Executive Summary Table of Contents
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Executive Summary Table of Contents
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Nurses constitute the largest part of the
workforce involved in public and private healthcare in the UK, and they are
responsible for an estimated 80 percent of patient care. Traditionally, nursing was
perceived as a low-paid vocation responsible for much of the practical needs of
caring for sick patients under the guidance of the medical profession. However,
in modern times the role of the nurse has changed considerably.
Nurses are
not a homogeneous group. As with the medical profession, there are several
specialisms requiring further training and qualifications, such as midwifery,
district nursing and health visiting, and branches of nursing include child
health, intensive care, learning disability and mental health. As medical
treatments increase in scope and complexity, so does the role of nursing within
them. Nurses are playing an increasingly integral part in government
initiatives to improve healthcare delivery, and as a result their role is
expanding into new areas of expertise, such as prescribing and running primary
care practices.
By far the largest employer of nurses in the UK is the
National Health Service (NHS). In 1998, nursing staff, midwives and health
visitors comprised 43 percent of the Hospital and Community Health Services (HCHS)
workforce, while practice nurses constituted 11 percent of the Family Health Services
(FHS) workforce. The majority of nurses (75 percent) working in the NHS, including
practice nurses, are qualified and registered with the United Kingdom Central
Council for Nursing, Midwifery and Health Visiting (UKCC). In the private
sector, however, the number of unqualified nursing assistants and auxiliaries
has been rising comparatively quickly -- particularly within the long-term care
market.
Nursing is currently in a state of crisis. Staff morale is low and
turnover is as high as 18 percent in the NHS. Demand for qualified nurses is exceeding
supply, with around 8,000 vacancies nationwide and up to 25 percent of the profession
eligible for retirement by 2001. At the same time, the number of student nurses
is falling. In the NHS, in particular, chronic shortfalls in nursing staff are
increasingly requiring the use of nursing banks and nursing agencies, which
were originally designed only to provide emergency cover.
The Government
has responded to the crisis with a number of initiatives, including an
advertising campaign, the introduction of crèches and family-friendly
shift patterns, and a new graded pay structure -- including, most recently, the
creation of a fourth grade of so-called `supernurses' or `consultant
practitioners', with salaries of up to £40,000 per year.
In the
future, demand for nursing care can only increase under the pressures of an
ageing population and advances in medicine. Accordingly, as demand increases,
so will the pressures on nursing staff. The number of nurses will increase
gradually as government measures take effect, to give a nursing workforce of
563,112 by 2004. Within this figure, the number of qualified nurses will rise
gradually, at around 2 percent annually, since training is time-consuming and
expensive. The number of unqualified nurses will rise more rapidly --
particularly in the private sector.
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