Bid to boost nurse staffing in hospitals ahead of coronavirus failed, NHS report reveals

Efforts to attract thousands of former nurses back into the NHS to care for patients at the peak of the coronavirus first wave failed and left hospitals short of almost 4,000 nurses, it has emerged.

According to an NHS England report, only 1,007 eligible former nurses out of a total of 71,000 returned to work during May and June while sickness caused by Covid-19 decimated staffing levels, leaving hospitals with a net drop in 3,694 full-time equivalent nurses.

The expert review, carried out during the summer, said actions by England’s chief nurse Ruth May to ready the NHS for the coronavirus first wave were hampered by a lack of data on the numbers and skills needed.

It raises questions over the ability of the NHS to cope as patient numbers in England near the peak seen in April when almost 19,000 Covid-19 patients were in hospital.

It also highlighted poor communication between the chief nurse’s office and the separate team run by NHS England’s chief people officer Prerana Issar, which it said caused confusion on the frontline.

There was criticism too for the way nurses who joined the temporary register, set up by the Nursing and Midwifery Council, were handled by consultancy Capita, who took on average more than 26 days to send nurses details to hospital trusts, who found the data they were sent wasn’t good enough to determine the skills and experiences of the nurses.

The Royal College of Nursing has demanded the government take steps to deliver more nurses for the NHS to help hospitals cope after a surge of infections across London and the southeast which led to the government cancelling Christmas mixing and imposing new tier 4 restrictions on millions of people.

The effect of the pandemic on nursing could also worsen staff shortages with increasing numbers of nurses saying they are planning to leave the profession.

More than a third of nurses have told the Royal College of Nursing they are planning to leave nursing, up from 25 per cent at the end of 2019.

Professor Alison Leary, chair of healthcare and workforce modelling at London South Bank University, told The Independent: “We are tracking consistently high intention to leave rates in the most experienced staff. There has been a lost opportunity to leverage a supplementary workforce or engage in emergency workforce planning.

“There is still too much reliance on new people coming into the workforce and not enough on retention, but this is just filling a leaky bucket.”

The NHS England report, written by a group of nursing experts and NHS chief executives, concluded: “More could have been done to ensure a single, cohesive operational plan. We heard of inconsistencies and ambiguities between the messaging of the CNO and CPO teams. We also heard that communication with temporary registrants was infrequent and did not explain the delays in their deployment and that this may have increased attrition from the process.”

It added: “A low percentage of the eligible former nurses joined the temporary register. We heard that the centrally managed employment checks process was slow and the number of temporary registrants who made it into practice was low. Engagement with returners to understand their motivation and what they wanted to contribute was felt to be, at best, patchy.

“There appears to be little focus on increasing the number joining the temporary register or engagement with those currently on the temporary register, despite this route having the largest potential supply.”

At the start of April chief nurse Ruth May wrote to the NHS setting out a seven-point plan to boost the nursing numbers to prepare for a predicted surge in coronavirus patients.

The report said there was considerable uncertainty and decisions needed to be made quickly.

It also correctly predicted the difficulties hospitals would experience in the autumn as a second wave struck the UK. As hospitals restarted other services, nurses could not be redeployed like they were at the start of the year without cancelling operations.

Overall, compared to February the NHS saw its nursing workforce grow by 6,825 in May as a result of redeployment of staff, the temporary register and using student nurses.

But sickness levels increased from 4.8 per cent to 6.1 per cent.

The report said: “This means that by the end of April 2020, the increase in staff absence from sickness had exceeded the additional nursing and midwifery capacity in post by 3,694, meaning the service actually had a net reduction in available hours.

“The data corroborates anecdotal feedback collected in the focus groups and national interviews indicating that there was severe strain on the nursing and midwifery workforce as a result of sickness.”

Dame Donna Kinnair, chief executive of the Royal College of Nursing told The Independent: “The pandemic has starkly highlighted what happens when there are tens of thousands of nursing vacancies in the NHS in England alone. Nurses know only too well the impact this has.

“Many nurses are so concerned about staffing levels and the impact on their welfare that they are considering leaving the profession. Unless there is immediate action to address the nursing workforce crisis even more professional and dedicated staff will leave. Government must now get a grip and deliver the nursing workforce that is needed.”

NHS England said it was investing £180m in extra training and recruitment of nurses, with UCAS this week reporting a 26 per cent jump in students accepting a place at university to train to be a nurse.

In addition, the number of nurses employed by the NHS has increased by 14,000 this year.

NHS England said it had made changes to the temporary register to make it easier for employment checks and placements to be done quicker as well as a more locally led approach to filling staffing gaps.

Chief nursing officer Ruth May said: “Nurses have been at the forefront of the fight against coronavirus, and we are grateful for the thousands who returned to help in the first wave of the pandemic, alongside the 14,000 more nurses now working in the NHS than a year ago. This quick report made some useful recommendations, most of which have already been implemented.”