Nursing Workforce – treating the symptoms and not the cause

This week’s Blog is written by Dr Pauline Milne (@NHSPauline).

Nursing workforce shortages have been a recurring issue for decades with continual cycles of ‘boom and bust’ becoming an all too common feature.  Once again, we are experiencing a period of ‘bust’ in the nursing workforce.  This shortage of Registered Nurses could be further exacerbated by recent political and policy decisions such as the implications of Brexit (Health Foundation 2018), removal of the bursary for pre-registration nurses in England, reductions in funding for continuing professional development and general working conditions (Twycross 2018). 

In the past policies to address nursing shortages have included ambitious recruitment targets, such as those in the NHS plan (Department of Heath 2000), resulting in widening the entry routes into nursing and a heavy reliance on international nurse recruitment.

More recent strategies include the introduction of new roles with shorter lead in times for example the Nursing Associate in England.  There is also a renewed focus on retaining nurses in the workforce alongside national recruitment campaigns (NHS England 2018).

There is however a risk that these strategies are merely attempting to treat the symptoms rather than address the cause of why we experience perpetual shortages of Registered Nurses.  I believe that the focus should be shifted to improving nursing workforce policy and planning.

Take a few moments to consider:

  • Who holds responsibility for nursing workforce planning in your organisation, in your region or at a national level?
  • Similarly, when new health policies are being implemented who is responsible for ensuring that the impact of these policies on nursing is considered and planned for?

It is likely that reflecting on these questions will have elicited a wide range of responses indicating the lack of clarity over these important responsibilities.  It is vital that senior nurses step into this space and take responsibility for planning the future supply and direction of the nursing workforce.  Additionally nurses at all levels should be able to access education and training to equip them with the skills and expertise to participate in meaningful nursing workforce planning activities and to actively engage in policy discussions.


 Dr Pauline Milne MBE PhD MN BN RN

Contact email:

Twitter: @NHSPauline



Department of Health (2000) The NHS Plan. A Plan for Investment. A Plan for Reform. London: DH.

Health Foundation (2018) UK public support recruitment of EU nurses post-Brexit, including ‘leave’ voters.  Retrieved from

NHS England (2018)   England’s top nurse announces major new recruitment and retention campaign to coincide with 70th anniversary of NHS.  Retrieved from

Twycross A (2018) Time to take a stand on nurses’ working conditions.  Editorial Evidence Based Nursing.  Retrieved from

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