Registered nursing vacancies in Wales have increased by more than 50%, according to estimates included in a new report from the Royal College of Nursing (RCN).
The RCN has published its Nursing in Numbers report for 2023 and called on the Welsh Government and other health and social care bodies to take urgent action – or face a worsening staffing problem.
“Nursing staff are exhausted, and recruitment hasn’t kept pace with patient need”
In its report, published today, the RCN has estimated that there were 2,717 registered nurse vacancies in Wales in 2023. This number represents an increase on the union’s estimation of 1,719 from a year ago.
The union’s 2,717 figure is based in part on new data published by the Welsh Government, which estimated 2,409 full-time equivalent (FTE) vacancies among nurses, midwives and health visitors.
However, the RCN claimed that the government figure undersells the extent of the problem, and has repeatedly called for more detailed data on workforce vacancies.
Nurses in Wales, according to the RCN’s report, work on average 69,877 hours over their normal hours each week. This equates to roughly 1,863 full-time registered nurses.
In the report, the union reiterated this concern and recommended improvements to data and workforce planning for health staff, and said it must, in future, include data on agency and bank spending.
According to the RCN, NHS Wales spent £161.2m on agency nursing, equivalent to 5,591 full-time newly qualified nurses, in 2022-23.
This is a 21% increase on 2021-22, and is the fifth year running that the union has reported a rise in agency spend.
Retention was also found to be a problem. The report read: “Salaries of nursing professionals have consistently fallen below inflation – a fact which is being exacerbated by the cost-of-living crisis.
“The RCN has called on governments from across the UK to recognise the safety critical role of nursing and act urgently to protect patient care by protecting the profession.
“The Welsh Government is responsible for nurse and healthcare support worker (HCSW) salaries. It needs to ensure that nurses and HCSWs are paid fairly,” it stated.
“RCN Wales members remain committed to ensuring that the profession is fairly paid for the safety-critical work they deliver,” it added.
The report mentioned a long-awaited draft retention plan by the Welsh Government and Health Education and Improvement Wales (HEIW), which made various recommendations about wellbeing support to prevent burnout, pay, and improving staffing levels, as well as changing overtime pay.
These recommendations echo some of the non-pay promises that the Welsh Government made during its industrial dispute with the RCN this year.
The college said this plan should be brought forward to improve Welsh nursing retention, and also recommended the government work towards safer staffing levels, invest more in nursing education.
It further recommended the creation of a Wales-wide post-registration commissioning strategy, to ensure that universities have a reason to offer courses by generating the jobs for graduates to enter into.
RCN Wales director Helen Whyley said the Welsh Government needed to “up its investment” in the profession, which makes up around 40% of the NHS Wales workforce.
“Nursing staff are exhausted, and recruitment hasn’t kept pace with patient need,” said Ms Whyley.
“From 2017 to 2022 the nursing and midwifery workforce grew just 7%. Over that time, the number of medical and dental professionals increased by 23%.
“In its latest offer to RCN members, the Welsh Government committed itself to pay restoration and a host of non-pay elements covering flexible working, corridor care and more. Its promises showed ambition – and RCN members accepted the offer on those terms.
“I’m calling on Eluned Morgan, minister for health and social services, not to take nursing for granted or allow the economic context to water down that ambition.
“Listen to nursing staff, safeguard patients, and make sure there is an NHS able to deliver care for future generations,” she said.
The report also referred to shortages in the social care sector, with 500 fewer registered nurses working in social care in 2022-23 than three years prior.
The RCN said this was a “worrying trend” and called on Social Care Wales to develop a plan to improve recruitment and retention in its sector.
Jackie Davies, RCN Wales board chair, said: “The health of the nation depends on diverse nursing skills from health care support workers to specialist and consultant nurses. Occupational health nurses, school nurses, and health visitors – all types of nurses are needed.
“The Welsh government and NHS organisations urgently need to develop a post-registration nursing education strategy.
“Too often, patients in Wales are let down by long waiting lists and unavailable services because nurses haven’t been provided with the opportunity to expand and deliver the skills that are needed.”
Responding to the report, a Welsh Government spokesperson said it was working to increase the number of nurse education places available, citing its National Workforce Implementation Plan.
“Our NWIP sets out how we will retain and increase the NHS Wales workforce to meet future demand and deal with a worldwide shortage of healthcare workers, including reducing reliance on agency staff.
“We have increased our training budget for the ninth year in a row to £281m this year, creating an extra 527 training places, including more than 380 more nurse training places,” they said.
“Since 2017, nurse training places have increased by 54.3% and midwifery training places increased by 41.8%,” they added.
“On 22 September, the HEIW published their nurse retention plan, in response to the NWIP, which will support organisations in addressing challenges in nurse retention in Wales.”