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Radical solutions needed to tackle NHS nursing shortage

September 04, 2002

Current government initiatives to tackle the problems of recruiting and retaining nurses may not resolve the crisis fast enough, and more radical solutions may need to be considered, say researchers in this week's BMJ.

Problems in recruiting and retaining nurses are hampering the "modernisation" of the NHS. The underlying causes of these problems include pay, the changing nature of jobs, how valued the staff feel, and other employment opportunities, write Belinda Finlayson and colleagues from the King's Fund in London.

The crisis is most acute in inner cities and teaching trusts, particularly in London, where some turnover rates range from 11% to 38%. High turnover results in higher costs and lower morale and may affect patient care.

Although the government is tackling the crisis, problems persist, they say. Overall progress has been slow; staff are unaware of the new opportunities available to them; some tarare modest; and little effort has been made to evaluate the impact of these initiatives.

Furthermore, workforce issues are still nowhere near the top of the agenda for managers or trust boards, who have other managerial "must do's," such as reducing waiting lists and times, managing emergency admissions, and breaking even financially, they add.

If fully implemented on time, the national initiatives will help, but it is questionable whether they will turn the tide, say the authors. In the meantime, more radical suggestions for a complex redesign of the healthcare workforce are being proposed. The merits of these proposals should be openly debated and their evidence base evaluated, they conclude.

British Medical Journal (BMJ)