The regions lagging in drive to recruit 50k nurses revealed

The Department of Health and Social Care issued a progress report today on its programme to increase nurse numbers by 50,000 by 2024, pledged in the Conservatives’ 2019 general election manifesto.

It states that the programme is on track, with a net increase of 27,000 between September 2019 and December 2021 – although this appears to have been achieved in large part by smaller numbers of nurses leaving the NHS during the pandemic; while both overseas and domestic recruitment have been strained.

The document says risks remain to the programme delivering by 2024, with “plausible planning scenarios where it could fall short”. Some important factors remain unpredictable, such as whether many more nurses will now leave the NHS as pandemic pressures are eased, it explains.

Regional analysis included in the report shows variation in growth in whole-time equivalent nurses across the seven NHS regions, with growth highest in the South East and East of England, and lowest in the North East and Yorkshire and London — with nearly five percentage points difference between them.

The progress document issued today also reveals a backup plan for pushing international recruitment even faster, if other sources struggle. 

It says: “While the programme is currently on target to achieve 50,000 additional nurses, there are plausible planning scenarios where it could fall short.”

It goes on to explain that shortfalls between now and 2024 would not be easily made up, because it typically takes undergraduates three years to qualify.

It adds: “As such, if the programme needed to respond rapidly to changing circumstances that risk falling short of the target, training new domestic nurses is not a viable route to do so.

“Instead, the programme would need to consider: further action to improve retention (noting that it is an area of significant uncertainty itself); international recruitment (it takes three to nine months to bring in an international nurse, on average); return to practice (though numbers are limited); [and] reducing attrition from student courses.”

The report continued: “Of these, the route that offers the greatest certainty and flexibility is international recruitment.

“As part of the programme, [the Department of Health and Social Care and NHS England] have therefore developed plans to expand international recruitment at short notice, should it be required.”

Sources told HSJ that improving retention was the area of highest risk for the programme and that if it struggles, it will be very difficult to compensate for any further shortfalls in new recruitment.

International recruitment was significantly dented by the covid pandemic but is said to have recovered quickly, while the pandemic also delayed some domestic new starters.