Nursing: Staffing

Baroness Merron Excerpts

Thursday 16th June 2022 Lords Chamber

[Baroness Merron (Lab)]

My Lords, I start by thanking our nursing workforce and, indeed, the whole health and social care team. I congratulate the noble Baroness, Lady Tyler, on securing this important and very timely debate, and thank her for the way in which she set out the issues. It is important that we are considering them today, given this report. I also thank the Royal College of Nursing for this comprehensive report, which I believe shines a real light on the realities that are being experienced by the nursing team and patients. It produces a very loud red flag for the future, which I am sure the Minister will address. The Nursing and Midwifery Council also helpfully shared its annual registration data, cited in the report. I shall refer to that later.

The key message coming through from this debate, as has come through so many times, is the question of whether the Government have it right on workforce. I am sorry to say that, on this occasion as on previous occasions, the answer is no. This is about having the workforce to do the job. It has been debated numerous times in your Lordships’ House and in the other place. Your Lordships’ House made its view known very clearly that any organisation worth its salt—that certainly includes our National Health Service—would undoubtedly have in place a workforce plan for now and for planning ahead, looking at retention, recruitment and training, and all the many complexities involved. Yet within the Health and Care Act we did not have that commitment.

I will refer to the survey findings, which come in the context of record waiting lists and 50,000 registered nurse vacancies. The report refers to the fact that the UK’s exit from the EU and the Covid-19 pandemic have both highlighted and worsened long-term problems with workforce supply in health and social care. However, the report also says that this is nothing new. For many years, nursing staff have been shouting about the impact of growing staff shortages and the rising demand on their ability to deliver care that is safe and effective. The report argues that the impact of these pressures is now “beyond concerning”, with patient safety, care outcomes, staff retention and staff well-being affected.

On this point, I was glad to hear from the right reverend Prelate, who spoke of her experiences of talking to nurses and rightly reminded us of the positive side: nurses’ passion for improvement and service, and their commitment to delivering for patients. The right reverend Prelate also rightly spoke about the pressure on nurses. I wonder whether the kind of commitment shown to us by nursing teams means that their situation is constantly overlooked. I believe that there is a great tendency for them to be taken for granted because, as the right reverend Prelate said, they will always deliver.

From the report, we know that

“staffing levels are compromising care”

and

“that there are not enough registered nurses on shift”.

There is also a greater intensity of nursing care required by patients. This highlights that we have a worsening situation, not one that is static. This once again makes the case for proper workforce planning that can move with the times. I anticipate that the Minister will refer to the pandemic as being one of the greatest pressures. While that it is true, the report also said:

“Going into the … pandemic … 73% of nursing staff surveyed … said that staffing levels on their last shift were not sufficient to meet all the needs of the patients safely and effectively. In 2022, this has risen to 83%.”


This is not a new problem; it has been exacerbated but it would not be right to refer solely to the impact of the pandemic.

We have heard a number of the key findings, but the one that really strikes me is this:

“Only 25% of shifts had the full number of planned registered nurses on shift.”


Linked to that, 81% of those surveyed

“felt that patient care being compromised was due to not having enough registered nurses on the shift”,

and yet one in five said

“they felt unable to raise their concerns.”

This is a very dangerous cocktail to which I hope the Minister will have a response.

The report makes a number of recommendations, and we have had a number of proposals in the debate today. I am interested to hear the Minister’s response to the recommendations of the report and the points raised within this debate.

As we know, the Government have announced an increase in the number of nurses, and that can be tracked back to a 2019 manifesto pledge. In addition to providing us with an update on this situation, it is worth reiterating the point made by the noble Baroness, Lady Tyler, on the comments of the Chief Nursing Officer for England, Ruth May, who said that while she welcomed the pledge, it fell short of what was actually needed. This will be the case because recruitment on its own is not the point; it is also about the vacancy numbers, the shortfall and the numbers of nurses that are leaving.

On that point, I refer to the information from the Nursing and Midwifery Council. When asked why people had left, they said the main reasons were too much pressure, poor workplace culture, struggles with increased workloads and a lack of staff. Could the Minister give us more information on when he will be able to share the 15-year plan for the workforce? When will it materialise, and how will it take all of these matters into account?

The report calls for a “credible, costed long-term” health and care workforce strategy. A nursing team is at the heart of this. I hope that the Minister will hear the points made in today’s debate, but also the previous calls for a proper workforce plan, which will be the only way we can meet the demands upon us.