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The new Government must grow the nurse workforce

The British public has spoken in the 2015 general election and we now have a Conservative Government presiding over the UK. High on the agenda will be the management of the NHS. Like the other major parties, the Conservatives had pledged to increase the budget for the NHS by £8 billion and increase the number of GPs, but unlike the Labour party, there was no mention of the need for more nurses to support the work of the NHS. It’s all well and good stating that we need more frontline workers, but where are they going to come from?

The Royal College of Nursing (RCN) final report before the general election, Frontline First: The fragile frontline, finds that there are fewer nurses than in 2010 and that an already over-stretched workforce is being forced to carry out even more work, with serious implications for patient care and staff welfare (RCN, 2015).

Analysis of the workforce numbers finds that while the total number of posts has increased by 6434, the true picture is less positive. The increase in the total nursing workforce (excluding midwives, health visitors and school nurses) is actually only 1470. While the number of full-time equivalent posts has increased, the number of people filling those posts has fallen by 1845, meaning that fewer nurses are providing more care (RCN, 2015).

The report also highlights other areas that the next Government must address as a matter of urgency. The community nursing workforce has been cut by over 3300, despite NHS plans to move care from hospitals to the community. Furthermore, the recent increases in student nursing places are not enough to make up for previous cuts, increasing demands and an ageing workforce. Dr Peter Carter states:

“While the health service has spent the last five years running on the spot, demand has continued to increase.”

I know this to be true as last year I was trying to recruit two DSN posts. I am very fortunate that my local Clinical Commissioning Group sees the value in DSNs; what was frustrating for me was that I had the funding but no candidates to fill the posts. We advertised three times before we were able to get suitable candidates, but even then the numbers of those who applied were low. Colleagues around the country seem to be experiencing similar difficulties in recruitment of DSNs. As a temporary solution, we are soon to commence a six-month secondment to the team from our local District Nursing Service, but this actually feels like “robbing Peter to pay Paul” as they are having the same difficulties with recruitment.

It is deeply concerning that in the face of dramatic increases in the numbers of people living with diabetes, some areas of the UK are struggling to maintain this key, cost-effective service provided by DSNs. Demand seems to have outgrown capacity. In Enfield, our Public Health Department estimates diabetes prevalence is now 8.04% and is set to pass 10% by 2020. When I moved to work in Enfield in 2005 the prevalence was 5.8%. Scary, isn’t it? But even more scary is that 40% of existing DSNs will retire in the next 10 years (Diabetes UK, 2014). This includes myself, with an anticipated retirement date of mid-October 2015; however, I am returning to work on reduced hours in the same position soon afterwards. 

Employers of DSNs must ensure that they have sufficient numbers of competent and clinically supervised nurses in post to deliver quality care. More skilled nurses are needed and the NHS must provide a clearly defined career pathway with appropriate training to ensure nurses have the skills to support people with diabetes to enhance their quality of life and reduce costs to the NHS. 

The new Conservative Government must learn from the RCN’s report and take immediate action to grow the nursing workforce.

The British public has spoken in the 2015 general election and we now have a Conservative Government presiding over the UK. High on the agenda will be the management of the NHS. Like the other major parties, the Conservatives had pledged to increase the budget for the NHS by £8 billion and increase the number of GPs, but unlike the Labour party, there was no mention of the need for more nurses to support the work of the NHS. It’s all well and good stating that we need more frontline workers, but where are they going to come from?

The Royal College of Nursing (RCN) final report before the general election, Frontline First: The fragile frontline, finds that there are fewer nurses than in 2010 and that an already over-stretched workforce is being forced to carry out even more work, with serious implications for patient care and staff welfare (RCN, 2015).

Analysis of the workforce numbers finds that while the total number of posts has increased by 6434, the true picture is less positive. The increase in the total nursing workforce (excluding midwives, health visitors and school nurses) is actually only 1470. While the number of full-time equivalent posts has increased, the number of people filling those posts has fallen by 1845, meaning that fewer nurses are providing more care (RCN, 2015).

The report also highlights other areas that the next Government must address as a matter of urgency. The community nursing workforce has been cut by over 3300, despite NHS plans to move care from hospitals to the community. Furthermore, the recent increases in student nursing places are not enough to make up for previous cuts, increasing demands and an ageing workforce. Dr Peter Carter states:

“While the health service has spent the last five years running on the spot, demand has continued to increase.”

I know this to be true as last year I was trying to recruit two DSN posts. I am very fortunate that my local Clinical Commissioning Group sees the value in DSNs; what was frustrating for me was that I had the funding but no candidates to fill the posts. We advertised three times before we were able to get suitable candidates, but even then the numbers of those who applied were low. Colleagues around the country seem to be experiencing similar difficulties in recruitment of DSNs. As a temporary solution, we are soon to commence a six-month secondment to the team from our local District Nursing Service, but this actually feels like “robbing Peter to pay Paul” as they are having the same difficulties with recruitment.

It is deeply concerning that in the face of dramatic increases in the numbers of people living with diabetes, some areas of the UK are struggling to maintain this key, cost-effective service provided by DSNs. Demand seems to have outgrown capacity. In Enfield, our Public Health Department estimates diabetes prevalence is now 8.04% and is set to pass 10% by 2020. When I moved to work in Enfield in 2005 the prevalence was 5.8%. Scary, isn’t it? But even more scary is that 40% of existing DSNs will retire in the next 10 years (Diabetes UK, 2014). This includes myself, with an anticipated retirement date of mid-October 2015; however, I am returning to work on reduced hours in the same position soon afterwards. 

Employers of DSNs must ensure that they have sufficient numbers of competent and clinically supervised nurses in post to deliver quality care. More skilled nurses are needed and the NHS must provide a clearly defined career pathway with appropriate training to ensure nurses have the skills to support people with diabetes to enhance their quality of life and reduce costs to the NHS. 

The new Conservative Government must learn from the RCN’s report and take immediate action to grow the nursing workforce.

Diabetes UK (2011) Diabetes specialist nurses “at breaking point”. Diabetes UK, London. Available at: http://bit.ly/1oPg5C8 (accessed 28.04.15)
Royal College of Nursing (2015) Frontline First: The fragile frontline. RCN, London. Available at: http://bit.ly/1PRGtuz (accessed 28.04.15)

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