COVID reveals a long-term shortage of nurses endangering NHS patients

“Protecting the NHS” is a recurring message that shaped the UK’s response to COVID-19.Danger of possible pandemic Overwhelm the NHS It has never disappeared in the distance.As we get closer 5 days of relaxation Regarding Christmas restrictions, the question of whether the NHS can deal with it is as appropriate as it was in March.

It became clear that the main limits of therapeutic capacity number Even the number of hospital beds, or even the number of intensive care units with ventilators, Properly skilled nurse Available to provide care. The pandemic exposed the Achilles tendon: lack of nursing.

This is not a new issue. About 10% of positions Registered nurse The NHS was vacant when the pandemic first occurred.Analysis from charity Health Foundation Over the last decade, NHS activity (number of patients seen and care provided) has increased year by year, but there has been no corresponding increase in the nursing workforce.

Between 2010 and 2017, the number of NHS nurses remained almost unchanged. From 2017 to June 2020 4.8% increaseHowever, the gap between the amount of work to be done and the number of nurses continues to widen.As a shortage of Registered nurse The NHS employs a large number of support staff, including: Nursing and healthcare assistant.. Last year, the number of support staff increased twice that of registered nurses.

Dangerous situation

Studies point to the risk of not having enough registered nurses on duty. A Research in 9 countries From 2014 nurseThe workload of one patient increased the patient’s chances of dying by 7%.And in our own research, my colleagues and I found that low levels of staff were likely to be reported by British nurses. The necessary care was left behind..

Further analysisLed by the University of Southampton, they have found that the amount of “left-behind care” contributes to the risk of unexpected death in inpatients.It also depends on the hospital Low level of registered nurse The higher the level of untrained support staff, the higher the mortality rate.

The risk of having a small number of nurses is Francis Inquiries 2013. The reduction in the number of nurses made in the last few years to achieve short-term savings did not take into account the risks to patients. The survey revealed a lack of policies or standards regarding the level of staffing of nurses and recommended that national guidelines be developed based on the study.After that, the National Institute for Health and Care Technology (Nice) was published. Guidelines for “safe staffing” In 2014.

The survey and Nice guidelines have succeeded in raising awareness of the need to have enough registered nurses. According to a survey in 2017 Three-quarters of the chief nurse Since the survey, he said there has been increasing support from the NHS Board for strengthening the nursing workforce.

Still, many NHS trusts were unable to hire primarily the required registered nurses, resulting in unsafe staffing.Policy succeeded Motivate the desire for safe staffing However, it did not generate the investment in the nursing workforce needed to provide it.

Fill the gap

In December 2019, the UK Government recognized the need to address this long-term shortage of nurses. He promised to increase the number of nurses enrolled in the NHS by 50,000 between 2024 and 25. But how feasible is this goal?

There is growing interest in nursing. 23% many students Accepted for nursing course In the UK in 2020, the number of applicants has increased sharply compared to 2019. After March 2020, COVID-19 may enhance your nursing profile.

But in the UK Domestic supply of nurses Per capita is well below the OECD average, not enough to meet demand. Therefore, the NHS relies on nurses from abroad to make up for the differences. One-third of the first nurses enrolled in the UK in 2019-20 were trained outside the UK. In total, 15% of UK registered nurses are trained elsewhere, more than double the OECD average.

To achieve government goals, the Health Foundation averages England 5,000 nurses a year From outside the UK between now and 2025. This is difficult as Brexit has terminated the free movement of workers to and from the EU and COVID-19 is causing travel turmoil for the foreseeable future.

The· Health Foundation It also states that an increase in domestic supply is essential. To do this, college competence needs to be addressed to correct the typical bottleneck of student clinical placement deficiencies. The Council of Health Deans on behalf of British universities teaching nurses Proposed Recruitment Simulation-based clinical experience – Reproduce real-life patient care with realistic virtual environments, mannequins, role-playing, and trained actors. Reduce total clinical time You need to qualify as a registered nurse (the time required in the EU is twice the time required to qualify in the United States and Australia). We should also consider expanding our faster two-year graduate admissions program.

Achieving net growth also requires reducing the number of nurses leaving the profession.About 33,000 (10%) nurses Exit the NHS Many citations each year “The pressure is too strong” As a cause.Probably modest Oversupply of nurses This is what we should aim for to reduce the cost of high turnover and reliance on temporary compensation.

Achieving the 50,000 goal is the beginning, not the end. Setting top-down goals represents a political attempt to activate a system that has failed for years to train and maintain the necessary nurses, with short-term revisions one after another. Depends on. COVID-19 reveals a national shortage of nursing skills that require a long-term vision, strong planning based on accurate data, and investment in solutions.

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