Yesterday the Nursing and Midwifery Council issued a press release reporting on a continued decline in the number of EU-qualified nurses and midwives joining the register, and a simultaneous increase in the number of EU-qualified nurses and midwives leaving. Behind the press release is a longer report, from which I have extracted two tables:
Judged on these figures the number of EU nurses coming to the UK looks to have slowed to a trickle. Elsewhere, in its report In short supply: pay policy and nurse numbersThe Health Foundationpoints out that in 2015 NHS England had 22,000 too few nurses specialising in the care of adult patients. The mental health field, The Health Foundation adds, is one where (for the present) tools to calculate safe staffing are virtually non-existent.
Meanwhile, UCAS (the Universities and Colleges Admissions Service) reports that applications for higher education programmes commencing in the 2017-18 academic year have declined across the board, but that it is nursing courses which have seen the sharpest fall. Applicants from England making at least one choice to study nursing dropped by 23% (to 33,810) in 2017.
The RCN, amongst others, has long been campaigning against persistent low pay for NHS nurses, arguing that a career which is so obviously poorly remunerated is no incentive to potential new recruits. Nor, for that matter, does it help efforts to retain existing staff. Previous reports from the RCN tell us that the UK’s nursing workforce is an ageing one.
Taken together, the loss of European nurses in the context of last year’s EU referendum, chronically poor workforce planning, a nursing profession which is getting older (and will therefore lose members to retirement), the loss of bursaries in England and continued low pay make for a toxic combination. But things can be done. Agreeing the future security of EU citizens in the UK would be a start, along with removing the NHS pay cap. Reintroducing bursaries might help rekindle UCAS applications. Better planning of future NHS staffing needs is long overdue. Nursing, of course, remains a mightily fulfilling career and I would hate to think that this (admittedly rather negative) post puts off anyone contemplating a move in this direction. But it also serves to highlight some of the serious challenges which lie ahead.
I am all for interdependence and collaboration, and take no pleasure in the prospect of the UK casting itself adrift from the European Union. With MSc students I have sometimes discussed global mental health, and policy in this area. This has included talking about work led by the EU. Derived from my teaching, here for information are some of the initiatives member states have taken together.
Mental health in all policies [which recognises how policy in non-health areas can have an effect on mental health]
The European Union also supports mental health research. Take, for example, the work of the ROAMER consortium which has agreed a series of research priorities. Here they are:
Preventing mental disorders, promoting mental health and focusing on young people
Focusing on causal mechanisms of mental disorders
Setting up international collaborations and networks for mental health research
Developing and implementing new and better interventions for mental health and well-being
Reducing stigma and empowering service users and carer
Research into health and social systems
For a comprehensive list of Horizon 2020 and FP7 projects in the field of mental health, try following this link.
Leaving the EU will greatly diminish opportunities for people in the UK to cooperate with people in Europe to tackle our shared problems, of which mental ill-health and its associated stigma is most definitely one. On the research front, post-EU referendum some in UK universities are already reporting that their collaborations with academics in other EU member states are under threat. Suffice to say I wish the vote on June 23rd had gone the other way.