One third of nurses leave hospitals each year, says inquiry

More than one third of the nursing staff employed at some London hospitals will leave their jobs each year, which is costly, disruptive for patients and bad for staff morale, a health study has found.

NHS trusts across Britain are struggling to recruit and retain nurses, but the problems are most severe for the teaching hospitals and those in inner cities, a report by the health policy think-tank the King's Fund says.

Out of 33 acute hospitals in London, 18 had nursing turnover rates of more than 25 per cent and seven hospitals in the centre of the capital had turnover rates of between 33 and 38 per cent each year.

The problem is blamed on the high costs of housing, transport and child care, which prevent many nurses from working in inner London.

The study, published in the British Medical Journal, also found one third of all new nursing graduates appear not to register for work, and a further 10 per cent do not work in the NHS in their first year in practice.

Belinda Finlayson, the lead author, says that for individual trusts, the high turnover rates are resulting in "high financial costs and low morale and may affect patient care".

On a national level, the recruitment and retention difficulties are "severely hampering the quality of service the NHS can provide and the progress towards modernisation", she says. But the Department of Health said the research was based on 1999-2000 figures, which were out of date, and that since then 28,000 extra nurses had been recruited to the NHS.

The study suggests that nursing vacancies across the NHS have been running at between 10,000 and 22,000 posts, a position that requires hefty spending to provide nursing cover.

While overseas nurses have reduced some of the manpower shortages, the report says that the number of nurses joining the UK register has declined in recent years.

In addition, nearly half of all NHS nurses and midwives are now aged over 40, which will see a doubling of retirements in the next few years. Training places have increased, but the study says that one fifth of all nursing students leave during the three-year course and one third of graduates choose not to register for work.

The underlying causes of the problems include low levels of pay, the changing nature of the job, perceptions of being "valued" and better prospects offered by other jobs.

The Government has sought to improve nurses' pay by implementing above-inflation pay rises and negotiations on salary reforms. But a newly qualified nurse was last year paid £15,445 compared with up to £17,000 for a novice teacher and £17,133 for an untrained police officer, Ms Finlayson says.

She recognises that ministers have launched various initiatives to tackle the current "crisis" but she says overall progress has been slow and serious problems persist.

Workforce issues are still nowhere near the top of the agenda for hospital managers or trust boards, who are diverted by other "must-dos" such as reducing waiting lists.

A Royal College of Nursing spokesman said the turnover figures highlighted an urgent need for nurses to be given better pay and job prospects so they stayed in the job longer.

The RCN's own research also suggested that 21 per cent of students who enter pre- registration nurse education and training do not register for work three years later.