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Nurses need a reason to ‘return to practice’

Marilyn Eveleigh thinks return to practice programmes can be successful, but only if they’re appealing to their target audience

Marilyn Eveleigh thinks return to practice programmes can be successful, but only if they’re appealing to their target audience


The welcome NHS Long Term Plan was published in January, but unfortunately it did not include the crucial, detailed workforce strategy required to deliver the vision. This was promised ‘later in the year’ after budget discussions and has now been delayed once again.

It is now spring and the Government and the professions are apparently working on it. Nursing shortages are highlighted as the most urgent workforce issue. This NHS Workforce Implementation Plan, known as the ‘people plan’, can no longer wait. Each day the NHS struggles on, haemorrhaging dedicated nurses who are exhausted by staff shortages and disheartened by their inability to fulfil the needs of an aging, entitled and vulnerable population.

Since January, more evidence has revealed the dire state of the nursing workforce:

  • The National Institute of Health Research reported that though staffing in acute trusts has increased by 10% since 2013, there are still too few to meet demand and fill rotas.  
  • Safe nurse staffing targets introduced as a consequence of the 2013 Mid Staffordshire NHS Trust scandal are not being universally met due to nurse shortages.
  • The Labour party reported that more than 160,000 nurses left the NHS prior to retirement since 2010.
  • In 2017, 27% more nurses and midwives left the NMC register than joined.
  • A third of practice nurses are due to retire by 2020.
  • The frontline has increasing pressures, with unpaid overtime becoming the norm: their goodwill and commitment keeps patients safe and many services afloat.  

To attract and retain talented, committed nurses, we need quick fixes: we need to dismantle unnecessary barriers to recruitment. We can’t wait for nursing students to qualify or bed in new models of training. We need to keep the nurses we have now and entice back those who have left.  

Therefore, it’s opportune that the NMC now encourage education and healthcare organisations to provide more flexible competence-based ‘return to practice’ (RTP) routes that can be tailored to the returning nurse. With only 1,600 nurses completing an RTP programme each year, we must make returning interesting, nurture the returner, and reward teams that enable a better work/life balance.

It sounds attractive and more cost-effective – and could be introduced immediately with managerial support and minimal funding. Spread the word.

To further support nursing, the NMC is now taking into consideration the context where errors are made in Fitness to Practice cases, acknowledging that systems, staffing and environments affect how nurses work and the safety of those in their care.  This is long overdue.

Over the period spanning December 2017 to December 2018, there was been a small but welcome 1.3% rise in GPNs. Amazingly, there has also been a recorded 22% jump in primary care nurse practitioners to 4,189. Over the same period, GP numbers have dropped by 3.4%. Now this is seriously worrying for patients, primary care and the Long Term Plan. Where is that Workforce Implementation Plan?