Nursing: More than one in 10 posts vacant at end of 2019
Getty ImagesMore than one in 10 registered nursing posts in Northern Ireland were vacant at the end of 2019, with temporary staffing costing the health service £115m a year.
That is according to a report by the Northern Ireland Audit Office (NIAO).
It found vacancies more than trebled from 770 in 2013 to over 2,700 in 2019.
The Department of Health said nursing training numbers had been increased and it wanted to change how services were delivered.
Other key findings from the report include:
- There are 2,100 unfilled registered nursing posts - an additional 1,600 nurses are needed to ensure safe staffing levels;
- Pre-registration nursing training budget has been cut from an annual average of £30.1m in 2008 and 2011 to £28.8m between 2011 and 2017, meaning fewer trainee places;
- Spending on temporary staff has jumped to £115m in 2018/19 from £14.6m in 2006/07 - an increase of almost 800%
- In 2018/19, three trusts paid up to £1,700 for agency nurse cover for a single bank holiday shift;
Kieran Donnelly, auditor general, said that at a time when more nurses should have been recruited, "short-term savings were instead pursued".
In the Workforce Planning for Nurses and Midwives report, Mr Donnelly said Northern Ireland was facing nursing and midwifery staff shortages.
If not addressed, they are likely to leave the Health and Social Care (HSC) sector facing "intolerable pressure", with "substantial further action and monitoring" needed, he added.
That is in spite of significant measures taken by the Department of Health to address staffing gaps, including:
- an increase in pre-registration nursing and midwifery places;
- a rise in the post-registration training budget;
- an international nursing recruitment campaign.
Mr Donnelly said that substantially reducing the number of training places has left the HSC and independent care sectors "with an insufficient staffing pool to cope with the rising demand for care".
The auditor general accepted that workforce planning was difficult to manage, given rising demands, limited resources and intense global competition for staff.
However, he said short-term decisions taken at a strategic level have meant that "overcoming these serious challenges will take even longer".
"The reliance on temporary nurses, particularly agency staff, has not only resulted in soaring costs, it also can compromise the quality and safety of patient care as staff are deployed in less familiar clinical settings," he said.
"It is clear that this does not represent value for money."
The age profile of HSC nurses and midwives has increased over the last decade, with 14% of nurses and 22% of midwives now aged 55 or over.
This, the auditor general said, could heighten the workforce issues faced by the Department of Health and trusts.
In 2018, the department published the 2026 Strategy, a workforce plan for the HSC sector.
It acknowledged the need to address high sickness absence, rising temporary staff costs, high vacancy rates, lack of clarity on configuration by 2026 and the potential affect of Brexit on workforce supply.
'Prove very challenging'
The NIAO report said the implementation of some of the strategy's 24 actions is already behind schedule and achieving its objectives will "prove very challenging".
The report was completed before the outbreak of Covid-19, but was not published until now "to ensure that audit work did not disrupt the efforts of severely challenged public bodies dealing with extremely challenging circumstances".
The Department of Health said nursing training numbers had been increased and that it accepts that rising expenditure on temporary staffing is unsustainable.
It said part of the answer is to transform how services are provided.
Sinn Féin's Colm Gildernew, the chair of the Stormont Health Committee, said the report showed the need for investment in health service staff.
"The public deserves this and so do all health and social care workers," he added.