The NHS : Responding To The Nursing Recruitment Crisis

The nursing recruitment crisis facing the NHS has been brought into sharp focus this week.

For the first time, the number of people joining the Nursing and Midwifery Council[1] (NMC) is lower than the people leaving it. Between 2016 and 2017, 45% more UK based nurses and midwives left the register than joined it. The NMC also revealed a notable rise in people under the age of 40 leaving the health service.

Approximately 40,000 nursing posts are currently vacant in England and 96% of UK hospitals are experiencing a shortage of nursing staff. In one week during June this year over 6,900 nursing vacancies were advertised on NHS Jobs – some remained unfilled eight months after they were originally posted.

What is causing the exodus of nursing staff?

The NMC cited the following reasons given for the increase in departures, excluding retirement:-

  • Working conditions, which are exacerbated by staffing levels.
  • Personal circumstances.
  • Disillusionment with patient care.

To compound the issue facing NHS hiring teams, the number of nurses from the EU registering to work in the UK has fallen by 96% since the referendum result in June last year.

The number of new applicants from the EU fell from 1,304 in July 2016 to 46 in April 2017.

Brexit discussions, the public sector pay cap and the withdrawal of bursaries which takes effect from 1st August will all shape the ability of NHS Trusts to attract, source and retain nursing staff. While these issues are outside the control of HR, there are specific strategies which can be implemented to address them, with the emphasis on a long-term approach to talent management:-

Review language tests 

A recent article[2] suggested that international nurses are being deterred from registering for work in the UK due to the challenges of the International English Language Testing System. These assessments were introduced in 2016 to ensure a high standard of English among new nursing recruits. Medical recruiters have, however, suggested that the stringent tests have resulted in even native English speakers failing to pass NHS requirements. This issue is currently under investigation. In the meantime, supporting recruitment with HR software will identify any problematic areas with online assessments, including language tests, within your own Trust.

Implement innovative recruitment strategies

Last week saw the launch of the ‘Best of Both Worlds’ recruitment campaign [3], a joint initiative by four NHS healthcare providers in Northamptonshire in a bid to attract more doctors and nurses to the region. The campaign is pooling the recruitment resources of the University of Northampton, University of Northampton, Northamptonshire Healthcare NHS Foundation Trust, Northampton General Hospital, Kettering General Hospital NHS Foundation Trust and St Andrew’s Healthcare to tap into a broader talent pool and allocate new recruits appropriately depending on the skills required.

Other initiatives in place to address nursing recruitment across the NHS include:-

  • The introduction of a fast track nurse training programme.
  • Allowing nurses to work across regions.
  • A planned recruitment programme to encourage 2,000 former nurses back into the NHS.

Our previous article also noted the award winning HR led decision taken by University College London Hospitals (UCLH) NHS Foundation Trust. The Trust became the first NHS employer to sign up to the National Living Wage in London to improve staff retention.

Offer flexible working

This year’s Flexible Jobs Index found that only 10% of open jobs with a salary ranging between £20,000 to £34,000 offer flexible working and 20% of employees are reluctant to ask for flexible hours. The NHS is reportedly slow to offer flexible work options which could increase retention among nursing staff, especially those under 40. It also faces competition from recruitment agencies which offer better work life balance opportunities to qualified nurses.

Work on culture

Working conditions were cited as a major reason for leaving according to the NMC, which are affected by leadership and workplace culture, two issues which the NHS acknowledges it must deal with. The Kings Fund proposed a culture of compassionate and inclusive leadership to replace that of ‘blame and fear’.  Workforce bullying was also noted by the CIPD[4] earlier this year as an ongoing and persistent problem, resulting in higher levels of sickness absence from work and inevitably contributing to the exodus of nurses. Dealing with this issue and tackling accusations of bias in recruitment must continue to be a priority for hiring teams.

Adopt a long-term workforce planning strategy driven by people analytics

Deloitte notes a similar experience in the US healthcare system which is currently experiencing problems with employee retention among newly hired nurses. It suggests investment in workforce planning coupled with the introduction of formal retention strategies[5] and sees people analytics as critical to achieving this.

The adoption of a similar approach would enable the NHS to make the transition from ‘qualitative to quantitative based’ predictive hiring.

The following three specific strategies are recommended:-

  • Start from where you are. Understanding your hiring patterns and issues with areas of sourcing and retention enables HR to plan for the future. Advorto’s recruitment software offers NHS specific recruitment solutions enabling your Trust to take this first step towards data driven workforce planning.
  • Align your talent acquisition strategy with Trust leadership priorities for buy in from relevant stakeholders.
  • Invest in talent acquisition to hire people with the right skills and expertise. The introduction of anonymised CVs screened through your applicant tracking system to reduce unconscious bias should be a given with the high levels of unfilled nursing roles noted earlier in this article.

The hiring patterns revealed in your recruitment data enable HR to facilitate effective workforce planning and more rapid hiring to address the nursing recruitment crisis. The emphasis must also be on collaborative hiring, as demonstrated by the initiative taken in Northamptonshire and supported by recruitment software.

It is not, however, an instant fix but requires a carefully managed period of transition and a long term approach, supported by HR technology designed to respond rapidly to the unique needs of NHS recruitment.

Advorto works with NHS trusts to identify and resolve critical hiring issues, including:-

  • Sifting imported applications with full auditing to confirm relevant checks have been carried out, ready for inspection by the CQC.
  • Provision of flexible and cost-effective configuration to meet the requirements of frequent regulatory changes.
  • Importing candidates applying via NHS Jobs into a compatible system. Provide an interface with the electronic staff register.
  • Facilitate rapid approval and posting of vacancies.

Contact us today to discuss how we can help your Trust to hire better people faster.

Further reading:-

The NHS : Finding A Way Through The Staffing Crisis

Health Recruitment : A UK Sector Focus

For more insight into people analytics you might like to read:-

People Analytics : Is It Really The Future Of HR?


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