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Press release: Supporting UK nurses - band 5 nurses to be taken off the home office shortage occupation list/NHS Employers issues support materials to help the NHS manage workforce changes

03 Jul 2006

The extra investment in nurse education means that the NHS no longer needs to hire more junior nurses from abroad, Health Minister Lord Warner announced today.

Nursing has historically been included on the Home Office shortage occupation list to support international recruitment where NHS trusts have been unable to fill vacancies using UK or EEA trained staff.

By removing general nurses from the shortage occupation list, employers will need to advertise any vacancies first and only if they are unable to fill the post can they turn to international recruitment.

At present, this change applies to nursing posts graded at Agenda for Change bands 5 and 6, where overall the supply of nurses is now healthy.

Health Minister Lord Warner said:

"The NHS has seen historical levels of investment and a period of expansion in the nursing workforce since 1997 in order to help reduce waiting times, improve access to services and ensure high quality treatment and care.

"On top of this we have made a huge investment in education and training and in the development of robust recruitment and retention policies.  This is now bearing fruit.  We now have more than 379,000 qualified nurses working in the NHS, 82,000 more than in 1997 as well as record levels of nurses in training.

"We are now moving away from year-on-year growth in the NHS workforce to more of a steady state where there is a closer match between demand and supply. Large-scale international nurse recruitment across the NHS was only ever intended to be a short-term measure. The aim of the NHS has always been to look towards home-grown staff in the first instance and have a diverse workforce that reflects local communities.

"Therefore to ensure that UK resident and newly trained nurses are given every opportunity to continue their career in the UK and to secure the future workforce of the NHS, we are today taking Agenda for Change band 5 and 6 nurses off the shortage list. "

In addition, NHS Employers today issued a range of information to support NHS organisations when faced with workforce change, endorsed by Health Minister Lord Warner.

Drawn up in consultation with professional and staff interests, the documents offer practical support to NHS students, staff and managers who may be facing redeployment, redundancy or difficulty getting their first job after graduation.

Maximising Employment Opportunities in a Changing NHS offers advice and best practice to employers on how to support their staff through the current workforce challenges.   It contains information on how trusts can make greater use of internal banks rather than relying on agency staff, recruit more new graduates into community roles, use accelerated development programmes to skill up the current workforce and make maximum use of the free national NHS jobs recruitment service.  A range of case studies illustrate what trusts are doing at local level to support their workforce.

NHS Employers is also publishing Retention of Experienced Staff in the NHS which contains information on how trusts can retain senior staff during times of change.  This document and the other support tools are available on NHS Employers' website at www.nhsemployers.org.

Steve Barnett, Director of NHS Employers, said:

"NHS Employers is providing a range of information that will help employers to support their staff through this period of change.  We are working closely with employers, staff organisation and other stakeholders at a national level to ensure that we all do everything we can to support the workforce through these changing times and to retain valuable skills and experience."

Phil Gray, Chief Executive of the Chartered Society of Physiotherapy, said:
 
"Physiotherapists will welcome today's document from NHS Employers as a clear signal to trusts that even in the current financial climate there is much they can do to put newly qualified physiotherapists to work and to retain the experienced practitioners who are innovating and modernising across the full range of care settings."

Health Minister Lord Warner added:

"It is clear that some NHS organisations are reviewing and rationalising the way they work to ensure they are fit for purpose and this includes considering the number of staff they employ and how they are best used.

"For this reason it is currently a worrying and uncertain time for some staff working in the NHS, and indeed for some healthcare graduates.

"I am reassured that where trusts are reducing posts they are mainly doing so through expected turnover, vacancy freezes, reducing the use of agency staff, and redeploying staff in different ways.  They are working hard to avoid redundancies and for the most part succeeding, despite some exaggerated claims.

"Unfortunately it seems that some redundancies will be inevitable, particularly in the most challenged trusts; but where posts are being reduced we want to ensure employers are involving staff in consultations about the way forward and are making every effort to ensure that care for patients is not affected.

"At a national level, the Department of Health is working closely with NHS Employers to ensure appropriate support and guidance is available."

Many initiatives for improving health care - such as providing more treatment in the community and the introduction of new roles for staff and new providers of services - are changing how staff work, particularly in acute hospitals.

Chief Nursing Officer Christine Beasley said:

"We've all seen the headlines claiming that thousands of staff face unemployment. Although the figures have been exaggerated clearly there are some nurses and midwives that are facing uncertainty in the NHS. In particular, new graduates are concerned they will not be able to find their first post.

"We do still need and will continue to need new staff to replace those who retire or take career breaks. Many employers, even those making reductions in workforce numbers still expect to take on newly qualified nurses graduates.

"However, new graduates in certain professions, such as nursing and physiotherapy, are likely to find more competition in finding their first job than in the recent past and people may have to be prepared to be mobile to secure a post.  My advice to students about to qualify is that there are jobs out there, perhaps not in your first choice of speciality or local trust but be open minded about where and in which areas you work."

Intelligence from NHS Employers shows the situation is patchy - some trusts expect to take on all or most of their graduates but there are significant geographical variations, for example, the East Midlands has problems but London, Leeds, Manchester and Essex expect to take on most of their new nurses. Many areas are committed to finding posts for all their graduates and are being innovative and creative in making sure this happens.

For example, some trusts are ring-fencing posts for local nurse graduates and where sufficient substantive posts are not available, for example, are taking them on in flexible pools where they work in a range of different settings according to the needs of the service and are provided with mentorship and support.

For those trusts who are still finding it difficult Maximising Employment Opportunities in a Changing NHS offers practical support to Trusts to help NHS graduates into employment.

