The number of nursing vacancies in the Welsh NHS is now close to 3,000 – a rise of nearly 1,200 from the previous year, it has been revealed. Analysis from the Royal College of Nursing (RCN) in Wales also found that vast sums of money are being spent on agency nurses to plug gaps in rotas.
Helen Whyley, RCN Wales director, described the vacancy rate as "deeply troubling" and said it demonstrated that nurses were leaving the NHS in their droves due to unrelenting demand and low pay. The union has urged its members to vote in favour of strike action as part of a ballot that runs until October 13.
Meanwhile on Wednesday a petition to extend the Nurse Staffing Levels Act 2016 to cover mental health inpatient wards and community nursing was debated in the Senedd. While many opposition parties have backed the petition health minister Eluned Morgan said this legislative pledge won't deliver its intended aims.
Read more: Understaffed wards, nurses in tears, and using foodbanks: The NHS staff struggling to survive
Here are some of the headline figures from RCN Wales' annual report on the state of the nursing workforce in Wales entitled Nursing in Numbers 2022:
- NHS Wales has 2,900.41 registered nurse vacancies – an increase from 1,719 in 2021.
- NHS Wales spent £133.4m on nursing and midwifery agency staff in 2021-22. This was an increase of 41% compared to the previous year.
- Every week nurses give the NHS an additional 67,780 hours a week. This is the equivalent of 1,807 full-time nurses.
- In the last 10 years the percentage of nursing staff that feel enthusiastic about their job has dropped by 19%. Those that feel they are too busy to provide the level of care they would like has increased by 9%.
- In 2021 there were only 1,323 registered nursing staff employed in social care (based on 72% commissioned services and 100% local authority).
- In 2021 some 319 registered nursing staff left social care and only 204 joined. This is a deficit of 115. To add to this at the time of gathering data there were 129 'live' vacancies.
- The number of health visitors decreased from 853 in September 2021 to 782.9 in March 2022.
Ms Whyley said: "Healthcare in Wales is in crisis and unfortunately patients are paying the price. Nurses are exhausted and under pressure to deliver the high standard of care their patients deserve while being conscious that the number of people waiting for treatment is rising.
"There are 2,900 registered nurse vacancies in the NHS alone – a rise of nearly 1,200 from the previous year. This is deeply troubling and shows that nurses are being pushed to the exit and are leaving the NHS. The Welsh Government needs to act now to safeguard patients and support the nursing workforce.
"The Welsh Government must address nurse staffing levels to ensure environments where patients receive care are safe. We are calling on Eluned Morgan MS, minister for health and social services, to listen to nursing staff, safeguard patients, and make sure there is an NHS able to deliver care for future generations."
During the Senedd debate the Welsh Conservatives, Plaid Cymru, and the Liberal Democrats all backed the RCN Wales petition, which gathered 10,500 signatures, to extend section 25B of the Nurse Staffing Levels Act 2016. Currently it only applies to acute adult medical and surgical wards though this was later extended to children's wards.
Joel James MS of the Welsh Conservatives said: "It's clear to us that the situation nurses find themselves in is both unacceptable and, in the long-term, completely unsustainable for the profession. Nurses are being systematically overworked by health boards who are ultimately cutting corners by not employing enough nurses for patient care.
"Long-term this is detrimental to the mental and physical health of nurses which then creates a higher risk of patient care being compromised and has a huge knock-on effect to the family life of nurses as they work longer shifts. It creates a negative impression that nursing is a poor career choice."
Plaid Cymru health spokesman Rhun ap Iorwerth MS quoted from the RCN's own petition which states that when there are fewer nurses than there should be a patient is 26% more likely to die. He added that nurses were operating in an environment of underinvestment.
"No wonder one of the biggest challenges we have is the sustainability of the nursing workforce," he said. "There are far more nurses leaving the NHS than can be matched by newly-qualified nurses or internationally-recruited nurses. And regrettably there has been far too little action by the Welsh Government. It's up to the Welsh Government to take the lead on nursing retention through a national retention strategy. The Welsh Government would rather stick its head in the sand than admit to the scale of the problem."
In response Ms Morgan said she was unable to agree with the petition's assertion that extending the act to cover mental health inpatient wards and community nursing will actually achieve an improved number of nurses in posts. "The act requires that an evidence-based workforce planning tool is a necessary component for considering application of section 25B to any particular care situation. Such tools do not currently exist for other situations," she explained.
"For example when you look at mental health wards they involve more complex care as they have multi-disciplinary teams – so you can't take what happens on one ward and project it onto another ward. Even if those tools did exist for every nursing situation it's simply inaccurate to suggest that extending section 25B to all of those areas would result in giving Wales a full team of nurses as the petition puts it. That's simply because at the moment those nurses don't exist. The nursing staff shortage is an issue that's being experienced globally."
She added: "We are already doing a huge amount to recruit and train nurses. The number of commissioned training places has increased by 69% to 2,396 since 2016 so that would take us a long way towards [filling] the 3,000 [vacancies] that the RCN and others have identified. I have also asked Health Education and Improvement Wales (HEIW) to do more work on the retention of nursing staff specifically."
Ms Morgan said she was also looking for ways to bring down the cost of agency nurses to the Welsh NHS – a task she admitted was not straightforward. To get more stories like this straight to your inbox, subscribe to our Wales Matters newsletter here.
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