For nurses in the UK, 2017 is a year of change. From Brexit to IR35, and well-publicised frontline staff shortages, a wide range of factors are influencing the day-to-day life of the average UK nurse.
Here, we look at how some of these factors are playing out.
The consensus seems to be that Brexit will discourage applications from overseas nurses, especially those from within the EU. If this is the case, nurses already working in the UK will face being even more overworked – that’s the big concern. After all, workload is already rising steeply every year: since 2010, there are 31% more hospital admissions, 45% more procedures, and 22% more patients in A&E.
However, this theory hasn’t become practice just yet. At HCL, applications from EU candidates have actually gone up rather than down since Brexit was announced. And while the mainstream press is reporting that less EU nurses have arrived in the UK since the EU Referendum, there may be another cause of this: IELTS testing. The revised banding that was introduced in January 2016 has seen a huge decrease in EU recruitment.
But undeniably, Brexit will affect nurses in the UK – whether they’re UK or EU citizens. If recruitment is impacted, workload will be too. It’s a worry, and the current workforce will need support and reassurance.
IR35 is a tax law. It was introduced in 2000 to prevent tax avoidance by workers supplying their services to clients – like the NHS – via an intermediary. But recent changes mean that the clients, rather than locum nurses themselves, will now decide whether they fall inside IR35.
In short, IR35 is affecting UK nurses because it adds some potential complication to how they’re paid, and how they manage their payments. In many cases, trusts will want to move agency nurses to an in-house bank as a result, so UK nurses will have to weigh up how this might affect their career and their working lifestyle.
Scrutiny over agency spending
Whether it’s advocated through so-called Sustainability and Transformation Plans (STPs) or the Carter Review, a consistent demand for NHS trusts is that agency spending on nurses must be reduced.
Many UK nurses choose to work through agencies as locums for good reason. They believe it offers them more flexibility and a better work-life balance, while many others think it makes more sense financially. It can also help nurses to build up more varied experience over a short period of time, boosting their CVs and opening new career opportunities.
But the effect of reduced agency spending will be felt by all UK nurses. Locum nursing hasn’t developed out of thin air; it’s the result of frontline demand. Without it, permanent nurses would be drastically overstretched, and patient safety would be threatened. So it’s a complex issue, and the rhetoric doesn’t always fit well with reality.
The ageing population
We have an ageing population: the median age in 1985 was 35, today it’s 40. Over the next two decades, the number of people over 85 – an age group that uses substantially more healthcare services than any other – will double.
For the UK’s nursing workforce, this clearly adds to an already heavy workload. If recruitment of new nurses can’t keep up, how can they manage the increased demand alone? It’s also important to consider the specific challenges of nursing an ageing population – it presents unique challenges, and often requires a very specific skill-set. UK nurses will need to adapt.
Nursing was never an easy career…
2017 is a year of big challenges for UK nurses. Major social and political issues like Brexit and our ageing population are affecting their everyday working lives. Sometimes they’ll be overworked and overstretched – and sometimes it will seem like a relentlessly difficult job.
But people don’t become nurses casually. There are easier ways to earn money; there are simpler means of paying the bills. Nurses do what they do because they’re at their best when under pressure, and they’re passionate about helping people. And nurses from all over the world continue to pursue careers in the UK because it remains a fantastic place to work.
So, while 2017 might appear to be a tough year to be a nurse, it’s worth looking at nursing with some perspective. It’s never been an easy job, and while the resilience of nurses mustn’t be pushed to its limits, it must also never be underestimated.
Liked this? Watch our video The NHS in Numbers for more insights on the pressures put on the NHS and its employees.