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National Audit Office demands more national leadership to tackle staffing shortfall

Its report finds arrangements for managing clinical staff supply in England are ‘fragmented and do not represent value for money’

The NHS has a shortfall of 50,000 clinical staff in England, according to the National Audit Office (NAO). It also says arrangements for managing staff supply are ‘fragmented and do not represent value for money’.

The NAO's report, published today, advises that stronger Department of Health (DH) leadership is required to help NHS trusts in England address short-term gaps in nursing staff numbers. 

It found an overall staffing shortfall of about 5.9% in 2014, which equates to 50,000 clinical staff.

The report, based on evidence collected between May and November 2015, says providers face a challenge in ensuring safe staffing while meeting efficiency targets and reducing reliance on temporary staff.

But it adds that there has been limited regional or national coordination of measures, such as overseas recruitment or return-to-practice initiatives, which could help to address shortfalls.

The NAO found the number of nurses from outside the European Economic Area (EEA) fell from 11,359 in 2004/05 to just 699 in 2014/15.

Its report says this could have been the result of tighter immigration rules for nurses between 2009 and 2015, adding that this fall was partly offset by a rise in the number of EEA recruits. 

About 1,000 former nurses and midwives returned to work each year between 2010 and 2014, according to the NAO, compared with 3,700 each year a decade earlier. 

The audit body also found there were 3,106 fewer nurse training places in 2014/15 compared with 2004/05 – a 19% decrease. 

The NAO says there is a lack of sufficiently reliable data to monitor staff numbers, which adds to uncertainty around Health Education England’s (HEE) commissioning decisions. The NAO also calls on the DH to ensure there is comprehensive data to help with workforce monitoring. 

Labour MP Meg Hillier, chair of the Commons’ public accounts committee, said one in 20 clinical posts are unfilled despite being budgeted for. She added that this means hospitals often rely on expensive agency staff.

‘The DH, HEE and trusts need to improve drastically how they manage the supply of clinical staff to ensure the NHS can meet demand,’ said Ms Hillier.

‘This report adds to the evidence base that will allow us to move further and faster.’

HEE said the report outlined areas it had already identified as needing improvement, including data collection and better coordination of NHS bodies to meet workforce challenges.

A HEE spokesperson said: ‘HEE has acted to bring employers and other partners together in its workforce advisory board.

'We are also boosting supply through our 'Come back to nursing' campaign, which has encouraged more than 700 nurses to retrain. They are now back on the front line caring for and supporting patients.’

A DH spokesperson said staffing is a priority and that more than 10,600 additional nurses have worked on wards since May 2010. She added that more than 50,000 nurses are currently in training. 

The DH is changing the funding of nursing students, midwives and allied health professionals, she said, which will create up to 10,000 more training places by the end of this parliament.

Read the 'Managing the supply of NHS clinical staff in England' report on the NAO website

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