Nursing shortages

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Nursing shortages

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  • 1.Nursing shortages arent what they used to be.

2. Nursing shortages ..what we know How UK has responded in the past Current UK situation International context What next? 3. Shortages: what we know There is no universal definition of a nursing shortage; increasing evidence of nurse supply/ demand imbalances in many countries. Imbalances can be organisational, specialty based, regional, national (cyclical-boom and bust) Supply of nurses in many countries, low income and high income, is failing to keep pace with increasing demand [e.g. Sub-Saharan African countries = shortfall of + 600,000 nurses in relation to Millennium Development Goals targets] Gender-based discrimination continues in many countries = nursing undervalued as womens work. There is a link between adequate nurse staffing levels and positive care outcomes. 4. UK and nursing shortages National policy control [] of supply= =How many new nurses to train =What they are trained in =How many nurses to employ in NHS/ how much to pay them =How much to invest in their re-skilling =How many non EU nurses to allow into UK =when NHS nurses can retire. 5. UK: history of nursing shortages 1932: Lancet Commission on Nursing 1939: Inter-Departmental Committee on Nursing Services 1947: Ministry of Health Working Party on the Recruitment and Training of Nurses 1972: (Briggs) Committee 1975 (Halsbury) Commission 1983 onward: - Nurses pay review body 2009: Prime Ministers Commission Nursing 6. UK: report on nursing shortages demand for care outstripping supply nurse staffing difficulties in some regions/ specialties increasing competition from other employers unjustified/biased news coverage of conditions in hospitals need for increased use of support workers to free up nurses need for increased emphasis on staff retention, attracting married nurses back to the health workforce 7. UK: report on nursing shortages demand for care outstripping supply nurse staffing difficulties in some regions/ specialties increasing competition from other employers unjustified/biased news coverage of conditions in hospitals need for increased use of support workers to free up nurses need for increased emphasis on staff retention, attracting married nurses back to the health workforce (MINISTRY OF HEALTH, 1947) 8. Previous UK solutions to shortages: Managing Supply Increase numbers in training Improve retention (and return) International recruitment Skill mix change- more support staff 9. UK- new nurses from UK based training 0 5000 10000 15000 20000 25000 1990-1 1991-2 1992-3 1993-4 1994-5 1995-6 1996-7 1997-8 1998-91999-2000 2000-1 2001-2 2002-3 2003-4 2004-5 2005-6 2006-7 2007-8 2008-9 2009-10 10. UK Trends: Number of new nurses registering from European Economic Area (EEA), and other countries 1993-2010 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 1993/4 1994/5 1995/6 1996/7 1997/8 1998/91999/002000/01 2001/2 2002/3 2003/4 2004/5 2005/6 2006/7 2007/8 2008/92009/10 Other EEA 11. NHS Scotland- total (wte) Nursing and Midwifery workforce 2001-2010 (ISD) 12. Staffing numbers, NHS England 1997 and 2009 (wte) 0 50000 100000 150000 200000 250000 300000 350000 400000 450000 1997 2009 Aux HCA EN RN 13. Trends: % change in staffing numbers, NHS England 1996-2009 (wte) 0 50 100 150 200 250 300 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 year % RN EN HCA Aux 14. Nurses per 1,000 population, OECD countries Ireland 1 Finland Switzerland Iceland Denmark Norway Luxembourg Sweden United States 1 Germany Netherlands Australia New Zealand Japan United Kingdom Canada OECD Czech Republic France 1 Slovenia Austria 2 Estonia Slovak Republic 1 Hungary Portugal 1 Poland Israel Spain Korea Greece 1 Mexico Turkey 1 2008 (or nearest year) Change 2000-08 (or 16.2 15.5 14.9 14.8 14.3 14.0 10.9 10.8 10.8 10.7 10.5 10.1 9.7 9.5 9.5 9.2 8.8 8.1 7.9 7.9 7.5 6.4 6.3 6.2 5.3 5.2 5.0 4.8 4.4 3.4 2.4 1.3 05101520 Per 1 000 population Professional nurses Associate professional nurses Nurses (no breakdown available) 1.8 1.6 1.9 1.4 2. 2 n.a. 1.5 0.7 1.4 1.3 0.1 n.a. 2 1.2 1.0 1.4 0.8 2 1.8 0.6 0.9 -2.1 1.9 n.a. -0.6 2 0.8 n.a. -4 0 Average annual gro 15. OECD countries: Increase in nurse headcount 2000-2008 (compound annual rate) 1. Data include practising nurses and nurses working in the health sector as managers, educators, researchers, etc. 2. Data refer to all nurses licensed to practice. Source: OECD Health Data 2010. 16. Hospital nurses wages: PPP comparison, 2008- $US (OECD data) 15 16 19 22 24 29 35 35 37 39 42 43 43 43 44 44 47 49 49 52 65 74 0 20 40 60 80 Slovak Republic Hungary Czech Republic Turkey Mexico Slovenia Finland Italy Portugal (2005) Japan Germany (2006) Israel Denmark (2005) 1 New Zealand Iceland Belgium (2005) Norway 1 United Kingdom Ireland Australia (2007) 1 United States Luxembourg USD PPP, thousands 17. What next? 1970s-2000s- Focus was on supply of nurses Supply side now not the priority (a risk) Focus now is on Managing demand and on Skill mix change 18. Applicants for pre-reg nursing education at HEI, 2000-2009 19. Projections: % Change in NHS nurses 2006/7 to 2015/16, England (wte) -14 -12 -10 -8 -6 -4 -2 0 2 4 6 2006/7 2015/16 % Buchan/Seccombe best case Buchan/Seccombe worst case WRT projection (est.) (sources: Buchan and Seccombe /RCN Policy Unit,2007; WRT 2008) 20. Skill mix change: UK does not have the second level nurse option Second level nurse? UK NO.so focus will be on the assistant practitioner Ireland NO Australia YES USA YES Canada YES New Zealand YES (restarted) 21. What next?: Managing demand Emphasis on labour cost containment with no reduction in quality of care Different working patterns: e-rostering Adaptive/ flexible staff: re-skilling (CPD) Differentiated pay/reward? 22. What next? Skill mix change (Fewer?) graduate nurses, in advanced roles, managing cases and teams, diagnosing and prescribing Increased use of HCA and AP Increased emphasis on self care = will challenge what we mean by nursing 23. In conclusion.. In the past, nursing shortages have been solved by having more nurses Over the next 10 years the emphasis will shift to having more effective nursing 24. Our views have increased the mark of the 10,000 Thank you viewers Looking forward to franchise, collaboration, partners. 25. This platform has been started by Parveen Kumar Chadha with the vision that nobody should suffer the way he has suffered because of lack and improper healthcare facilities in India. We need lots of funds manpower etc. to make this vision a reality please contact us. Join us as a member for a noble cause. 26. Contact us:- 011-25464531, 9818569476 E-mail:- nursingnursing@yahoo.in