In a new briefing document the RCN in Wales called on the Welsh government to take action to address severe nursing shortages including ensuring sustainable funding for nurse education.
“This uncertainty means potential students in Wales are confused and disheartened”
The document, which has been presented to Welsh Assembly members, highlighted the need for more nurses across the country amid widespread vacancies, soaring spending on agency nurses and an “extreme shortage” of registered nurses in the independent sector.
“Wales needs more registered nurses to deliver care. This requires an increase in student numbers and measures to safeguard international recruitment and address retention,” said the document, which was developed with nursing staff across Wales.
The briefing, which also called for safe staffing legislation to be extended, comes ahead of the publication of a workforce strategy for health and social care being developed by Health Education and Improvement Wales and Social Care Wales and is due to be published in November this year.
RCN Wales said the workforce strategy should include a commitment to publish an annual workforce and education commissioning plan, which would clearly set out the number of places on nursing courses.
It also called for a “more transparent process” for commissioning nurse education with clear roles for universities, professional bodies and trade unions.
“Having a clear, transparent process for stakeholders to contribute evidence would increase confidence in the process and outcomes and increase the quality and robustness of the outcomes and their relationship to the need of Welsh health and social care,” said the document.
“Every week nurses in Wales give the NHS extra hours to the value of 976 full-time nurses”
Meanwhile, the document said the workforce strategy must be underpinned by “a sustainable funding system for healthcare professional education”, which would include financial support for students.
Unlike in England where the nursing bursary has been scrapped, nursing students in Wales still get their tuition fees paid and are eligible for a £1,000 grant and other financial support if they commit to working in the NHS in Wales for two years.
However, the briefing document suggested Wales was “not reaping the full benefits of the decision to retain the bursary” because it was only confirmed for a year or two at a time.
This month a further round of “engagement” around the bursary was announced.
“This uncertainty means that potential students in Wales are confused and disheartened,” said the briefing document.
“Moreover, the universities planning their finances cannot be certain of the future system. This is having a negative impact as departments fail to invest in nursing and consider making cuts to provision.”
Efforts to widen access to nurse training must also be a key feature of the workforce strategy, according to the briefing which highlighted the need for a national apprenticeship model that led to a nursing degree, greater use of distance learning and efforts to increase the scope of clinical placements with more available in the independent sector, primary care and social care.
The briefing also called for safe staffing law to be expanded – as promised by the Welsh government.
In 2016 Wales became the first country in Europe to introduce safe staffing legislation, meaning health boards and NHS trusts now have a legal duty to ensure there are enough nurses to provide “sensitive” patient care in all settings.
“We are investing record levels to expand the number of nurse training places in Wales”
Welsh Government spokeswoman
In addition, the law states that in adult acute medical and surgical inpatient wards, a specific nurse staffing level must be calculated and reasonable steps taken to maintain it. RCN Wales has said this requirement should be extended to apply to all settings, including mental health, community nursing and children’s wards.
The briefing stressed the need to focus on retention and ensure nurses could access continuing professional development (CPD), good rates of pay and flexible working.
In particular, improving access to CPD must be a priority for the workforce strategy, said the document, which warned that some employers had stopped all access to CPD for nurses because of difficulty backfilling shifts.
Helen Whyley, director of RCN Wales, said nurses in Wales were currently struggling to meet demand with most working unpaid overtime.
Source: RCN Wales
“Every week nurses in Wales give the NHS extra hours to the value of 976 full-time nurses. This is unacceptable,” she said.
“In addition, NHS Wales has spent £63.8m on agency nursing in 2018-19. This is the equivalent salary spend of 2,635 newly qualified nurses. The Welsh government must take action to reduce this spend,” she added.
She said it was essential nurses and healthcare support workers were “consistently supported through education, training, recruitment and CPD to be able to meet changing service needs and new models of care”.
“The Welsh government needs to consider our briefing and its recommendations to produce a positive direction for patient care,” she said.
Welsh Assembly members were given copies of the document at a briefing session held at the National Assembly earlier this month.
A Welsh Government spokeswoman said: “We are investing record levels to expand the number of nurse training places in Wales; we have retained the NHS bursary and we continue to support recruitment through our Train Work Live campaign. We will continue to work with NHS Wales to reduce agency nurse costs and use.”