The idea that the government has fixed the healthcare crisis is laughable

This week the health secretary, Sajid Javid is determined to show us two things: how far he’s come in boosting nurse numbers and his blueprint for the future direction of the NHS. The two, I fully agree, are heavily intertwined.

As the leader of the professional body representing the largest group of health and care staff in the UK, I took a keen interest in these two developments on their behalf.

On Monday, Mr Javid’s department released the first official progress report on the 2019 election pledge to hire 50,000 more nurses in England. At a glance, it tells a story of an improving picture. But I’m afraid it is not one that any nurse today would recognise on the frontline.

Since that election, nursing might have grown fractionally in numbers but has been severely affected by the pandemic. There has been a sharp increase in people leaving nursing recently, with many more of our members saying they are considering alternative careers. The impact of the pandemic on our profession is far from settled.

How can we explain the rise in nursing staff compared to late 2019? In short, many delayed their retirement out of a sense of duty to patients in the pandemic and a large overseas recruitment drive means that half of those joining the UK nursing profession are internationally recruited.

Every single one of these is a skilled professional whose career in the NHS or social care must be long and fulfilling. Ministers should feel compelled to ensure it will be.

Yet the NHS itself puts out figures on how many people it is trying to recruit and the number of nursing jobs it cannot fill has risen in the last year, not fallen.

Only last week figures from NHS England confirmed that the number of full-time equivalent registered nurse vacancies had risen by nine per cent to 39,652, compared with the same period last year.

The suggestion that the nursing workforce is growing at the scale of demand and need simply does not chime with the day-to-day experience of our nursing staff trying to provide safe and effective care with a significantly depleted workforce.

At the beginning of a shift, more and more of our members feel anxious about the lack of staff, making mistakes or not being able to deliver care to the level they expect.

After their shifts many of them stay to finish their care and treatment for patients. Many are working unpaid hours every week and worry about leaving care undone.

These are not the symptoms of a healthcare system which is coping. They are signs of one in crisis, where they aren’t enough staff to provide safe and effective care.

So what’s the solution? The reform our members and patients want to see above all else is about care standards. Without addressing the nursing workforce crisis, other ambitions risk never being realised. How do ministers do this?

Firstly, by improving retention. Experienced nursing staff who stayed in the profession during the pandemic are now leaving in greater numbers and one of the simplest ways to keep more staff is a fair pay rise that recognises their professional skill.

Secondly, the government needs to be transparent about how it calculates the nursing workforce requirements genuinely needed for safe and effective care. This includes the right numbers with the right skills and experience.

And thirdly, ministers must produce and fund a strategy for increasing the domestic UK nursing workforce for the future, across health and care.

The government’s 50,000 target for England focuses on the NHS only and does not clearly take into account the need for nursing staff in wider settings and sectors, such as social care, public health and education. Legislation passing through parliament could help address this.

Last week, the House of Lords supported an amendment to the Health and Care Bill which would require the government to regularly report on data and set out the health and care workforce gaps.

When this amendment comes back to the Commons, the government has an opportunity to accept it and show its further commitment to accelerating the growth of the nursing and other health workforces.

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The Secretary of State should go further than just be transparent about the issues, but also accept full accountability for resolving the situation.

An acceptance of accountability will go some way to demonstrating to the nursing profession that he hears their concerns and will take responsibility for action.

If government continues to ignore the voice of nursing, they are ignoring the voice of the patient. Without enough nursing professionals, safe and effective patient care is simply impossible to deliver.

Pat Cullen is the General Secretary and Chief Executive at the Royal College of Nursing