Vacancies have always been high
The NHS had persistent and severe workforce shortages before the Covid-19 pandemic. This sat behind the previous government’s decisions to invest in creating more nurse training places, re-introduce a maintenance grant for nursing students and incentivise international recruitment.
These measures did increase recruitment of nurses, but at the same time demand for nurses grew, in part because of the Covid-19 pandemic, as well as the ongoing recovery from it. This meant that while the number of nurses went up, the number of vacancies did not decrease.
What is now concerning is that the most recent data shows that in the first months of 2022/23 the NHS saw a sudden uptick in vacant nursing posts. There are now 46,000 vacant nursing posts, a record high.
Are more nurses leaving?
We know that the number of nurses being trained and in post has been increasing. So why is there a sudden increase in vacancies?
In part, growing vacancy rates are being driven by increased demand for nurses across the NHS. However, our new analysis suggests that the issue is being exacerbated by an increase in the number of nurses choosing to leave the NHS. Over the past 12 months, more than 34,000 nurses left their role in the NHS, an increase of 25 per cent on the previous year. This is not an isolated or incidental increase, if we look at the data over successive quarters, we find that a clear trend is emerging where a steadily growing number are choosing to leave. Throughout the pandemic and its peaks during 2020 and 2021, the number of nurses leaving remained at a similar level to that seen pre-pandemic, which suggests this is a new trend of nurses leaving who otherwise would not have done, rather than a backlog of resignations.
What is more, the current rate of increase is not driven by people retiring. It is in fact younger nurses who are leaving their roles in the NHS in the greatest numbers. Two-thirds, or nearly 23,000, of those who left over the past year were under 45 years of age, an increase of 26 per cent on the previous year.
To try to understand why more nurses are choosing to leave, we can look to the most recent NHS Staff Survey which shows that 34 per cent of nurses often thought about leaving, 52 per cent had felt unwell as a result work related stress and 40 per cent felt burnt out because of their work.
Bleak prospects for winter
It may have been repeated ad nauseum, but that’s only because it’s true: workforce shortages across the NHS are a key rate-limiting factor in working through the elective backlog and making improvements on key performance indicators.
Unfortunately, as we enter the winter months, our analysis suggests that shortages are worsening and the workforce crisis is intensifying.
The summer months have already seen all the wrong records broken in terms of the NHS’s operational performance. As we enter winter and demand rises, as it inevitably does in the colder months, and the impact of gaps in the workforce is amplified, it would seem almost certain that waiting times and access will get worse.
No silver bullets, but some stop-gap measures before the long road ahead…
Training, sourcing and recruiting nurses takes a long time. There will not be enough nurses in the NHS to meet actual levels of demand this winter, nor have there been in any recent winter.
For this winter, the government has limited stop-gap measures at its disposal, all of which it can and should use. For example, work has already begun on shoring up supply of international recruits to help bolster the nursing workforce.
Resolving the workforce crisis, developing a sustainable supply of nurses into the NHS while boosting retention by improving the NHS offer to its staff will take years. A multi-year, fully funded workforce plan is needed to ensure we don’t find ourselves in the same place in Autumn 2023.
I've been a nurse for 30 years. One of the saddest aspects for me is seeing new nurses bursting with enthusiasm and eager to become part of the profession leave after 5 or 6 years.
They've become disillusioned, cynical and exhausted.
They leave with their confidence in tatters and problems with their mental health.
Both my wife and myself worked right through the Covid period but we were already burnt out before Covid. We have had to now leave the profession in our mid to late fifties. If the issues underlying work related stress had been addressed we could have potentially worked for a good number of further years. We are just two of many thousands of very dedicated, experienced and highly skilled older Nursing Staff who have quit. I think if you were to ask most leavers the reasons for their exit from Nursing they would not particularly cite pay as much as unreasonable working conditions and needless paperwork. In some places in my area we have lost whole teams from the profession. It has been tragic.As beaurocracy has increased standards of Patient care have plummeted.
After 17 years of service I am burnout and exhausted... They try and teach us resilience ... And delegation.... Delegate to whom? There is nobody left and there are not enough staff and the ones we have have health issues and are working on a thread. I have mental health issues and PTSD from how I was treated by management and left to try and cope with intolerable pressure for 2 years, I till get panic attacks. Only when the government finally take action and listen to the unions to set safe staffing levels to reflect the complexity of the work which will ensure safe care for our patients will we be making some progress to recruit and recover. Until then. It's is not recoverable. Nurses won't risk their pin numbers to do an impossible job, it's not worth the stress, money or possible legal issues! Sooo a message to all avoid nursing. Im 35years old and I want out!
This is market forces at work, so beloved of our governments since 1979. They need to listen to their own rhetoric. When the workforce is in short supply you need to pay more and treat them better! Also, the Festival of Brexit, at £120 million would have funded a £400 pound cost for 300,000 workers, how many similar wastes of money have there been, never mind the Truss incompetence! More power to the Nurses campaign.
I have to disagree with this. We should be concerned with why those nurses are feeling so disillusioned with the profession that they are giving this advice to their students. What should they say instead? 'The profession and the NHS have treated me as a wonderful, valued and respected professional'? Our students are pretty switched on and would see right through that - they don't need to be told that other nursing staff are unhappy.
Unfortunately it’s true!! I would not recommend nursing to anyone at the moment.
It’s all very well saying is this the culture we should be encouraging? Probably not but nurses have had enough! I have never in my years as a nurse known morale as low as this.
Really; get the blinkers off. The Government are as helpful as a fart in a perfume factory, nurses are leaving in droves!! What’s seriously increased the numbers leaving was the handling over COVID. Students; get your degree’s if you really want to but seriously; do something else!!! Travel, further study, but do not go into nursing until the industry is sorted out.
If I had my time again I would not choose nursing. Yeah to begin with great; now it’s a profession that I would not recommend. The Government don’t respect us, morale is non existent. Anyone knows that if the RCN decides to strike; we’re in big big trouble.
My advice to Student Nurses; until the industry is back on its feet; really don’t bother!! It’s not worth the stress. Think of something else.
This is coming from a guy who was born to be a nurse!!
Oh where do I start? Jane Salvage back in the 1980s urged nurses to raise their voices and act, so what happened since? I started in 1986, as a graduate, ex Royal Navy aircraft mechanic aged 28 and was appalled at the working conditions and especially life experiences of older people in both private care homes and the NHS. It took me a few years to find a voice. The reasons are myriad; some of which are rooted in the base concepts of institutionalised care, an anti intellectualism in clinical practice but of course poor support for ongoing professional development and student support. All of these meant promising young staff with a vision left. Staff levels and skill mix were challenging to say the least in many clinical areas exacerbating these trends as they left little time for critical reflection, reflexivity while sapping the energy for action.
The issues around staffing will not be resolved in isolation. Nurses need to organise, get politically savvy and join other groups to resist the continuing denigration of nursing and health care.
I agree. We need to focus on retention and how we engage with our workforce. We need to lose the age old culture in nursing of being derogatory about the profession to younger nurses and support nurture and encourage them. I hear far too many band 5 and band 6 nurses telling students ‘to look for another career before it’s too late’. Is this really the culture the profession should be encouraging
Not impressed by this article. Change the focus and start discussing how we retain our nurses. I presented the RCN pay evidence to the PRB in the 20/21 pay round. A lot of it was around staffing and no one took any notice to it. I've presented to the PRB in earlier years, NO ONE TOOK ANY NOTICE OF THE ISSUES OF STAFFING.
So let's make of voice heard and strike!!