wollaston said: ‘We met many front line nurses during the course of this inquiry. We heard a clear message about workload pressures as well as ideas about how to address these.’
The committee also called for the development of a nationally agreed dataset, to record an ‘agreed figure for the nursing shortfall’. The dataset should include figures on how many nurses have taken up advanced practitioner roles, it said, following NHS Employers chief executive Danny Mortimer’s claim at the committee meeting in November that the NHS had ‘failed to anticipate’ the growth of the advanced nurse practitioner role.
The report said that nurse recruitment plans should not be focused only on financial efficiency: ‘Future projections of need should be based on demographic and other demand factors rather than just affordability.’
‘They also need to include proper consideration of the interrelated nature of the social care and other non-NHS nursing and wider healthcare workforce.
‘HEE should publish detailed projections for nursing staff for the coming years—both numbers entering the workforce from different routes and the anticipated need for staff—and must clearly set out the basis on which its future projections of need for nursing staff are made. These projections must include nurses working in and outside the NHS.’
Chief executive and registrar of the Nursing and Midwifery Council Jackie Smith ‘fully supports’ the committee’s recommendation to ringfence CPD budgets.
She said: ‘Providing much needed development opportunities is key to career progression and ensuring that we are investing in a workforce that can meet the demands of a population with complex needs.
‘While it is vital we create new routes in, urgent action is needed to retain the workforce as nurses are leaving the profession and our own data shows this. Developing a national data set is something we fully support.’