8.1 ANALYSIS OF PROJECTED NUMBERS IN POST AND VACANCIES
Each year, the Scottish Executive assesses the numbers of student nurses and midwives that require to be trained to meet the needs of NHS Trusts and other employers of nurses and midwives in Scotland over the following five years. In doing so, ISD Scotland obtains data from NHS Trusts (and others) on the number of nurses and midwives anticipated to be required over the next five years. These data are modelled to derive the number of students required and is published on an all-Scotland basis.
Each year, ISD publish data on vacancies for qualified nurses and midwives showing the number of vacancies (and the number of vacancies of three months' or more duration) as at 31 March per NHS Trust. The data can be viewed at http://www.isdscotland.org/isd/info3.jsp?pContentID=1350&p-applic=CCC&p-service=Content.show&
The vacancy data as at 31 March 2003, showed an increase in the long-term vacancies in Scotland (from 1.0% in 2002 to 1.1% in 2003). The position varied markedly throughout Scotland. In Greater Glasgow, long-term vacancies had more than doubled (from the Scottish average of 1.0% in 2002 to 2.5% in 2003).
The SNIP projections from 31 March 2003 indicate a significant increase in the number of qualified nurses required in Scotland over the next five years - particularly general and mental health nurses. While the trends apply throughout Scotland, there is an element of regional variation, e.g. an above average demand for mental health nurses in the West of Scotland.*
This analysis combines the two sets of data - qualified nurses required each
year over four years from 31 March 2003 and long-term vacancies as at 31 March
2003 - and
re-expresses the data on an NHS Board basis. The resulting projected number
of vacancies as at 31 March each year for the next four years is shown.**
The intention in this chapter is to prompt and inform a debate about how best to improve the situation and reduce the actual number of vacancies.
* Within the SNIP process, demand is forecast for each of the following five years. The number of student nurses for the intake in year one is set so as to allow supply to equal demand in year five - assuming that actual demand in year five is the same as that predicted five years earlier. It follows that there would, theoretically, be no vacancies in year five. The following analysis uses the first four years of the demand forecast.
** For the purposes of this report, the following composition has been used. North: Highland, Grampian, Orkney, Tayside, Western Isles, Shetland. East: Borders, Fife, Lothian, Forth Valley. West: Ayrshire and Arran, Argyll and Clyde, Greater Glasgow, Lanarkshire, Dumfries and Galloway, State Hospital.
DATA
The data are presented for all nurses and midwives and separately for general, sick children's, mental health and learning disabilities nurses and for midwives.
The appended tables show:
|
Title |
Details |
|
NHS Board |
The State Hospital in Lanarkshire and the Golden Jubilee National Hospital are shown separately. This relates to permanent staff only. |
|
ISD Vacancies - three months or more |
Vacancies as at 31 March 2003. ISD data on three months or more vacancies is also recorded in wte. For the purpose of this exercise, the data has been converted into headcount using the same parameters as for the SNIP baselines. |
|
Workforce at beginning of year |
Staff in post one year previously plus newly qualified nurse joiners in that year. |
|
SNIP increase (forecast demand) |
The anticipated headcount increase. This is based on each NHS Board's projected demand for registered nurses and midwives on a year by year basis. This is calculated by taking the anticipated number of students qualifying each year and applying the non-practice rates for each category as shown in Chapter 5. |
|
NQN joiners |
The anticipated number of newly qualified nurses recruited. This is the proportion of NQNs historically recruited to each NHS Board or region. |
|
Projected vacancies |
The previous year's vacancies plus the workforce at the beginning of the year multiplied by the net turnover rate plus the SNIP increase minus the newly qualified nurse joiners. The net turnover rate is calculated from linked NAMS data and an average is taken over four years. It is calculated as leavers - rejoiners - joiners who are not newly qualified nurses. |
Analysis of Data
|
The methodology applied to the combined SNIP and vacancy data assumes that the workforce dynamics (turnover, non-practice rates, etc.) in 2003 remain unchanged from 2004 to 2007. Initiatives such as those detailed in Chapter 6 are designed to recruit, retain and develop more nurses and midwives and the result of their success will be a reduction in the number of nursing and midwifery vacancies in the future. |
Registered Nurses - General
In Scotland, vacancies are currently running at 1.2% varying from 3.2% or 183 in Greater Glasgow to less than 10 in each of nine NHS Board areas. The 'Clyde Valley' NHS Boards of Argyll and Clyde, Greater Glasgow and Lanarkshire account for 36% of staff in post but have 68% of vacancies. This is not the result of Greater Glasgow being a 'teaching' NHS Board. The three other 'teaching' NHS Boards of Grampian, Tayside and Lothian account for almost as many staff in post (34%) but have only 23% of vacancies.
Vacancies are projected as follows:
|
2003 |
2004 |
2005 |
2006 |
2007 |
|
1.2% |
6.1% |
5.0% |
2.5% |
-0.4% |
The improvement in 2006/07 is partly the result of more NQN Joiners (as the significantly increased 2003 intake enters employment) but is the result of the SNIP increases being 'front-loaded' for 2004/05. This suggests that the service developments underlying the increase in Registered General Nurses are at risk of being delayed for a couple of years.
