Social care nurses must be protected from workplace abuse and be enabled to report incidents, near misses or concerns candidly, a report into the nurse workforce exodus has said.
The Royal College of Nursing report Valuing Nursing in the UK – Staffing for Safe and Effective Care report sets out the issues contributing to the poor retention of nursing staff, the reasons why they’re leaving, and calls for immediate action from the UK governments.
In social care, there is a lack of official programmes of support for nurses, meaning that the opportunity is limited for staff to feel safe and confident to speak up about workplace concerns. “This is compounded in social care where many registered nurses work in isolation, without ready access to support or mentorship,” the report concludes. It says if staff are limited in their ability to speak up about their concerns, it is likely that the organisation is not actively learning and improving. This puts the organisation at risk of a negative workplace culture, which in turn has implications for both retention and the delivery of safe and effective care.
Other issues particularly relevant to social care is the use of debt bondage where migrant workers have borrowed money to take up employment in the UK and the use of excessive deductions from wages for subsistence costs such as food and rent.
The code of practice for the international recruitment of health and social care personnel sets out the policy for international recruitment in the UK and includes principles on the use of repayment clauses. However, this is not a legally binding instrument.
The report shows that between 2018 and 2022, nearly 43,000 people aged 21 to 50 left the Nursing and Midwifery Council (NMC) register. It also finds the number of people leaving the NMC register increased by 9 per cent from 2020-21 on the previous year and increased by a further 3 per cent in 2022.
The RCN blames years of underfunding – including a decade of real-terms pay cuts – for the exodus and is calling for an immediate, substantial pay rise for nursing staff.
Further demands include:
- delivering fully funded health and care workforce plans
- publishing independently verifiable assessments of health and care nursing workforce requirements to meet the needs of the population and address health inequalities
- ensuring there is accountability for nursing workforce planning and supply in law.