Response by The Queen’s Nursing Institute (QNI)

The Report of the Committee’s Expert Panel on the health and social care workforce in England was published on 25th July 2022.

The Report is an evaluation of the Government’s overall progress on delivering its workforce commitments in the National Health Service and social care.

The report should be praised for its depth and insight into a wide range of fields that affect the health and social care workforce today and repays close reading.

The report shows that the challenges and shortfall in numbers facing the healthcare workforce affect all clinical health and social care professions, occupations and specialisms. The prediction that almost a million new staff are needed across health and social care to cope with growing demand and to replace staff leaving and retiring is a sobering figure. Nurses in the community will be very familiar with this picture in their own geographical areas and in their own teams.

Workforce Planning

The Report criticises the Government for lacking a realistic workforce plan, and a failure to commit to real numbers rather than general ambitions. This lack of clarity undermines confidence in the Government’s stated plans for the NHS and social care and improving population health.

The QNI has long argued that shortages in the community nursing workforce leads to greater pressures in other parts of the health and care system and the Report gives robust and independent evidence that there is no part of the NHS that is insulated from chronic staff shortages.

The decision to cut the NHS bursary for nursing students was criticised by nursing organisations including the QNI when that decision was made. In light of the continuing nursing shortages, and struggle to recruit and retain staff, any policy measure that makes it harder to train as a nurse in England must be viewed as very unwise.

The Report notes that funding to Health Education England has fallen in real terms between 2013-14 and 2019-20, which is of serious concern given the future funding arrangements for District Nurse education, highlighted by the QNI’s own report published on 19th July.

Rising Cost of Living

The cost-of-living crisis is being keenly felt by nurses and if pay rises are below the rate of inflation this will mean a drop in real income, weakening the ability of the NHS to retain staff.

Charities such as the QNI have a vital role to play in supporting members of the health and social care workforce, and they must use their resources in a highly targeted, agile and efficient way to deliver the maximum good. The QNI offers financial assistance to community nurses in need, educational grants, and initiatives such as the ‘TalktoUs’ Listening Service for nurses who are facing work or life challenges.

Imperfect Technology

The report cites work by the Queen’s Nursing Institute (p.49 and p.57) around challenges with digital technology in health and social care:

“The most recent social care White paper points to research suggesting that 23% of care home staff cannot access the internet consistently at work, and 45% of social care providers expressed concern that care staff lacked digital skills. … Interim data from a 2022 survey from the Queen’s Nursing Institute (QNI) shows that 79% of respondents experience poor connectivity when seeing patients, and 37% of respondents stated that they cannot access a GP electronic record to facilitate patient care. The QNI interim survey findings suggest that systems are slow, with connectivity and power issues, little integration and are poorly designed, for example with different versions of care plans. The RCN also pointed out that more technology in the care setting will require accompanying nursing capacity to implement it.” (Page 49).

The Report highlights that while innovations in technology have led to system improvements, they are not in themselves a solution to a workforce that is under strength, given a rising and ageing population and growing complexity of healthcare needs.

Working Conditions

The QNI welcomes the emphasis on working conditions in the report, the quality of which affects staff recruitment and retention of community nurses in a competitive labour market. The Report finds that existing strategies to improve working conditions for staff are often vague and lack sufficient funding.


The primary purpose of the Report is not to propose solutions for Government but to comment on its progress. Rather, the Report threads advice and suggests solutions to problems throughout the document, based on evidence from a large number of organisations, rather than listing them all in a single place.

As a solution-focused organisation with very strong links into the nursing workforce in the community, primary care and social care, the QNI is ideally placed to support future work by the Department of Health and Social Care to strengthen its plans for the healthcare workforce in multiple areas.

The QNI is currently undertaking a national workforce survey to determine the number of registered nurses who are employed in community settings, as this data is currently fragmented due to the number and diversity of employing organisations. The results of this work will contribute to knowledge around current and future staffing needs.

The QNI is also undertaking a survey to update its report, ‘Nursing in the Digital Age’ published five years ago, to assess how the adoption and use of technology has changed over the past five years, and where further improvements are most needed in the community setting.


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