More must be done to address the children's nursing workforce crisis

Association of Chief Children’s Nurses is active in national conversations about the future of children’s nurse staffing

Picture: Alamy

The deficits in the NHS workforce are well publicised and have been described by the chief analyst at the King’s Fund think tank as a ‘national emergency’ (Triggle 2018).

Several factors have converged to create this situation, including a historically high nursing student attrition rate during training (Orton 2011) as about one quarter of students fail to complete their course. The RePair project (Health Education England 2017) shows that one third of children’s nurses fail to complete training.

The reduction in nurse numbers is compounded by an increase in the number who leave the profession within two years of qualifying.

Workplace changes

Mind the Gap (Jones and Davies 2015) suggests a range of workplace changes could encourage newly qualified practitioners to remain in clinical practice and develop long healthcare careers, but recommendations have only been partially implemented.

Other factors have played a part in nurse attrition including non-inflationary linked pay scales, depletion in CPD budgets, abolition of student bursaries and insufficient protected time for staff development.

There has also been a reduction in the number of new graduates registering with the Nursing and Midwifery Council (RCN 2019) and a downturn in new registrations from EU nurses.

Establishing the extent of the problem in children’s nursing is challenging because there is no single repository of relevant information. However, anecdotal feedback from providers suggests that it is difficult to maintain adequate staffing levels in children’s services.  

Responding to demand

So how should providers respond to the staffing shortfall, and how should they prepare and respond to the demands of the NHS Long-Term Plan for England?

National work programmes and retention strategies to solve these problems are proliferating. 

NHS Improvement is offering trusts assistance to address issues affecting turnover, including morale and engagement. However, progress is slow and so far, the actions taken have not stemmed the exodus of nurses from the profession. 

The Association of Chief Children’s Nurses (ACCN) is an active participant in national conversations about children’s nurse staffing and was central to the development of a national staffing resource (NHS Improvement 2017).

In response to members concerns about sustainability of the children’s nursing workforce, the ACCN has discussed different models of post-registration education. These discussions have prompted suggestions about how to attract and fund more nurses to acquire competencies to care for children and young people.    

Moving the problem around

Arguably, however, measures to attract nurses from other fields simply moves the problem around. Further work is needed on the many factors affecting the children’s nursing workforce nationally.

It is vital to achieve consensus between providers and higher education institutions to take strategies forward. The ACCN is optimistic that this shared vision will influence the leaders in national organisations whose decisions will determine children’s nursing workforce development of the future.

The ACCN plan to report further findings later this year.  


About the authors

Dorothy_BeanDorothy Bean is lead nurse for corporate projects, Birmingham Women's and Children’s Hospital



Annette_DearmunAnnette Dearmun is nurse consultant, Fullflight Limited, Oxford, and consultant editor Nursing Children and Young People


Both are ACCN members