The Hackitt Review- Two years on
Recent headlines about the strain being felt by the NHS, particularly by NHS nurses, have made gloomy reading. The Royal College of Nursing (RCN) has this month released the findings of their survey on the pressures faced by nursing staff. 59% of respondents said that they could not provide the level of care they would like to provide because of time pressures.
This followed a survey of 10,500 UNISON members working in the NHS, the results of which made equally bleak reading. Nurses claimed that they were “at the centre of a perfect storm” given the increases in workload and patient numbers. 82% of respondents reported increases in their workload and 36% felt that this had resulted in a negative impact on patient care.
The problems caused by nursing shortages have also been highlighted by recent inspection reports published by the Care Quality Commission (CQC). This included a report placing Cambridge University Hospitals NHS Foundation Trust in special measures after inspectors rated services at Addenbrooke’s Hospital and the Rosie Hospital as “inadequate”. Inspectors were concerned about a lack of staff and that staff were frequently moved to other wards to cover the shortfall in nursing teams.
However, an announcement yesterday that the Home Secretary will relax immigration controls on nurses working in the UK could provide a glimmer of hope at the end of the tunnel.
Earlier this year government advisors recommended that nurses should not be added to the “shortage occupation list”. This is a list of occupations that are deemed to be in short supply, so that employers can recruit to fill vacancies in these areas from outside of the European Economic Area (EEA) without having to jump through certain immigration hoops.
There was also growing concern about immigration rules which meant that non-EEA nurses earning less than £35,000 a year, and who had been in the UK for six years, would have had to leave the country from April next year. The RCN estimated that the changes would have resulted in up to 3,365 nurses, who had cost the NHS £20.19m to recruit, being forced to leave the country.
NHS employers and chiefs from ten NHS Trusts wrote to the Home Secretary about their concerns that the immigration rules were preventing them from recruiting the nurses they need this winter. They said that nurses from outside of the EEA were having their visa applications rejected and that this was compromising patient safety.
NHS England Chief Executive Simon Stevens spoke out about both of these issues last week. He said “…most hospitals tell me that the idea that we would seriously consider deporting some of our most experienced and committed nurses solely because they’re not earning £35,000 clearly needs a rethink,” and “most nurses I speak to struggle to understand why our immigration rules define ballet dancers as a shortage occupation - but not nursing”.
The Home Secretary has intervened in response to the concerns raised, and yesterday, wrote to Professor Sir David Metcalf CBE, Chairman of the Migration Advisory Committee (MAC) to review whether there is a shortage of nurses or specialist nursing roles which would be sensible to fill through non-EEA migration. The Home Secretary took a further notable step of agreeing to place nurses on the shortage occupation list on a temporary basis pending the MAC’s report and analysis by 15 February 2016. This welcome news means that non-EEA nurses will in the interim no longer be at risk of having their visas rejected, and for the approaching winter period, at least potential risks and concerns in relation to nurse staffing levels within the NHS will be alleviated.
EU and non-EU nurses alike should be able to breathe a sigh of relief. Nurses are of course bound by the NMC’s Code, which requires them to make the care and safety of patients their main concern. If the NHS was not able to recruit and retain a sufficient number of nurses to ensure that proper care could be delivered to patients, there was a risk that nurses would feel compelled to leave so as not to be in breach of their professional code. Let’s hope that we’ve avoided this catastrophe and that we’re able to retain the brilliant and committed nurses who are the bedrock of our national health service.
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