Ministers are warned of a growing workforce crisis in England’s hospitals as they struggle to recruit staff for tens of thousands of nursing posts, with one in five nurses in some wards now unoccupied.
Hospital leaders say the nursing deficit has been exacerbated by a collapse in the number of recruits from Europe, including Spain and Italy.
The latest NHS figures reveal that there are around 39,000 vacancies for registered nurses in the UK, with one in 10 nurses employed in emergency departments in London and one in five nurses vacant in psychiatric wards in the South East.
The number of nurses from the European Economic Area participating in the Register of Nursing and Midwives has fallen by more than 90%, from 9,389 in the year to 31 March 2016 to 810 in this year to 31 March 2021.
Thousands of nursing shifts each week cannot be filled due to staff shortages, according to hospital protection staffing reports seen by Observer.
Prime Minister Boris Johnson is already under pressure over the shortage of workers in Britain after Brexit, from truck drivers to farm workers. Concerns among health executives about the impact on patient care of acute staff shortages are revealed when experts last week warned that the flu could kill up to 60,000 this winter.
NHS trust is paid by NHS England up to £ 7,000 for each vacancy to try to recruit nurses from overseas countries including India and the Philippines.
Patricia Marquis, director of the Royal College of Nursing (RCN) in England, said: “There are simply not enough staff to provide the necessary care and we now have a crisis in the nurse. We should never have gotten into a position where we were so dependent on international nurses. We’re on a knife edge. ”
Hospital troops struggling to fill nursing positions include:
University hospitals in North Midlands NHS trust – which runs Royal Stoke University Hospital and Stafford County Hospital – and which has reported 401 unoccupied nurses to its board, a vacancy of 12%. Confidence temporarily suspended non-emergency operations last month due to high demand and staff shortages. It recruits nurses from abroad, including from India and Ghana.
Leeds Teaching Hospital’s NHS trust, which has reported nearly 700 vacancies for nurses, midwives and practitioners, a vacancy rate of 13%. It postponed 287 surgeries in July and August and last weekend appealed for nurses to work extra shifts due to “lack of staff in our critical wards”.
Central and Southern Essex NHS foundation trust, with a vacancy rate of 17% for nurses, one of the highest in the country. It has 2,269 full-time clinical and non-clinical vacancies. The trust reported that during the summer, up to 1,850 patients a month waited longer than four hours in A&E due to staff shortages.
A survey conducted by the union Unite among 188 employees in critical care at Guy’s and St Thomas’ NHS foundation trust has uncovered staff’s concerns about “chronic” nursing shortages and risks to patient safety. Nine out of 10 employees reported understaffing in their department at each shift.
Dave Carr, 58, a critical care nurse at St Thomas’ Hospital and a Unite representative, said: “I work in intensive care for patients recovering from surgery and we need up to 11 nurses on that shift. , one for each patient. We regularly have only three or four of our own nurses available and need to borrow nurses from other areas or get temporary staff. The staff is completely devastated. More than 100 nurses have left the trust in the last 10 months. ”
Shelley Pearce, 34, an accident and emergency nurse and RCN workplace representative in the south of England, said nurses from Europe endured abuse from some members of the public after the Brexit referendum. She said: “I can well understand why some made the decision to go home because they did not seem to be wanted.”
The government has promised to increase the number of NHS nurses by 50,000 by 2025. NHS England announced 28 million. Pound in September last year to recruit nurses from abroad to help pay for accommodation, flights and quarantine. The advance price for recruiting a nurse from abroad is between £ 10,000 and £ 12,000.
By comparison, it takes three years to train a nurse in the UK and costs from £ 50,000 to £ 70,000. The government does not pay tuition fees, but provides maintenance grants worth at least £ 5,000 a year.
There is a global shortage of nurses and therefore there has been criticism of trusts recruiting from abroad instead of training more UK staff. Even the new Minister of Care and Mental Health, Gillian Keegan, is reported to have called it “incredibly ineffective and also wrong and just bizarre”.
Despite this, a report from the Nuffield Trust thinktank commissioned by the NHS and published last week said that significant overseas recruitment would be required if the public nursing goal were to be achieved. Saffron Cordery, deputy chief executive of NHS providers, called for a fully-planned workforce plan in the government’s spending review this month.
She said: “We have had a shortage of labor for many years and we have seen it worsened by Brexit. The workforce is the engine of any hospital, and when you have guards unoccupied, it’s a huge challenge. ”
Danny Mortimer, CEO of NHS Employers, part of the NHS Confederation, said: “We have experienced the pressure we would normally see in the winter months over the summer. Many employees predict that this will be one of the most difficult winters the NHS has ever faced. ”
A survey of more than 1,000 NHS staff from the Healthcare Workers’ Foundation, a charity that supports health care workers, found 73% were considering leaving last year. Nearly one in three frontline staff said they were likely to leave next year.
The total number of full-time equivalents in the NHS in England has increased from 83,203 in June 2020 to 93,806 in June 2021, according to figures from NHS Digital, the government’s health and information center. During the same period, the vacancies of nurses increased from 37,760 to 38,952.
Hospital troops say they are recruiting staff from abroad to help fill positions. University hospitals in the North Midlands NHS Trust said it had recently hired nearly 300 additional nurses, 93 of them from abroad. Leeds Teaching Hospitals NHS trust said staffing was an “ongoing challenge” but it was successful in recruiting new staff. The Central and South Essex NHS Foundation Trust said its gaps were filled by agency and temporary staff. A spokesman for the trust of the Guy’s and St Thomas’ NHS Foundation confirmed that 118 nurses left this year, but said 97 started and another 30 had to undergo pre-employment checks. A spokesman said the trust listened to all the concerns of the staff. The trust said: “The safety of our patients and the well-being of our staff are our top priorities. We are investing in recruiting more nurses and continue to provide comprehensive health and well-being support to our staff. ”
Health experts say the total NHS workforce is growing, but not enough to keep up with demand, and the proportion of unfilled jobs across NHS England has grown over the course of the year.
The NHS said: “The NHS is committed to reducing vacancies in nurses, including through international recruitment, and increasing well-being support to existing staff to increase retention.
“The nursing and midwifery workforce grew by over 2.7% over the past year with over 330,000 additional full-time staff providing care, and 80,000 people across the country applied for a nursing course this year.”