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NHS facing hydra-headed nursing and midwifery shortfall

A combination of Brexit, Britain’s ageing population and government policy on bursaries could leave NHS trusts in England significantly short of nurses, new analysis has found.

The research, conducted by the Institute for Employment Studies, has found vulnerabilities in the current NHS nursing workforce which may leave staffing vulnerable as an unintended consequence of Brexit.

The paper finds that nurses, already a scarcity in the NHS, are ageing and falling in numbers, with fewer training places and nursing posts due to tight budgets and one in three nurses projected to reach retirement age over the next decade. This is leaving trusts increasingly dependent on EU staff who may be forced to leave by Brexit.

Dr Rachel Marangozov, lead author of the paper, said: “The ongoing uncertainty around Brexit poses serious questions for NHS workforce planners, who need to act now to reduce the impact of ‘worst case’ scenarios.

“This will be particularly important given that the NHS already faces funding challenges, increasing demand for its services and a rapidly ageing nursing workforce.”

The paper finds that trusts in London and the south east of England are particularly vulnerable to recruitment disruption post-Brexit, with 20% of nurses at the Royal Brompton and Harefield NHS FT being from elsewhere in the EU in 2015.

The IES research found that some trusts are also vulnerable to higher than average growth in usage by people over the age of 85, with Milton Keynes University Hospital FT, Burton Hospitals NHS FT and Wrightington, Wigan and Leigh NHST all falling in the centre of the Venn circle.

The Royal College of Nursing (RCN) said that the IES research chimes with its warnings of a time when the nursing recruitment crisis risks “reaching catastrophic proportions”, despite more registered nurses being needed than ever before.

Stephanie Aiken, deputy director of Nursing for the RCN criticised the government’s decision to charge fees to nursing students in England and replace NHS bursaries with student loans, as the Times reported this weekend that applications for midwifery and nursing degrees have fallen by over 20%, twice as much as other academic courses.

“The UK is already over-reliant on nurses from other countries, but if this supply is to be cut off at the same time as we are training fewer ourselves then this must act as a wake-up call – the government should reverse its decision on student funding and urgently address the nursing shortfall, especially as it enters negotiations on leaving the European Union,” Aiken said.

“It is not enough for the government simply to hope that more people apply to be nurses when all the available evidence shows that they will not do so. This is a very worrying situation that could cause the staffing crisis to deteriorate past the point of no return.”

The Royal College of Midwives seconded Aiken’s warnings, highlighting that some universities have revealed almost 50% fewer applications compared to this time last year, with uptake worst affected in London and the south east. 

Jon Skewes, director for policy, employment relations and communications at the RCM, called the figures “appalling”, saying that many potentially great midwives had been deterred due to costs, with graduates and mature students particularly important to the midwifery student base.

“Maternity services in the UK are already struggling due to a shortage of 3,500 midwives in England alone. This shortage is also likely to deepen if EU citizens currently working in the NHS lose their working rights post Brexit,” Skewes said.

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