On Wednesday 23rd September, the Public Accounts Committee (PAC) highlighted an “emerging crisis in nursing” with concerns about record shortages in the number of nurses and low morale among them as Britain races towards a second coronavirus wave.The NHS is presently short of 40,000 nurses and researchers are pressingfor a review of the 12-hour shifts of all nurses to ensure their physical, mental and emotional well-being are intact. Health experts have constantly flagged up the issues of racism, pay disparity, burnout and exhaustion that most nurses and midwives face especially those from overseas countries.
But aside from local residents clapping for the welfare of these nurses and recognising their contribution, not much has changed at the policy front. Speaking about the plight of these nurses, Rohit Sagoo, Founder of British Sikh Nurses, said, "The claps for nursing and medical staff have now stopped, but the pressures of working in a pandemic continue and the challenges that nurses face are even greater as the number of positive Covid-19 cases rise.
“The landscape for combating coronavirus ever changes with mixed messages we have received from the government telling us to first protect lives and save the NHS to washing hands and socially distancing. We also face a nursing staff shortage of 40,000 nurses in the UK and have drafted some nurses from India in the last month that will be starting work at Nottingham University Hospital. What will be apparent for this group of nurses will be the communication barriers between native Indian nurses and British patients coupled with the underlying fear of racial stereotyping. We are already on the verge of leaving the EU as well as facing a cultural shift with the #BlackLivesMatter campaign so it is imperative that nurses from abroad are treated with the respect and dignity they deserve."
Plans to reduce vacancy by 2028
According to the PAC report, as of 2019the NHS employed around 320,000 nurses in hospitals and community services. This means that the nurses constituted 25% of the total NHS staff, with a further 24,000 employed in GP practices. To plug the existing shortage of nurses, the NHS Long Term Plan set out future service commitments and acknowledged the need to increase staff numbers with their goal of reducing the nursing vacancy rate to 5% by 2028. By the start of 2020, there were nearly 40,000 nursing vacancies in the NHS, a rate of 11%.
In the meantime, earlier this month British Association of Physicians of Indian Origin (BAPIO) announced the launch of a support network to facilitate 25,000-30,000 nurses from India who are or will be serving the NHS shortly. British Indian Nurses Association (BINA) will helpprovide them with all the necessary training, guidelines of the NHS and make them aware of the GMC regulations besides helping them navigate the cultural and linguistic barriers they may face in their career progression.
Frustrated with their poor working countries and not having received any financial raise despite widespread protests, it has emerged that some are quitting their jobs just in three years. This especially after the government announced a 2% increment for the doctors.
Speaking about the dire conditions of the nurses, Avni Trivedi, Women’s Health and Paediatric Osteopath said, “Nursing and carework isn’t valued enough by society. It’s often performed by women, and people of colour. Working conditions can be poor, with long hours and complex hierarchical structures and pay is often barely above the living wage. How is it possible for someone to take care of others if their own needs are woefully neglected?
“It is understandable that large numbers of nurses are leaving the profession. Many go into nursing as a vocation, and they should be able to tend to their patients whilst also being able to be healthy and stable in their own lives. It’s not enough to just ‘clap for carers’. Nursing staff already work hard and have worked throughout a global pandemic. At the very least, they deserve to have pay rises, fewer night shifts, and skilled supervision to process the recent months so that they aren’t surviving with compassion fatigue. Confidential support is essential so that they can feedback working issues without fearing for their jobs.”
Surveyshows 36% nurses want to quit
Earlier last week, the Kings Fund has also raised similar issues. In an interview with The Guardian, Suzie Bailey, the King’s Fund’s director of leadership and organisational development said, “The current situation is not sustainable. An urgent review is needed to investigate alternative shift patterns and look at mitigating the impact of 12-hour shifts on staff wellbeing, care quality and safety.”
Some children’s nurses also spoke to the thinktank and authors of this report, reporting that they were asked to “suck it up” as opposed to demanding for better working conditions. A children’s nurse reportedly said at their work, “the culture is that you suck it up and don’t have a break, or you’re made to feel like you can’t hack it. There’s a sense that you will just do whatever is asked of you because the patient needs that support.”
Now, some Ministers and Parliamentarians have also taken this cause one step further raising similar concerns of the nurses. Besides work conditions there were on-going campaigns about Immigration Health Surcharge (IHS) with campaigners stating that migrant nurses should not be paying £400 besides additional visa charges. Boris Johnson had previously scrapped these fees but a poll of 158 NHS workers reported having to continue to pay for HIS in July. It is unclear how many such nurses are still suffering in silence.
Meg Hillier, Chairwoman of the Public Accounts Committee, said, “The picture from the front line of nursing in the NHS and care homes is not good.I fear, with the strain of a huge shortage of nurses and the worrying reports of low morale and huge numbers considering leaving in the next year, we are facing an emerging crisis in nursing.
“We fully recognise that the NHS is reeling under the strain of Covid-19, with staff unsure how they will cope with the second wave that it seems clear is already upon us.But it must not take its eye off the ball and allow a slide back into short-term, crisis mode.
“It must press on with coherent plans to get the nursing workforce back to capacity, under the kind of working conditions that can encourage hard-won, hard-working nurses to stay in our NHS and care homes.”
A Royal College of Nursing survey found 36 percent of respondents were considering leaving the profession in the next year, up from 28 percent before the pandemic. In the meantime, shadow health secretary Justin Madders said, “This is a devastating report that exposes the lack of long-term thinking and strategy at the heart of the government's approach to the NHS workforce.”
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Health experts have constantly flagged up the issues of racism, pay disparity, burnout and exhaustion that most nurses and midwives face especially those from overseas countries.
