Using data to understand the social dimensions of the nursing profession

Many years ago, I trained as a nurse in the Fife College of Nursing & Midwifery.

I loved my time there and developed a passion for my profession. I qualified as a Registered General Nurse and practiced for several years. With increasing academic requirements, I then went to university and studied the social sciences, eventually doing my doctorate at the University of St Andrews, which had a growing reputation for using large, linked administrative data. The work being done there struck me as being amazing – here you had research that demonstrated how people’s social circumstances could impinge on their lives. Since then I have wondered if those approaches could be applied to the nursing profession.

After getting a lecturing post, I was fortunate to become a member of the Scottish Centre for Administrative Data Research (SCADR). This has enabled me to develop my understanding of routinely collected data and how it can be used for social science research for public benefit. One current project is looking to contribute to our understanding of the nursing and midwifery professions; specifically about recruitment, retention, and diversity.

Recruitment and retention in a socially diverse profession

The nursing and midwifery professions are experiencing notable challenges to recruitment and retention. A report from June 2022 indicated that NHS Scotland had over 6,000 unfilled vacancies, which was a jump of 24% from the year before. That figure does not include the social care sector so overall will be even higher.

The Nursing and Midwifery Council (NMC) indicate that there are some 750,000 people on their nursing and midwifery registers. That’s equivalent to a city bigger than Glasgow. That is a very large number of people spread out across a considerable number of clinical areas and with many different roles.

Finding ways forward is challenging when the profession is so large. Nurses live in a range of social circumstances, which may affect their ability to work full-time, or even to remain engaged in the profession. Yet very little is known about the socio-economic composition of the profession or how social and geographic circumstances impact on retention and recruitment. We hope that our research exploring the dynamics of the nursing workforce will help with this. 

The potential of administrative data to inform policy

SCADR has worked with the NMC and Office for National Statistics (ONS) to develop an anonymised dataset from the NMC register for secure researchers to address key questions. When a person is registered as a nurse or midwife, information such as date of qualification and place of qualification is captured. Analysing these dynamics over time creates a longitudinal dataset, enabling us to show:

• how long people stay in the profession
• moves from one part of the register to another, eg: hospital or community settings
• moves from one location to another
• how long people remain in the profession – is retention affected by what their role is or where they are based?

Findings will be released through blogs and reports on the SCADR website and elsewhere in academic papers and professional journals which will importantly feedback to those most affected: nurses themselves. We can then propose to policymakers to use this evidence to help create supportive policies.

Our next steps will be to address questions made possible by linking to the 2021 census for England and Wales. The census data includes answers to a range of questions that can enable analysis to:

• ascertain the social composition of the professions
• gain information on health and occupation.

Initial insights will look to ascertain how many registrants were practicing in the week of the census and reasons for not practicing.

Developments in the future

What happens thereafter will be influenced by developments in the nursing and midwifery professions, what administrative data exists and how we are guided by our stakeholder group. Key to our work is that it must support our nursing and midwifery professionals and enable them to practice effectively. If it does the latter, it has been successful.