A workforce survey of critical care nurses in the National Health Service

Abstract

Aim To measure key aspects of the critical care nursing workforce across the National Health Service (NHS) and compare these with recommended standards where they exist. Background The provision of high‐quality and safe critical care services is dependent on adequate numbers of highly skilled nurses. Understanding the issues and challenges within critical care services across the NHS is key to future planning and policy in this area. Design A stakeholder‐driven consensus development approach was adopted to design a workforce survey by members of the Critical Care National Network Nurse Leads (CC3N) Forum. Methods The survey was conducted across all the critical care units in England, Northern Ireland, Wales, and Scotland. Data were collated to enable presentation of descriptive statistics. Results Data returns were received from 240 of the 272 units in England and Northern Ireland. Scotland and Wales data were excluded from analysis and reporting. Differences in the sample and data returns limited comparison with the previous survey in some aspects. Stability was seen in vacancy and sickness rates. Improvements were seen in safe nurse: patient ratios, supernumerary “nurse in charge,” critical care outreach service cover, use of national competency framework, and agency use. Dependency on overseas nurses in some units remains high. Specialist critical care training levels in many units do not meet current required standards. Conclusion Clear improvements have been made. There is significant stability. Some challenges remain. Continued review of resource allocation is important in the coming years, as is policy and strategy to ensure recruitment, appropriate training, and support for staff well‐being. Relevance to clinical practice The reader will gain insight into the critical care nursing workforce in the NHS in England and Northern Ireland. The results are useful for nurses, nurse managers, and policymakers.

Critical care pharmacy workforce: a 2020 re-evaluation of the UK deployment and characteristics

“…The overall gap across the UK is 203 wte pharmacists to meet minimum weekday standards. In absolute numbers, this is not a large number of posts, for comparison there are at least 17,615 wte nurses in critical care in England and Wales [ 32 ], however this deficit represents 6 posts for every 10 critical care units in the UK.…”

Critical care nursing workforce in crisis: A discussion paper examining contributing factors, the impact of the COVID‐19 pandemic and potential solutions

“…For example, in the UK, the productivity of nurses has increased by 23% in the last decade, but nurse recruitment has only seen an increase of 1% (The Health Foundation, 2019b). Over this same period, the number of nurses leaving the profession to seek employment elsewhere has also increased (Chen et al, 2019;Nursing Midwifery Council, n.d.;Stone et al, 2006), with critical care being one of the worst affected areas for turnover (Cutler et al, 2021). Although there is currently no specific systematic review investigating the efficacy of burnout interventions for critical care nurses, there are some systematic reviews that include nurses as part of larger groups of healthcare professionals (Aryankhesal et al, 2019;Awa et al, 2010;Zhang et al, 2020).…”

“…Furthermore, in 2017, more nurses in the UK were leaving the profession than joining it (Nursing Midwifery Council, n.d.). The problem of high turnover has been cited as a dominant contributor to healthcare workforce shortages (Castro Lopes et al, 2017) and is a global issue (The Health Foundation, 2019a), which is especially prevalent in critical care (Cortese, 2012; Cutler et al, 2021; Stone et al, 2006; van Dam et al, 2013). A 2021 meta‐analysis reported that 27% of critical care nurses worldwide were intending to leave critical care nursing (Xu et al, 2021).…”

“…In critical care, turnover is a substantial issue. In the UK, for example, a significant number of critical care units have an annual staff turnover of over 20% (and as high as 42% for some) (Cutler et al, 2021), and a recent survey of members of the UK CC3N (Critical Care Network) found that one in two current adult critical care nurses are expecting to leave their current unit in the next 3 years (CC3N, 2022).…”

What's in this journal? The workforce issue

“…Continuing the focus on workforce, in the next article in this special issue, Cutler et al 10 report their workforce survey of NHS critical care nurses undertaken in 2017. The aim of this was to assess the current status of the UK critical care workforce and compare this against national standards and earlier survey data.…”