The Queen's Nursing Institute (QNI) became a member of the International Council Of Nurses (ICN) in 2021 and we are delighted to be in the room with so many nurses from around the world, to share and learn and to debate current global nursing issues. The issue of the global nursing shortage has already been raised several time in conversations with international nursing colleagues. The UK, like many other western countries, is recruiting heavily internationally without compensating these countries for the depletion of their trained nurses.
There is a similar position for the UK now with doctors being recruited by Australia before they have reached consultancy, depleting the UK of the planned number of doctors needed to meet the health needs of all citizens. Doctors move to other countries from the UK in part because the conditions are more attractive and they can still continue to practice and develop but in a less pressured environment. So we then recruit from other countries to fill the workforce gap. Just like nurses, a huge number of doctors are recruited internationally as the workforce in the UK emigrates to work in other countries.
It feels like we need to ask the question ‘What problem are we trying to solve?’ with this conundrum. The problem is that we do not retain those that we train, confounding our workforce planning. So we need to do two things: first, we need to solve the problem of retention in multiple ways – primarily by asking the workforce ‘What can be done to keep you here?’ – in so doing, we find out what is driving them to leave their friends and family to work in another country.
Secondly, we need to train more than we need, to account for the loss to other countries – which will always happen to a degree, but not to the levels we are seeing now of around 50% of cohorts, which places our health system at risk. In the 1980s, many nurses left the UK to work in other countries and at the time, the middle east was a favourite option.
The migration was often for only one or two years, because there were actually no jobs for newly qualified nurses in the UK at the point when they qualified; we had over-trained based on the numbers needed, but the positive side of this was that services were fully staffed.
Over training on planned workforce need allows for an enhanced level of attrition during the training and the movement of newly qualified nurses around the UK or internationally, without placing the health and social care services at risk. The workforce plan in England will not solve all the legacy problems that have led, in part, to placing the UK in such a depleted position now, but must go someway to recognising the need to focus on retention and a planned over-recruitment to nursing programmes.
I very much look forward to working with colleagues on the implementation of the workforce plan and supporting more care to be delivered in the community setting by appropriately trained and educated nurses. Nurses are incredibly good value and their training is a national investment into the health of citizens; it is an essential foundation of the skills, knowledge and competence to keep keep our citizens safe and well, maximising their health potential and thriving in society
My colleague Professor Alison Leary MBE, Chair of workforce modelling at South Bank University often quotes Red Adair: ‘If you think it is expensive to hire a professional to do the job, wait until you hire an amateur.’
Nurses are the lynchpin of their local communities and should be seen as a precious asset to be nurtured and valued.