Third of nurses plan to quit NHS in ‘emerging crisis’

Long shifts and poor treatment during the pandemic are taking their toll on nursing staff
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A third of nurses are considering leaving the NHS in the next year, according to research highlighted by the House of Commons Public Accounts Committee (PAC).

The committee’s report quotes a survey from the Royal College of Nursing (RCN) suggesting that 36% of respondents were considering leaving in the next year, with two-thirds attributing this to low pay and almost half claiming it was due to their treatment during the pandemic.

The exodus has sparked fears of an “emerging crisis” in nursing, the PAC said.

The PAC concluded that it was unlikely the government would meet its targets of recruiting 50,000 more nurses by 2025. NHS trusts already face significant shortages of nurses, with more than 40,000 vacancies open in the NHS in England alone.

Meg Hillier, chairwoman of the PAC, said: “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.”

When asked how many nurses were expected to come through the three supply routes identified by the Department of Health and Social Care (DHSC) – registered nurses, overseas recruitment and better retention – the PAC said the department could not say.

Danny Mortimer, deputy chief executive of the NHS Confederation, said it was concerned by the findings of the report. “It makes abundantly clear that the NHS and social care both still need many more nurses going forward, although we welcome the Department of Health and Social Care’s recent commitment to rectifying this,” he said.

“This includes the commitment made in August of £172 million to support employers with nurse degree apprenticeships, as well as funding for 420 nursing associates and assistant practitioners to ‘top up’ to become nurses. We also welcomed [chief nursing officer] Ruth May’s letter to regional chief nurses and nursing directors, which set out a commitment of £28 million for international recruitment of nurses.

“We know, of course, that employers are also working hard to address this issue through retention and recruitment, but they will want greater clarity from national NHS leaders, who need to better quantify how many nurses they expect to join the profession from each of the routes available.”

The PAC’s conclusions have emerged as a similar report by the King’s Fund think tank found that an increasing number of nurses have quit their roles within three years of joining. One tenth left within their first year in role, it found.

A host of factors including stress, long shifts and lack of access to food and drink at work – as well as the ever more complex demands of caring for patients – is forcing NHS nurses and midwives to leave at “alarmingly high levels”, according to its review of working conditions.

The impact of the coronavirus pandemic has “laid bare and exacerbated long-standing problems” faced by nurses and midwives, the King’s Fund said, and would be felt for a long time to come.

There is also a “large and growing gap between capacity and demand” in district nursing services, according to the think tank. Between 2010 and 2019, there has been a 35% reduction in health visitors, and a 38% reduction in nurses who support learning disabilities. Staff in district nursing roles say they are “broken”, “exhausted” and “on their needs”, according to its research.

The King’s Fund’s report, commissioned by the RCN foundation, called for new minimum standards to improve working conditions and a review of 12-hour shifts.

A list of eight key recommendations also include providing nursing staff with more authority, empowerment and influence, improving justice and fairness, better support for multi-disciplinary team working, more compassionate leadership and better learning frameworks for career development.

Responding to the PAC’s findings, the DHSC said: “We are incredibly grateful for the dedication nurses have shown throughout the pandemic. We are working to attract and retain more brilliant nursing staff by offering practical support for wellbeing, as well as a new maintenance package of £5,000 for all eligible new and continuing students.

“We are on our way to delivering 50,000 more nurses by the end of this parliament, with already over 13,800 more working in the NHS and a 22% rise in nursing university acceptances this year.”

Hillier added: “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 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.”

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