Staffing Crisis – Will the Government Actually Follow Through?

It seems that the Government might actually deliver on one of their manifesto commitments – providing 50,000 more nurses to the NHS by 2024. The overall total number nurses in England was 327,907 in December 2021, compared to 300,904 in September 2019. It is estimated this number will rise to 351,000 by March 2024.

In a progress report the Government has also outlined how additional nurses will be recruited and where they will come from. This includes:

  • domestic recruitment (ie. undergraduates, postgraduates, apprenticeships, nursing associates and assistant practitioners converting to fully qualified nurses);
  • international recruitment; and
  • retention of existing staff

As far as the breakdown, it is estimated that international recruitment will deliver between 51,000 and 57,000 more nurses and 68,000 to 75,000 more nurses will be trained in England by 2024.

Points of Concern

Since the pandemic many nurses have retired, left the NHS or reduced their hours. This proved extremely detrimental when demands for services were at an all-time high. As a result there is now a huge backlog for appointments and visits. The 50,000 new nurses was designed to offset the gap. It will include all full-time equivalent registered nurses working in the NHS in England. This covers all NHS providers across acute, community, mental health and ambulance settings, and all those employed in general practice. Crucially, it will not include non-NHS providers, including social care providers and social enterprises, though these sectors will benefit indirectly as the numbers of nurses trained increases overall.

This highlights concerns on how many nurses will actually be provided and their impact. Using retention as a way to measure increase in the number of staff means that staff levels don’t actually increase. This implies that the Government is not actually delivering on its promise, but reworking the numbers as they did with the care tax and National Insurance rises announced in October 2021.

Further there is not just a shortage in the NHS, it is across the care sector as a whole, and crucially in adult social care. While 50,000 more nurses will no doubt have a huge impact on the NHS’ ability to cope with demand, meaning that less pressure will be put on social care providers to compensate for the NHS, it doesn’t address the issue of staffing shortages in other facets of health and social care.

Quoting numbers as high as 57,000 and 75,000 gives the impression that the Government will actually exceed on its promise, however this doesn’t say much about the retention or turnover of those recruitment and training efforts and what the data is regarding those who actually become nurses in the NHS. The cumulative trajectory in the Progress Report itself is actually only 42,000 to 61,000 by 2024, which includes issues with recruitment, retention, and retirees, meaning that the numbers can be very misleading and indicates that the Government can fall short by as much as 20% on their promise.

It will be interesting to see if the efforts the Government makes will (1) actually come to fruition and (2) if they will continue to focus on the NHS at what appears to be the expense of other health and social care providers.


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