The UK Government has responded to a damning report into its “inadequate” approach to NHS workforce planning including claims that its 50,000-nurse target is not enough.
The report was published last July by the parliamentary Health and Social Care Committee (HSCC), and it included dozens of recommendations relating to staffing in the NHS, including for nurses.
Now, health minister Will Quince has responded on behalf of the government – rejecting many of these recommendations.
Mr Quince pointed, throughout his responses, to the government’s upcoming long-term workforce plan and existing commitments to increasing the number of nurses employed by the NHS.
The HSCC’s report made 73 recommendations surrounding recruitment, training and retention in both health and adult social care.
Among the recommendations for nursing was one urging the UK Government to bring back the health education bursary for nurses.
The HSCC said the government’s target of increasing the number of nurses working in the NHS in England by 50,000 between 2019 and 2024 was “not having any meaningful impact on the true scale of nursing shortages”.
It called for a return of free nurse education via a bursary scheme, and stated that newly registered nurses and midwives should be guaranteed at least three years’ work in the trust where they trained to prevent them going to work for agencies.
Mr Quince said the government rejects this recommendation, claiming the 50,000-nurse programme had, in fact, led to a record growth in the nursing workforce.
Regarding the HSCC’s bursary recommendation, Mr Quince said the addition of a minimum £5,000 living costs grant in September 2020 – after the tuition fee bursary was scrapped in 2017 – was enough to plug any financial gap for nurses in training.
Recommendation 24 urged the government and NHS to review job descriptions for nursing and midwifery jobs under the Agenda for Change (AfC) pay scheme.
There are concerns outdated descriptions mean nurses and midwives are not getting paid for the realities of their jobs.
Speaking at the union Unison’s health conference last week, one nurse said: “What we need to do is look at job descriptions for nursing, they were written 20 years ago when we did AfC.
“The profiles against which our jobs are measured, they are way, way out of date.
“They tell you nothing about the complexity and skills and experience needed.”
Mr Quince accepted the recommendation to review job descriptions, though said “work is already underway”.
The NHS Staff Council has been reviewing the profiles for all nursing and midwifery roles since summer 2021, Mr Quince said. The work is expected to take 18-24 months, “subject to capacity”.
It comes as the Royal College of Nursing is seeking to address the issue by securing the introduction a separate pay spine exclusively for nurses – a proposal opposed by other unions.
The third nursing-related recommendation asked the Nursing and Midwifery Council (NMC) to, like the General Medical Council did for doctors, impose a target on itself to “eliminate” disproportionate complaints from employers about Black and minority ethnic nurses and midwives by 2026.
HSCC further recommended a target of 2031 to eradicate disadvantage and discrimination in nursing and midwifery education.
Mr Quince responded: “The government accepts this recommendation in principle.”
He said the NMC was “committed to tackling discrimination and inequality and to promoting diversity and inclusion” and that it had already produced a plan with steps to address issues in this area.
Specifically, Mr Quince added: “Analysis has highlighted discrimination in fitness to practise referrals from employers and the NMC has taken steps to address this, including issuing guidance to employers on how to conduct fair investigations and when to refer issues to the regulator, however they recognise there is much more to do.”
He referred to research from the NMC, published last year, which found that some employers refer a disproportionately high number of Black professionals for a fitness to practise review.
Mr Quince said the NMC would consider the HSCC’s recommendations to introduce specific targets as part of its existing commitments.
Other recommendations included paying all Agenda for Change staff a proper wage, developing a strategy for attracting and retaining female surgeons, and giving social care staff free access to more NHS training.
As well as the specific recommendations, HSCC also rated, in a format akin to Care Quality Commission (CQC) reports, the government’s current progress towards its workforce targets.
An expert panel rated the overall progress on its commitments that relate to ensuring the NHS has enough staff it needs, as “inadequate”.
Specifically, the government was rated worst overall for the categories of “commitment met” and “funding and resources”; it was rated as requiring improvement for “impact” and “appropriateness”.
Responding, the government wrote: “The government shares the view of the panel on the importance of ensuring that the NHS and social care system has the staff it needs, with the skills it requires to deliver safe and quality patient care.”
It again referred to the cost-of-living grant that was introduced in 2020 for student nurses and its progress towards the 50,000-nurse target.
“Through the 50,000-nurse manifesto commitment, we are addressing nurse vacancies through action on retention of the existing workforce, boosting domestic training and education routes into nursing and using international recruitment opportunities to supply the NHS with a nursing workforce that is sustainable in the long term,” it said.
It also pointed to its long-awaited NHS Long Term Workforce Plan which is due to be published soon.
This government response comes as nurses in England’s NHS are waiting to find out if a new pay offer from the UK Government will be accepted by the unions, following ballots with their members.