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Nurses: Training

Volume 789: debated on Wednesday 7 March 2018


Asked by

To ask Her Majesty’s Government what specific proposals they have to increase the number of fully trained nurses working in the National Health Service and the associated care services.

My Lords, there are record numbers of nurses working in the NHS in England, including 13,900 more acute, elderly and general nurses. To increase the future supply of registered nurses, the Government are funding over 5,000 more student nursing places for those entering training each year from September 2018. We are opening up new training opportunities to increase the number of professionally qualified nursing staff across the health and social care workforce through the apprenticeship route.

I thank the noble Lord for his reply, but I do not think the Government really grasp the seriousness of the shortage of nurses. In the last two years, 33% fewer students came forward. We have a shortage of 40,000 nurses and it will take years to put that right. Can I make a suggestion to him? The best and quickest way to increase the number of trained nurses is for the Government to drop their opposition to the bursary scheme for postgraduate students. These two-year courses are cheaper; it would cost the average funder £33,500 for the two-year course, which is half as much as the average trust would pay simply to employ an agency nurse for a year to fill the gaps. Why will the Government not follow that route?

My Lords, we take very seriously the need to train more nurses. There are 52,000 nurses in training and, as I have said, there is a commitment to increase the number of training places by 25%, which is obviously how we get to a long-term solution. On the issue that the noble Lord has raised about postgraduate bursaries, the policy intention is to bring these courses in line with other courses. I know that this is an issue of great concern. The Royal College of Nursing has expressed its concerns and we take those seriously. I also know that the regulations have been prayed against in the other place; they are also being looked at in the Secondary Legislation Scrutiny Committee and we await its report. I reassure him that the issue is being considered and we will respond once the committee has reported.

My Lords, as someone who is frequently involved in regulatory work involving nurses, I ask my noble friend what is being done to ensure a proper standard of clinical performance and a proficiency in languages on the part of nurses trained abroad and, most especially, on the part of those trained outside the European Union.

I thank my noble friend for highlighting that important issue. A very stringent language test is imposed by the Nursing and Midwifery Council—indeed, it is perhaps so stringent that it has excluded some nurses who are perfectly capable of practising in this country. A review of that is going on at the moment to make sure that a proper line is drawn—ensuring professional competence, including in technical language, while not excluding people who would be perfectly capable of practising well in this country.

My Lords, is the Minister aware that the vacancy rate for nurses in social care settings has doubled over the last four years? Given the other pressures on nursing homes, will the Government take specific action—perhaps grants for placements—to relieve this problem, which the NAO has described as dangerous?

The noble Baroness has highlighted an important issue, which is the number of nurses in social care. I recognise that to be a problem, as does the department. A specific social care workforce consultation will get under way and is linked to the overall draft workforce plan that Health Education England has published. This is something that we are looking at. We can solve it to some extent by increasing the overall number of nurses, but we need to find ways of attracting them into the social care profession.

My Lords, does the Minister agree that the lack of NHS nurses and other healthcare workers is due to the lack of a long-term sustainable workforce plan, as identified by the House of Lords committee report? If, following that report, the Government now have a long-term workforce plan for the NHS, when might it be published?

I congratulate the noble Lord on his committee’s work in this area and on making a proposal, which we have followed in putting forward a 10-year draft plan. I hope that he will have had the chance to see that—it will of course firm into a concrete plan. It is fair to say that it is honest about both the successes and the challenges that we face in needing to train more nurses. We are trying to find new ways of doing that, not just through the university route but through apprenticeships.

My Lords, yesterday evening I went home and turned on my local news to find that the Royal Sussex County Hospital was calling on people who might otherwise use its services to keep away. The hospital has some 900 vacancies. How can the noble Lord come to the Dispatch Box and tell us about the wonderful figures that suggest that all is well and good in the health service regarding nursing vacancies, when the reality on the ground is somewhat different? My local hospital is facing a crisis.

I do not pretend that all is well and good; I merely state what has happened. We know that there are challenges from increasing demand in the health service. We need more staff, which is why we are committed to training more staff. Unfortunately, I am not in a position to comment on the challenges of the noble Lord’s trust but I will be delighted to look at them with him. However, as we know, there is more demand and we have an ageing population. We need more staff and we are trying to train those staff.

My Lords, I declare an interest which is not in the register. One of my first jobs was as a VAD nurse, which some of your Lordships might remember—it was a long time ago. What do the Government think of bringing back VAD nurses, or, as they are called today, auxiliary or volunteer nurses, to help in the nursing crisis?

I thank my noble friend for that question. I think that we need to diversify the routes into nursing and this is probably how we do it. One way in which that is happening is through the creation of nursing associates, which is a level 5 apprenticeship programme. To be clear, these are not nursing positions—they are not registered nurses—but they provide an opportunity for those who have a desire to get into that career and want to learn on the job but who do not yet have the skills to start working towards a full-time registered nursing position.