Recommendations & Conclusions
5 items
2
Recommendation
Eighteenth Report - NHS nursing workfor…
Not Addressed
The Department could not show that its commitment to 50,000 more nurses by 2025 matches the actual need for nurses in the NHS. It is essential that the NHS understands not just how many nurses it needs, but where and in what specialism. The NHS Long Term Plan, published in …
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The Department could not show that its commitment to 50,000 more nurses by 2025 matches the actual need for nurses in the NHS. It is essential that the NHS understands not just how many nurses it needs, but where and in what specialism. The NHS Long Term Plan, published in January 2019, did not have a complete assessment of the type and number of nurses needed to deliver the plan, leaving that to the People Plan promised for later in 2019. In December 2019, while the People Plan was still in development, the government made a pledge to deliver 50,000 more nurses by 2025. However in March 2020 NHSE&I and HEE were still developing a model to understand and quantify the demand for nurses. Demand varies between specialisms and regions. For example, nursing vacancy rates are particularly high for mental health trusts and in London. NHSE&I says that local areas are revising their estimates of the number of nurses they need in light of COVID-19, which it will publish with the second part of the People Plan, after the next Spending Review. Recommendation: NHSE&I and HEE should update and publish the results of their modelling work on the demand for NHS nurses, including details for regions and specialisms and any impacts arising from the COVID-19 outbreak.
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Government response AI summary
The government's response does not address the recommendation to update and publish modelling work on NHS nurse demand, instead discussing funding decisions for the Towns Fund and Levelling Up Fund.
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HM Treasury
4
Recommendation
Eighteenth Report - NHS nursing workfor…
Not Addressed
The nursing needs of social care remain an unaddressed afterthought for the Department of Health & Social Care. Vacancies for nurses in social care have increased from a rate of 4.1% in 2012–13 to 9.9% in 2018–19, while the number of registered nursing posts in social care has fallen by …
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The nursing needs of social care remain an unaddressed afterthought for the Department of Health & Social Care. Vacancies for nurses in social care have increased from a rate of 4.1% in 2012–13 to 9.9% in 2018–19, while the number of registered nursing posts in social care has fallen by 10,400 (20%) since 2012–13. The NHS and social care providers both recruit from the same overall pool of nurses. While NHSE&I recognises the importance of social care and the value of better integration between the two sectors, social care will still not be included in the NHS People Plan. The Department considers that it would be too challenging to develop an integrated workforce plan for health and social care as its powers and influence over the two sectors are very different. The NHS expects local partnerships to develop plans across the two sectors, but such partnerships are not statutory, have no organisational accountabilities and rely on the goodwill of constituent bodies. The limited consideration of the needs of social care relative to health is sadly all too familiar from what we have seen previously, for example, when reporting on the adult social care workforce or readying the NHS and social care for COVID-19. Recommendation: The Department should set out its understanding of the nursing requirement across health and social care, and how it expects its actions will support nurse recruitment and retention in social care.
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Government response AI summary
The government response is incomplete and does not address the recommendation to set out its understanding of nursing requirements across health and social care and how it supports recruitment and retention in social care.
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HM Treasury
1
Conclusion
Eighteenth Report - NHS nursing workfor…
Not Addressed
On the basis of a Report by the Comptroller and Auditor General, we took evidence from the Department of Health & Social Care (the Department), NHS England and NHS Improvement (NHSE&I) and Health Education England (HEE) on the NHS nursing workforce.1
Government response AI summary
The government provided a factual overview of the NHS nursing workforce, the roles of various bodies, and the context of the committee's report, without addressing any specific points from this introductory conclusion.
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HM Treasury
9
Conclusion
Eighteenth Report - NHS nursing workfor…
Not Addressed
The Department acknowledged that the demand for nurses and the extent of nurse shortages vary between specialisms and regions.14 For example, in the period July– September 2019, NHS trusts in England reported an overall nursing vacancy rate of 12%, but these ranged as high as 16% for mental health trusts …
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The Department acknowledged that the demand for nurses and the extent of nurse shortages vary between specialisms and regions.14 For example, in the period July– September 2019, NHS trusts in England reported an overall nursing vacancy rate of 12%, but these ranged as high as 16% for mental health trusts and 15% in London.15 Macmillan Cancer Support noted that the number of specialist cancer nurses is not rising at the pace that patients need. Similarly, Unison reported that the number of nurses registered with specialist community and public health qualifications has fallen every year since 2016.16 Between 2010 and 2019, the overall number of NHS nurses in hospital and community services rose by 5%, but numbers in some specialisms reduced—for example, a 38% reduction for learning disability nurses.17 8 NHS, We are the NHS: People Plan 2020/21 – action for us all, July 2020 9 Qq 21–22 10 C&AG’s Report, para 11 - 12 11 Qq 20, 24 12 C&AG’s Report, para 4, 3.4a; Sue Ryder submission, para 10; NWF0002 - The King’s Fund submission, para 14 13 Q 23; C&AG’s Report, paras 11, 3.11 14 Q 71 15 C&AG’s Report, para 1.4 16 NWF0007 - MacMillan Cancer Support submission, para 2.2; NWF0003 - UNISON submission, para 15 17 C&AG’s Report, para 1.2 10 NHS nursing workforce
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Government response AI summary
The government stated its disagreement with the committee's (non-existent) recommendation, but then reiterated its commitment to delivering 50,000 more nurses overall through the NHS Long Term Plan and People Plan. The response did not specifically address the acknowledged variability of nurse shortages across different specialisms …
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HM Treasury
13
Conclusion
Eighteenth Report - NHS nursing workfor…
The Interim People Plan envisages a more pivotal role for integrated care systems, which are local partnerships of health and social care bodies that are jointly involved in local workforce planning and strategy. However, the NAO reported that partnerships are not statutory and therefore have no organisational accountabilities, and rely …
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The Interim People Plan envisages a more pivotal role for integrated care systems, which are local partnerships of health and social care bodies that are jointly involved in local workforce planning and strategy. However, the NAO reported that partnerships are not statutory and therefore have no organisational accountabilities, and rely on the goodwill of constituent bodies.26 The King’s Fund and Sue Ryder also noted that partnerships vary in their readiness and capacity to take on wider workforce planning.27 In 2018, the Care Quality Commission reported, on the basis of 20 local system reviews, 18 Qq 20, 21, 34, 36 19 Q 37 20 Skills for Care, The State of the adult social care sector and workforce in England, Chart 28, October 2019 21 NWF0006 - Royal College of Nursing submission, para 1.6 22 Qq 18, 65 23 Qq 15–17, 19, 24 C&AG’s Report, para 3.11 25 Qq 17, 29 26 C&AG’s Report, paras 1.12 27 NWF0004 - Sue Ryder submission, para 2; NWF0002 - The King’s Fund submission, para 12 NHS nursing workforce 11 that it had not been assured of effective joint workforce planning across health and social care.28 HEE told us that integrated care systems are “working much more seamlessly” between the NHS and social care but acknowledged that there is “much more work to do” to bring the two sectors together.29
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HM Treasury