What Needs To Be Done To Get The Most Out Of An Increase In Nursing Numbers?

How can healthcare managers ensure they are able to fully realise the benefits of a rise in nursing numbers?

This year has seen numbers of nurses, midwives, and nursing associates on the NMC Register and eligible to practise increasing by 1.8%.

The two primary challenges facing healthcare institutions in a time of seemingly structural staff shortages are finding qualified professionals and then keeping them: in other words, Recruitment and Retention.

The mid-year report, published by the NMC for the six months to 30 September 2021, shows an additional 13,011 nurses, midwives and nursing associates, taking the total registered to 744,929.

This increase means 11,331 more nurses and 594 more midwives across the UK. There are also an additional 1,156 nursing associates, in England only.

However, figures for people leaving the register have also increased and are now at the highest level since 2017. Between April and September this year, a total of 13,945 people left, an increase from 11,020 during the same period in 2020

Do you think that the reasons for people leaving the NMC register, and the implications of that on the health service are well enough understood by healthcare managers and government ministers?

An investigation into this issue in 2017 by Health Education England garnered feedback from nurses who were leaving or planning to leave. Several common issues were identified, including a lack of support, large amounts of paperwork, and scarce opportunities to progress their career, as well as a lack of autonomy, and their pay not always commensurate to their role and responsibilities.

A report called ‘Building the NHS Nursing Workforce in England’, published in December 2020 by the Health Foundation – argued that the government’s target of 50,000 new nurses in England by 2024/25 will have to be exceeded for the NHS to fully recover from the coronavirus pandemic.

How realistic do you think the 50,000 target is? And can having those extra nurses achieve its desired purpose without addressing the attrition rate of those already working in healthcare?

Following shortly after this report, a survey by Nursing Times from January 2021 showed 80% of nurses felt patient safety was being compromised as a consequence of this severe staff shortage.

The chief executive and general secretary of the Royal College of Nursing Dame Donna Kinnair, said: “There simply aren’t enough [staff] to care safely for patients in hospitals, clinics, their own homes or anywhere else.”

Are concerns about patient safety due to understaffing being given the proper consideration? And does there need to be some public discussion about what level of care can be provided with the staff that are available?

One possible solution is the idea of having a completely digitised application process with fully integrated applicant tracking. It is hoped that such an approach would constitute a more effective and efficient process for both recruiters and applicants.

Given that much of current recruitment processes are already digitised, do you think going further down this route can realistically address the issue of staff shortages?

Or do these shortages, and the resultant demand for staff across all healthcare providers, mean that a more personal, individualised approach where the candidate feels valued and engaged could yield better results, even it is not deemed to be as ‘efficient’?

Once a candidate has applied and been accepted, an area of critical importance is the onboarding process. A positive experience here can measurably reduce staff turnover rates down the line. This positive experience may be something as simple as an organised process; like having all the necessary paperwork to hand, but it can also involve more personal touches.

For example, arranging for new staff members to meet their colleagues informally first, and making sure to touch base with them at key points in the early days of their employment.

This level of attention to detail obviously requires time and resources, so there is a question of practicality. If existing staff members are already working flat-out to meet patient demand, can the requisite time and resources be made available, and if so at what cost to other priorities?

Once you have got a new employee started, the focus needs to shift to how to retain them. Providing clear pathways for staff to develop their skills and careers is one way of reducing turnover rates. This can be done both as an aid to staff progressing onto more skilled roles, but also for staff to develop complementary skills for the role they are currently undertaking.

Do you think that the constant need to firefight ‘crises’ in the health service leaves many of those employed within it either too stressed or too jaded to engage with matters that are not of immediate clinical importance, such as career development and additional training?

Please let us know what you think in the comments. What can and should be done by healthcare managers to ensure that the increase in nursing numbers provides the improvement it should to health services? And alongside that, what needs to happen to reduce the numbers leaving the profession?

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