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Stronger leadership needed to reverse staff shortfall National Audit Office says providers must ensure safe staffing while meeting efficiency targets By Alistair Kleebauer @alistairbauer THE NHS in England has a shortfall of 50,000 clinical staff, and its arrangements for managing staff supply are ‘fragmented and do not represent value for money’, the National Audit Office (NAO) has claimed. An NAO report, published last month, reveals there was an overall staffing shortfall of about 5.9% in 2014, which equates to 50,000 clinical staff. It calls for stronger Department of Health (DH) leadership to help NHS trusts in England address short-term gaps in nurse numbers. The report, based on evidence collected between May and November 2015, states that providers face a challenge in ensuring safe staffing while meeting efficiency targets and reducing reliance on temporary staff. It adds that there has been limited regional or national co-ordination of measures, such as overseas recruitment or return-to-practice initiatives, that could have helped 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

only 699 in 2014/15. Its report states that the fall could have been due to tighter immigration rules for nurses between 2009 and 2015, adding that it was offset partly by a rise in the number of recruits from within the EEA. 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 that there were 3,106 fewer nurse training places in 2014/15 compared with 2004/05, representing a 19% decrease. Commissioning decisions The NAO says there is a lack of sufficiently reliable data with which to monitor staff numbers, and that this adds to uncertainty about Health Education England’s (HEE) commissioning decisions. It also calls on the DH to ensure there are comprehensive data to help with workforce monitoring. Labour MP Meg Hillier, chair of the Commons’ public accounts committee, said that one in 20 clinical posts remains

unfilled despite being budgeted for. This means that hospitals often rely on expensive agency staff, she added. ‘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 outlines areas it had already identified as in need of improvement, including data collection and better co-ordination of NHS bodies to meet workforce challenges. A HEE spokesperson said: ‘HEE has brought 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 that staffing is a priority and that, since May 2010, more than 10,600 additional nurses have worked on wards and more than 50,000 nurses are in training. The DH is changing how nursing students, midwives and allied health professionals are funded, she said, which will create up to 10,000 more training places by the end of this parliament. Find out more The NAO report can be accessed at tinyurl.com/hpomnnf

Breathe easy

Hospital hygiene and handwashing still not good enough, say MPs THE NATIONAL Institute for Health and Care Excellence and the Care Quality Commission must do more to monitor handwashing and hygiene in hospitals, MPs have said. In a debate in Westminster Hall in December last year, they claimed that existing rules are not followed closely enough and that the inspection regimes are ineffective. Health minister Ben Gummer said the chief medical officer is working on the problems. NURSING MANAGEMENT

WellChild lead nurse for Yorkshire Amika Challacombe and patient

CHILDREN’S NURSE Amika Challacombe has received funding from ITV’s Text Santa appeal to become the charity WellChild’s lead nurse for Yorkshire. Based at Sheffield Children’s NHS Foundation Trust, Ms Challacombe will specialise in supporting families at home to reduce the time young people with breathing difficulties spend on ventilators in hospital. WellChild’s children’s nurse programme began in 2006 and will fund a further six posts around the UK this year. March 2016 | Volume 22 | Number 10

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Hospital hygiene and handwashing still not good enough, say MPs.

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