Government’s nursing target “does not benefit social care” 

Analysis published today by the Health Foundation’s REAL Centre shows that the NHS in England could face a shortfall of around 38,000 full-time equivalent (FTE) registered nurses by 2023/24 relative to the numbers needed to deliver pre-pandemic levels of care. This is despite the expectation that the government could meet its target of recruiting an additional 50,000 FTE registered NHS nurses by the end of the parliament.

Doctor-woman-with-white-coat-and-stethoscope.
Nurse with white coat and stethoscope.

The findings, which call into question the ability of an incoming government to rebuild the NHS and improve standards of care following the pandemic, are part of a wider research report on the future of the NHS workforce in England.

It argues that the government, in setting the target of an extra 50,000 nurses, fails to grasp the growing demand for care driven by an ageing population and an increased number of people with complex health conditions. The UK has fewer nurses per head of population than the OECD average. While NHS nurse numbers in England have increased over the past 3 years, they have not kept pace with demand. NHS nursing shortages vary by geography and service area. The current government target of 50,000 extra NHS nurses does not focus on targeting nursing recruitment where it is most needed, such as in primary, social and community care, and learning disability and mental health services.

The number of registered nurses working in adult social care in England has declined significantly over the last decade,” said Nihar Shembavnekar, economist at the Health Foundation and one of the report authors. “The government’s target to recruit an additional 50,000 NHS nurses does not benefit social care, one of the sectors where nursing recruitment is needed most. Nursing needs to be made a more attractive career choice across both social care and the NHS, supported by a robust, fully funded long-term plan to address workforce shortages.”

The analysis also explores potential gaps in the nursing workforce over a longer period beyond the next election by looking at three different scenarios. Under the ‘current policy scenario’ where current trends continue and nurse workforce policies are unchanged, the nurse shortfall in NHS trusts in England is projected to be 30,300 FTE by 2030/31. This nursing shortfall over the next decade would pose a serious threat to the level of care the NHS was able to provide for patients. In a ‘pessimistic scenario’ where more nurses leave the profession early and the number of newly registered internationally recruited nurses declines after 2023, NHS trusts could face an even greater shortfall of around 140,600 FTE nurses by 2030/31. 

The analysts warn that some areas of nursing face bigger shortfalls than others, with general practice and adult social care in England facing persistent shortages until the end of the decade.

However, the report authors highlight that the situation can be turned around with better long-term planning. Specifically, policymakers need to fund and deliver sustained increases in students starting nursing degrees; reduce student nurses leaving before qualifying; reduce the proportion of nurses leaving the NHS before retirement age whilst also continuing to recruit international nurses. In this ‘optimistic scenario’, the analytical projections suggest it would be possible for the number of nurses in NHS trusts – although not in general practice and social care – to match projected demand by the end of the decade. 

“Nurses are indispensable to the delivery of NHS care but due to a lack of long-term planning, persistent high vacancy rates mean the NHS cannot deliver the level and quality of care people rightly deserve,” said Anita Charlesworth, director of research and REAL Centre at the Health Foundation.

“The NHS in England appears to be on track to recruit the additional 50,000 nurses promised by the government by 2023/24, but this relies heavily on sustaining historically high levels of international recruitment, very much a ‘quick fix’ and does not replace the need to train and retain more nurses in the UK. The 50,000 target is arbitrary and not based on the number of nurses the NHS needs; nor does it ensure that nurses are recruited to the areas and types of care where the need is greatest. 50,000 extra nurses will still leave the NHS almost 40,000 short of what is needed. 

“‘If the new prime minister wants to rebuild the NHS and return it to pre-pandemic levels of care, they need to make nursing a more attractive career choice and put in place a robust, costed long-term plan to address workforce shortages, backed up by independent projections of how many staff will be needed.”

As well as specific projections on the nursing workforce, the REAL Centre’s report also assesses future supply and demand trends for the wider NHS workforce. It says that, if current trends continue, the NHS could face a shortfall of around 160,000 FTE staff across all staff groups by 2030/31. This is around 55% higher than an estimated NHS workforce shortfall of around 103,000 FTE staff in 2021/22. 

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