Between 2000 and 2010 the nursing and midwifery workforce in the NHS in England grew by 26 per cent, an average of 2 per cent per year, the result of a concerted effort to reverse nursing shortages in the previous decade by increasing training places, improving staff retention and active international recruitment (1).
However, the number of nurses on the Nursing and Midwifery Council’s UK register of all practising nurses, began declining in 2008 and continued to fall in the following three years, while the headcount of qualified nursing staff working in the NHS in England only began to reduce after reaching a high of 375,505 in 2009.
Number of nurses and midwives on the UK effective register, 2000-2010
Source: Royal College of Nursing (2011). A Decisive Decade: The UK nursing labour market review 2011
A number of factors could drive a mismatch between supply and demand for the non-medical and nursing workforce.
Migration patterns have changed, the number of UK-trained nurses leaving to work in other countries now outnumbers those trained outside the United Kingdom seeking to work in the United Kingdom (2).
Age of the workforce
Perhaps most importantly, the current workforce is ageing: 12.4 per cent of the nursing workforce is aged 55 and over (2011 figures) and the figures are even higher for some roles, for example, 24 per cent for health visitors. In midwifery, 48.6 per cent of the workforce will be eligible for retirement in the next 10 years (2).
Between 2010/11 and 2012/13, the number of nursing training places fell 12.7 per cent from 20,092 to 17,546 (3). From 2013 nursing education will become all-graduate entry, but it is uncertain what impact this will have.
The number of training places in the allied health professions and pharmacy workforce is also being reduced in response to funding constraints – this may have an impact on the supply of staff in the next 20 years.
Demand for nursing and allied health professionals is expected to outstrip supply unless the number of training places is increased or recruitment outside the United Kingdom intensifies.
Future scenarios for the nursing workforce
The Royal College of Nursing has have developed a set of ‘what if?’ scenarios to model the effect of various changes on the NHS workforce in England up to 2021/22 (4).
'What if?' scenarios
The table below suggests that at current rates the nursing workforce will fall 12 per cent by 2021/22 (scenario A). At one extreme (scenario C) improved retention of existing staff and current rates of entry would increase staff numbers by 9.5 per cent. At the other end of the spectrum (scenario H), higher retirement, more nurses leaving to work abroad, and reduced numbers of entrants would result in 28 per cent reduction in the numbers of nurses, 99,000 fewer nurses than in 2010/11.
Source: Royal College of Nursing (2011). Report. A Decisive Decade – Mapping the future NHS workforce
- NHS Information Centre (2012). Data. NHS Staff 2001-2011 (medical and dental): Table 1a: NHS hospital and community health service (HCHS) and general practice workforce as at 30 September each specified year
- Royal College of Nursing (2011). Report. A Decisive Decade: The UK nursing labour market review 2011
- Lintern S (2012). Article. 'Disaster' warning follows 12% drop in nurse training places Nursing Times, 18 September
Royal College of Nursing (2011). Report. A Decisive Decade – Mapping the future NHS workforce