Europe South Asia Asia Pacific Americas Middle East Africa BBC Homepage World Service Education



Front Page

World

UK

UK Politics

Business

Sci/Tech

Health

Education

Sport

Entertainment

Talking Point
On Air
Feedback
Low Graphics
Help

Tuesday, December 29, 1998 Published at 15:48 GMT


Health

Why an NHS nurse is hard to find

Nurses want better pay and working conditions

The revelation that NHS spending on agency nurses has doubled in six years comes as no surprise to the bodies that represent the profession.

The NHS is suffering what the Royal College of Nursing (RCN) calls "the worst recruitment crisis in 25 years". It estimates the NHS is short of 8,000 staff nurses.

In a bid to keep staffing levels up, hospitals have recruited nurses from as far afield as Australia and the Philippines.

But not even this is enough, and the shortfall has to be made up from somewhere. It is left up to nursing agencies to shoulder the burden.

However, paying for an agency nurse is more expensive than employing a staff nurse, as agencies are only supposed to provide emergency cover when there is a temporary shortage of staff.

Pay concerns

The main reason for the recruitment and retention crisis - attracting nurses into the NHS and then keeping them there - is usually singled out as pay.


[ image: NHS staff are paid less than agency staff]
NHS staff are paid less than agency staff
Nurses are expected to work long hours under heavy pressure, yet the starting salary of £12,855 for a newly-qualified nurse is less than that of police constable or a teacher.

The RCN estimates it would take a 20% pay rise to bring an NHS nurse's salary into line with that of a police constable and a 17% boost to match a teacher's.

Before starting work at that level of pay, a nurse has to spend three to four years training.

An unqualified nursing assistant gets paid £8,315.

Working for a nursing agency can prove more lucrative, especially if - as is happening at the moment - the agency work provides full-time employment.

Agency pay rates vary from place to place, but a similarly-qualified nurse working for an agency in London could expect to earn double that sum, with rates ranging from £11 per hour for mornings and £13 for afternoons and evenings on weekdays, to £27 per hour on bank holiday weekends.

For nurses with specialist experience, the rates are even higher.

Flexible working

However, pay is not the only reason nurses choose to leave the NHS.

"Another important reason is to do with conditions, so we want to see more family friendly policies and more flexibility," said an RCN spokeswoman.

"Some nurses choose to work for an agency because it gives them more flexibility whereas in the NHS in a lot of areas that sort of flexibility doesn't exist."


[ image: Liz Jenkins:
Liz Jenkins: "Continuity of care suffers"
There are also fears that the crisis is threatening the quality of patient care.

Liz Jenkins, assistant general secretary of the RCN, said: "When you get too many agency nurses, you get no continuity of care.

"The patient in their bed sees a different person every day who doesn't understand their condition, who may not even know much about the hospital they work in."

An RCN survey carried out in September looked at about 50 different trusts to see how the shortage was affecting patient care.

It found that a high percentage of nurses were "very-concerned" that the shortages were having an impact on patient care.

Government action

The government says it is taking action. In September, then health minister Alan Milburn announced a £50m package to tackle the crisis.

It included:

  • Extra training places for nurses, including funding to make it easier to enter nursing through measures such as an increase in the number of part-time courses in nursing and midwifery;
  • Extra money to retrain nurses who have left the NHS and enable them to return;
  • Making money available so that assistants can progress to become fully-qualified nurses;
  • An increase in the amount paid to student nurses.


[ image: Alan Milburn: Angered health workers]
Alan Milburn: Angered health workers
One of Mr Milburn's last moves as health minister before he was promoted to the Cabinet was to announce a review of NHS pay.

He set out proposals for reform of NHS pay in letters to the two chairman of the independent pay review bodies which recommend annual increases for doctors, nurses and other NHS staff.

However, he enraged NHS workers by insisting the government would only be able to undertake reform of their pay if the review bodies recommend rises that are "affordable as well as fair" for 1999-2000.

Christine Hancock, general secretary of the RCN, said at the time: "Nurses need a proper pay boost now. The promise of jam tomorrow simply isn't enough."



Advanced options | Search tips




Back to top | BBC News Home | BBC Homepage | ©


Health Contents

Background Briefings
Medical notes

Relevant Stories

29 Dec 98†|†Health
Agency nurse costs soar in NHS

17 Dec 98†|†Health
NHS workers reject pay reform plan

01 Dec 98†|†Health
Nurses lobby Blair

06 Nov 98†|†Health
Hospital recruits Down Under

21 Oct 98†|†Health
Foreign nurses in UK 'could double'

20 Oct 98†|†Health
Nurse shortages 'pose a risk to patients'

15 Oct 98†|†Health
Nurses demonstrate in Whitehall

13 Oct 98†|†Health
Nurses want £1.2bn pay rise

09 Oct 98†|†Health
Row erupts over nurses' pay

08 Jan 99†|†Health
Nurses want to quit, says survey

02 Oct 98†|†Health
Nurses demand big pay rise





Internet Links


Royal College of Nursing

Department of Health

UNISON


The BBC is not responsible for the content of external internet sites.




In this section

Disability in depth

Spotlight: Bristol inquiry

Antibiotics: A fading wonder

Mental health: An overview

Alternative medicine: A growth industry

The meningitis files

Long-term care: A special report

Aids up close

From cradle to grave

NHS reforms: A guide

NHS Performance 1999

From Special Report
NHS in crisis: Special report

British Medical Association conference '99

Royal College of Nursing conference '99