NHS Employers are working with the Council of Deans for Nursing and the Professions on a number of immediate and longer term strategies.

Paul Turner, Head of the Council of Deans said:

"The Council of Deans is working jointly with NHS Employers to improve and share intelligence on employment opportunities and career development for newly qualifying nurses.

"We will continue to advance and develop strategies that positively promote nursing as a career choice and continue the development of pre-registration programmes that have a well-balanced community and hospital focus with balanced and well supported placement experiences."

Related publications

Maximising employment opportunities in a changing NHS (47 kB PDF)
This briefing looks at the changing NHS and the impact this will have on employing staff. It offers innovative examples of Trust recruitment, for example in the area of newly qualified healthcare professionals.|

Notes for editors

WORK PERMIT CHANGES:

• This change will make no difference to nurses currently working in the UK.
• The Home Office will shortly be issuing a six week period of notice to employers before changes to the National Shortage Occupation List.  The changes are likely to come into effect around 7 August 2006.
• Work permits may be granted for a period of up to 5 years. Most international nurses permanently employed by the NHS will have time-limited contracts of employment. There are arrangements within the work permit rules to allow an employer to seek an extension of a work permit without needing to test the resident labour market. However, employers will not be able to recruit to a vacant post without first placing an advert within the UK.
• Whilst there is a healthy supply of nurses at band 5 of the Agenda for Change scale, there are still shortages in certain specialties among the most advanced and senior nurse grades in bands 7 and 8 and they are unaffected by this change.
• We are also making this change to band 6 as the supply of nurses here is also becoming healthier and this will encourage employers to recruit existing UK trained band 5 nurses into these roles, rather than undertaking international recruitment. This will help to free up more opportunities for band 5 for newly qualified staff.
• Whilst we encourage the NHS to fill vacancies where possible from within the UK, it is important employers have flexibility in those advanced specialties where shortages persist. We will keep this under review as the recent growth in junior nurses starts to feed into the more senior grades.
• This change only affects nurses. We are reviewing the arrangements for other groups as staff shortages in other professions have also been significantly reduced over recent years.
• Taking nursing off the shortage list does not stop employers undertaking international recruitment, it only means that they have to demonstrate that they cannot fill a post with a UK or EEA applicant first. If employers are unable to fill a particular nursing post following advertisement, they may then apply to the Home Office for a work permit.

NHS VACANCIES

• Vacancies for graduates continue to be posted on NHS Jobs and the NHS Careers information service can direct graduates to appropriate sources of information and advice. Graduates are encouraged to be flexible when applying for posts.
• There are, on average, over 7,000 vacancies posted on NHS Jobs per month, with over 2,000 of these vacancies in nursing and midwifery.

CASE STUDIES OF TRUSTS

• NHS Professionals, the not-for-profit flexible staffing service run by the NHS are offering programmes, in partnership with NHS trusts, which allow nurses to obtain preceptorships to work in a trust after they are newly qualified. This allows nurses to remain working in the NHS and enjoy the benefits of this, such as continuous professional development, the opportunity to develop new skills and the opportunity to work flexibly if they choose. Additionally, employing nurses through this programme means NHS trusts can meet their flexible worker needs, fill vacancies more easily and benefit from employing nurses with previous NHS experience and skill sets. Retaining nurses through such a programme has the additional benefit that the NHS does not loose staff with valuable skills and experience.
• To find out more about this preceptorship programme please contact Chris Day, director of marketing and communications, NHS Professionals on 01924 582 084 or email chris.day@nhsprofessionals.nhs.uk.
• Through effective workforce planning, Essex strategic health authority (SHA) now guarantee all newly qualified nurses employment in the NHS in their area. Workforce planning, including assessing current nursing levels and projected levels over five years* and implementing an area wide approach to commissioning nursing training posts led to a 65% growth in the nursing workforce (35% above the national average) over two years and the guarantee to 100% (over 760 per year) of their newly qualified nursing workforce, of employment in the NHS in their local area. Effective workforce planning in this area has benefited NHS trusts by enabling them to retain experienced and skilled nurses within the NHS and has benefited nurses by offering them continuous professional development and the opportunity to develop new skills in their local NHS.
• For further information, please contact Michelle Gallifent, director of education & development, Essex Workforce Development Confederation on 01245 397 677 or email michelle.gallifent@essexwdc.nhs.uk.
• Bradford Teaching Hospital NHS Foundation Trust's award-winning physiotherapy department is one of the busiest in the north of England, caring for around 30,000 new patients every year.  Physiotherapists provide a district-wide service including in hospitals, the community, with patient's in their own homes or in GP practices and schools.  The service is possible because around three years ago a decision was taken to integrate all physiotherapy services in Bradford.  Now, all physiotherapists are employed by the Trust and work in teams to deliver care where it is needed, often outside of the acute setting.  The flexibility of the service has allowed for newly qualified physiotherapists to take a first job working in primary care, building skills as they work.
• For a copy of Maximising employment opportunities in a changing NHS and Retention of Experienced Staff in the NHS  visit www.nhsemployers.nhs.uk
• For further information, please contact Sally Aldous at the Department Health Media Centre on 020 7210 5230 or Emma Stafford at NHS Employers on 020 7074 3307

Contact details

The press office provides a comprehensive service to keep journalists informed about the work of NHS Employers.

If you have a media enquiry, please contact the press office team:

• Gemma Jeffcoate
  0207 074 3308 or gemma.jeffcoate@nhsemployers.org
• Emma Stafford
  0207 074 3307 or emma.stafford@nhsemployers.org

For out of hours media enquiries, please contact the duty press officer on 07880 500726.

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