Category Archives: Nursing

Nurses more likely to leave NHS hospitals where costs of living have increased quickly

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The following is the press release from our colleagues at the Institute for Fiscal Studies for the report published 24 February 2021: ‘Cost of living and the impact on nursing labour outcomes in NHS acute trusts’. The report is authored by Carol Propper, Isabel Stockton and George Stoye.

Improving the retention of NHS staff has been a long-term policy challenge, and will be of even greater importance in the aftermath of the Covid-19 pandemic. NHS pay is currently tightly regulated in order to reduce variation in pay for the same roles in different parts of the country and to stop hospitals competing for staff on the basis of pay. However, this regulation has consequences: a new report by researchers at the Institute for Fiscal Studies, as part of the National Institute for Health Research Policy Research Unit on Health and Social Care Workforce, shows that national pay-setting limits the flexibility of hospital trusts to respond to local conditions, exacerbating shortages in hospital nursing labour before the start of the pandemic. These shortages exist despite increases in the overall number of nurses working in the NHS.

Using novel administrative payroll data covering the entirety of the NHS acute hospital sector between 2012 and 2018, researchers find that in parts of England where house prices – a proxy of cost of living – have increased rapidly, the relative earnings of nurses in these areas have decreased compared to nurses living and working in areas with slower growth in living costs. This has translated into increased movement of staff between hospitals, and more exits from the hospital sector entirely among frontline nurses. Continue reading →

Evaluating the Nursing Associate Role: Initial Findings

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Interim Report

Ian Kessler is Professor of International HRM at King’s Business School and Deputy Director of the Policy Research Unit in Health and Social Care Workforce (HSCWRU). Prof Kessler is lead author of the Interim Report and two case studies from the HSCWRU Nursing Associates study, published today. (1,624 words)

Film of webinar (23/11/20) where Prof Kessler discussed these findings.

We are conducting a survey of senior health and social managers on the use and management of the nursing associate role. The survey is open until 18 December 2020.

The introduction of the Nursing Associate (NA) role in England represents a decisive step towards changing the structure of the nursing workforce, with a view to improving the quality of health and social care. Originally proposed by the 2015 Willis report on nurse and care assistant education[1], as ‘a bridging role’ between the care assistant and the registered nurse, the NA has emerged in NHS England as a pay band 4 role, requiring a two-year level 5 qualification, registered with and regulated by the Nursing and Midwifery Council (NMC). The NA programme was launched in early 2017 in two waves 11 pilot and 14 ‘fast follower’ sites, respectively taking-on 1,000 Trainee Nursing Associates (TNA). There were subsequent waves, with 5,000 TNAs recruited in 2018 and 7,500 in 2019. It is a role which attracts interest given its capacity to address a variety of workforce and care management goals. However, as with the introduction of any new role, there are organisational challenges to be faced in ensuring that it becomes established at the workplace level and accepted by the various actors with a stake in it, including nurses, managers, healthcare assistants and service users. Continue reading →

Grow your own – an idea whose time has come (again)

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Richard Griffin MBE is Visiting Senior Research Fellow, King’s Business School. (869 words)

Back in 2010 I produced a paper for the Department of Health with the snappy title of Widening Participation Into Pre-registration Nursing Degree Programmes. Nursing was becoming an all degree profession and there was a concern at the time that this might narrow the pool of future recruits as vocational routes were closed. The document mapped pathways up to and into pre-registration degrees for existing support staff, including via the then current version of apprenticeships. It also set out the wider benefits of a “Grow Your Own” (GYO) approach to workforce development and recruitment. These included, not only securing future labour supply, but also helping ensure that the NHS workforce better reflected its local population, supporting diversity and reducing turnover.

Fast forward a decade and I’m having a conversation with an NHS Trust who had hoped to recruit from their existing support staff on to a degree apprenticeship. There is no shortage of candidates, but it appears the step up from support role to a pre-registration degree is too large for staff and the Trust is unable to recruit. The 2010 paper, which I repeated for Camilla Cavendish’s review three years later, made the point that GYO needs to be “end-to-end”, starting even before employment begins and delivering investment in the formal education of support staff at every level, creating clear pathways to mobilise what we called back then, the NHS “skills escalator”. GYO seeks to create progression steps creating horizontal and verticals career routes, avoiding the “gap” problem experienced by the Trust I was talking to. Continue reading →

Hourly ward rounds may not be the best way for nurses to deliver care: findings from a new nursing study

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Professor Ruth Harris works in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s College London. (458 words)

The widespread practice of intentional rounding (IR) in England may not the best way for nurses to deliver care and IR makes a minor contribution, if at all, to the way nursing staff engage with patients. This is the main finding of our study that was commissioned and funded by the National Institute for Health Research (NIHR).

Intentional rounding is a protocol of standard regular checks with individual patients at set intervals and was introduced in hospitals in England in 2013 as part of the government’s response to care failures in the NHS, most notably at Mid-Staffordshire NHS Trust. Continue reading →

National study starts of new nursing role

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How can the new Nursing Associates help resolve some of the workforce recruitment and retention problems in health and social care? A new King’s College London-led study is finding out the answers to this question and it will also be seeking the views and experiences of patients and people using care services of these new staff. The study, funded by the National Institute for Health Research (NIHR) at the NIHR Policy Research Unit in Health and Social Care Workforce, will be the first to gather information, statistics and experiences of the new Nursing Associates in practice and from people supporting them. Continue reading →