nursing shortages
DESCRIPTION
Nursing shortagesTRANSCRIPT
Nursing shortages aren’t what they used to be…….
Nursing shortages…
• ..what we know
• How UK has responded in the past
• Current UK situation
• International context
• What next?
Shortages: what we know• There is no universal definition of a nursing shortage; increasing evidence of
nurse supply/ demand imbalances in many countries. Imbalances can be organisational, specialty based, regional, national ……(cyclical-”boom and bust”)
• Supply of nurses in many countries, low income and high income, is failing
to keep pace with increasing demand [e.g. Sub-Saharan African countries = shortfall of + 600,000 nurses in relation to Millennium Development Goals targets]
• Gender-based discrimination continues in many countries = nursing undervalued as “women’s work”.
• There is a link between adequate nurse staffing levels and positive care outcomes.
.
UK and nursing shortages
• National policy control [£] of “supply”=• =How many “new” nurses to train• =What they are trained in……• =How many nurses to employ in NHS/ how
much to pay them• =How much £ to invest in their re-skilling• =How many non EU nurses to allow into UK• =when NHS nurses can retire…….
UK: history of nursing shortages
• 1932: Lancet Commission on Nursing• 1939: Inter-Departmental Committee on
Nursing Services• 1947: Ministry of Health Working Party on the
Recruitment and Training of Nurses• 1972: (Briggs) Committee • 1975 (Halsbury) Commission • 1983 onward: - Nurses pay review body • 2009: Prime Ministers Commission Nursing
UK: report on nursing shortages
• demand for care outstripping supply• nurse staffing difficulties in some regions/
specialties• increasing competition from other employers• “unjustified”/biased news coverage of conditions in
hospitals• need for increased use of support workers to “free
up” nurses• need for increased emphasis on staff retention,
attracting “married nurses” back to the health workforce
UK: report on nursing shortages
• demand for care outstripping supply• nurse staffing difficulties in some regions/ specialties• increasing competition from other employers• “unjustified”/biased news coverage of conditions in
hospitals• need for increased use of support workers to “free up”
nurses• need for increased emphasis on staff retention, attracting
“married nurses” back to the health workforce
• (MINISTRY OF HEALTH, 1947)
Previous UK “solutions” to shortages: Managing Supply
• Increase numbers in training• Improve retention (and return)• International recruitment • Skill mix change- more support staff
UK- “new “ nurses from UK based training
0
5000
10000
15000
20000
25000
UK Trends: Number of new nurses registering from European Economic Area (EEA), and “other”
countries 1993-2010
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
Other
EEA
NHS Scotland- total (wte) Nursing and Midwifery workforce 2001-2010 (ISD)
Staffing numbers, NHS England 1997 and 2009 (wte)
0
50000
100000
150000
200000
250000
300000
350000
400000
450000
1997 2009
Aux
HCA
EN
RN
Trends: % change in staffing numbers, NHS England 1996-2009
(wte)
0
50
100
150
200
250
300
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
year
%
RN
EN
HCA
Aux
Nurses per 1,000 population, OECD countries
Ireland 1Finland
SwitzerlandIceland
DenmarkNorway
LuxembourgSweden
United States 1Germany
NetherlandsAustralia
New ZealandJapan
United KingdomCanadaOECD
Czech RepublicFrance 1SloveniaAustria 2Estonia
Slovak Republic 1Hungary
Portugal 1PolandIsraelSpainKorea
Greece 1Mexico
Turkey 1
2008 (or nearest year) Change 2000-08 (or nearest year)
16.215.5
14.914.814.314.0
10.910.810.810.710.510.1
9.79.59.59.28.8
8.17.97.97.5
6.46.36.2
5.35.25.04.84.4
3.42.4
1.3
05101520
Per 1 000 population
Professional nursesAssociate professional nursesNurses (no breakdown available)
1.81.61.9
1.42.1
2.4n.a.
1.50.7
1.41.3
0.1n.a.
2.21.2
1.01.4
0.82.2
1.80.60.9
-2.11.9
4.8n.a.
-0.63.7
4.92.1
0.8n.a.
-4 0 4 8
Average annual growth rate (%)
OECD countries: Increase in nurse headcount 2000-2008
(compound annual rate)
1. Data include practising nurses and nurses working in the health sector as managers, educators, researchers, etc. 2. Data refer to all nurses licensed to practice.• Source: OECD Health Data 2010.
Hospital nurses wages: PPP comparison, 2008- $US (OECD data)
151619
2224
2935353739
42434343444447494952
6574
0 20 40 60 80
Slovak RepublicHungary
Czech RepublicTurkeyMexico
SloveniaFinland
ItalyPortugal (2005)
JapanGermany (2006)
IsraelDenmark (2005) 1
New ZealandIceland
Belgium (2005)Norway 1
United KingdomIreland
Australia (2007) 1United StatesLuxembourg
USD PPP, thousands
What next?
• 1970’s-2000’s- Focus was on supply of nurses
• Supply side now not the priority (a risk)
• Focus now is on Managing demand and on Skill mix change
Applicants for pre-reg nursing education at HEI, 2000-2009
Projections: % Change in NHS nurses2006/7 to 2015/16, England (wte)
-14
-12
-10
-8
-6
-4
-2
0
2
4
6
2006/7 2015/16
%
Buchan/Seccombe best case
Buchan/Seccombe worst case
WRT projection (est.)
• (sources: Buchan and Seccombe /RCN Policy Unit,2007; WRT 2008)
Skill mix change: UK does not have
the second level nurse option……Second level nurse?
UK NO…….so focus will be on the assistant practitioner
Ireland NO
Australia YES
USA YES
Canada YES
New Zealand YES (restarted)
What next?: Managing demand
• Emphasis on labour cost containment with no reduction in quality of care
• Different working patterns: e-rostering
• Adaptive/ flexible staff: re-skilling (CPD)
• Differentiated pay/reward?
What next? Skill mix change
• (Fewer?) graduate nurses, in “advanced” roles, managing cases and teams, diagnosing and prescribing
• Increased use of HCA and AP
• Increased emphasis on self care
• = will challenge what we mean by “nursing”
In conclusion…..
• In the past, nursing shortages have been “solved” by having “more nurses”
• Over the next 10 years the emphasis will shift to having “more effective nursing”
Our views have increased the mark of the 10,000
Thank you viewers Looking forward to franchise,
collaboration, partners.
This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India. We need lots of funds manpower etc. to make this vision a reality please contact us. Join us as a member for a noble cause.
