Nurses are present wherever there are people. We are members of a diverse workforce. We work across the UK, offering the highest standard of care to people of all ages and from all backgrounds, in so many different settings from our hospitals to our patients' homes. We are, however, short in number and we are underpaid and this cannot be sugar coated. No amount of platitudes will take away this nasty taste. In the UK today, our biggest problem in health and social care is the workforce (and lack thereof) not only in nursing but across the gamut of health and social care services.
I have been reflecting on this year's International Nurses Day theme: ‘Nurses: A voice to lead—invest in nursing and respect rights to secure global health.’ An investment in nursing is needed now, combining solid recruitment and retention strategies.
Among comparable Organisation for Economic Co-operation and Development (OECD) countries, the UK has relatively low numbers of hospital beds and nurses and doctors per 1000 population. The UK also undertakes relatively low numbers of advanced diagnostic examinations. The NHS is not in the best of health and neither are those who staff it—a result of years of neglect.
The enduring and malignant issue of workforce and pay that consecutive governments have been complicit in and have continually turned a blind eye to has to be addressed. The House of Commons Committee of Public Accounts (2022) noted that the NHS will be less able to deal with backlogs if it does not address long-standing workforce issues and ensure the existing workforce is well supported. It beggars belief that this committee is churning out the same message that the NHS needs to address its workforce problems—this has been the case year on year on year, yet we still find ourselves in the predicament we are in, with nurses bearing the brunt of this shortage.
It will take at least 3 years, if not longer, before there will be a material increase in NHS capacity. The NHS needs to be training more staff right now and to give serious consideration to how training capacity can be expanded. The empty rhetoric bandied about is just that, hollow promises, a little too little too late. Action is needed to safeguard the health and wellbeing of nurses who are performing under conditions that are totally unacceptable and detrimental to their health, the health of their families and the health of the nation.
In its response to the Committee of Public Accounts (House of Commons Committee of Public Accounts 2022: 15) NHS England/NHS Improvement noted that one of the biggest known risks affecting the demand for health care is the annual winter disruption to elective care. I beg to differ. The biggest known risk to our health service and the health and wellbeing of nurses is workforce shortages and this must be overtly acknowledged. The NHS workforce in England is in crisis and urgent action is needed.
Unless NHS England/NHS Improvement understands this and there is serious, meaningful attention paid to this ongoing issue, then any pie-in-the-sky reforms to health and social services will take aeons to occur and the harm caused to the workforce while waiting for this to happen will be devastating. Nurses, and other NHS staff, are its greatest asset. But nurses are exhausted, they are disillusioned and they are underpaid.
Since 2008 there has been a prolonged funding squeeze, many years of poor workforce planning, weak policy and fragmented responsibilities, which has meant that staff shortages have become endemic (The King's Fund, 2022). If there is any hope of longer-term resilience this must be reinforced by a workforce that is of the right size.
What you do matters, what you do makes a difference, what you do is difficult, it is physically and emotionally exhausting. For doing all of this you deserve to be paid a decent wage.