3.1.3 There is a projected increase in Registered General Nurses of 14% between 2003 and 2007 and the Greater Glasgow increase is in line with this at 14%. The projected vacancies for 2007, however, suggest -121 vacancies (i.e. a projected 'over-supply') in Scotland (down from 353 in 2003). -121 is a net figure - the 'Clyde Valley' NHS Boards of Argyll and Clyde, Greater Glasgow and Lanarkshire project 619 vacancies while the rest of Scotland has a projected over-supply of 740.
Registered Nurses - Mental Health
In Scotland, vacancies are currently running at 0.7% (with Argyll and Clyde having almost half the Scottish vacancies) but this is set to increase dramatically before dropping in the final year as follows:
|
2003 |
2004 |
2005 |
2006 |
2007 |
|
0.7% |
4.2% |
4.4% |
3.5% |
0.3% |
This is the result of significant SNIP increases - particularly in 2003.
When vacancies are at their peak in 2005, the 'Clyde Valley' Boards of Argyll and Clyde, Greater Glasgow and Lanarkshire have 54% of vacancies while having only 36% of Registered Mental Health Nurses in Scotland.
Registered Nurses - Learning Disability
The workforce is set to grow by only 2.3% from 2003 to 2007.
57 vacancies are projected for 2007.
|
2003 |
2004 |
2005 |
2006 |
2007 |
|
2.7% |
6.4% |
3.4% |
4.4% |
5.3% |
Registered Midwives
The midwifery workforce is projected to grow by 9.3% from 2003 to 2007 and vacancies are set to increase from 0.9% to 1.9%.
The projected vacancies peak at 4.1% in 2004 with Greater Glasgow having only 18% of midwifery staff but 28% of the vacancies. In 2007, Greater Glasgow and Lothian are set to have 64 vacancies whereas the rest of Scotland would only have a net total of seven.
|
2003
|
2004
|
2005
|
2006
|
2007
|
|
0.9% |
4.1% |
3.1% |
2.0% |
1.9% |
Registered Nurses - Children
The RN - Children is set to grow by 25% from 2003 to 2007 but the number of vacancies, although increasing in the intervening years, is only up slightly in 2007 at 3.3%.
The Clyde Valley NHS Boards of Greater Glasgow, Argyll and Clyde and Lanarkshire are projected to have 192 vacancies with the rest of Scotland having an oversupply of 119.
|
2003 |
2004 |
2005 |
2006 |
2007 |
|
2.0% |
7.9% |
6.7% |
5.9% |
3.3% |
REGIONAL ANALYSIS
The following tables show the NHS Board data re-expressed for the three Workforce Development Unit regions in Scotland.
|
East of Scotland |
2003 |
2004 |
2005 |
2006 |
2007 |
|
RN - General |
63 |
333 |
188 |
-71 |
-380 |
|
RN - Mental Health |
4 |
114 |
84 |
69 |
16 |
|
RN - Learning Disability |
0 |
18 |
41 |
58 |
70 |
|
RM |
2 |
41 |
27 |
10 |
2 |
|
RN - Children |
0 |
52 |
25 |
4 |
-19 |
|
All |
69 |
558 |
365 |
70 |
-311 |
The East of Scotland was projected to have an over-supply of RNs - General and Children but an under-supply of RNs - Mental Health and Learning Disability and of RMs.
|
North of Scotland |
2003 |
2004 |
2005 |
2006 |
2007 |
|
RN - General |
51 |
301 |
274 |
111 |
-109 |
|
RN - Mental Health |
2 |
42 |
50 |
35 |
-21 |
|
RN - Learning Disability |
0 |
17 |
-20 |
-30 |
-28 |
|
RM |
15 |
29 |
17 |
6 |
-6 |
|
RN - Children |
2 |
-12 |
-32 |
-38 |
-68 |
|
All |
70 |
377 |
289 |
84 |
-232 |
The North of Scotland was projected to have an over-supply in all five categories of nurses and midwives.
|
West of Scotland |
2003 |
2004 |
2005 |
2006 |
2007 |
|
RN - General |
239 |
1118 |
1039 |
752 |
368 |
|
RN - Mental Health |
40 |
128 |
179 |
152 |
32 |
|
RN - Learning Disability |
28 |
28 |
14 |
18 |
14 |
|
RM |
13 |
67 |
62 |
57 |
75 |
|
RN - Children |
33 |
101 |
137 |
158 |
160 |
|
All |
353 |
1442 |
1431 |
1137 |
649 |
The West of Scotland, on the other hand, was projected to have an under-supply in all five categories of nurses and midwives.
The following table shows the position for Scotland as a whole.
|
Scotland |
2003 |
2004 |
2005 |
2006 |
2007 |
|
RN - General |
353 |
1752 |
1501 |
792 |
-121 |
|
RN - Mental Health |
46 |
284 |
313 |
256 |
27 |
|
RN - Learning Disability |
28 |
63 |
35 |
46 |
56 |
|
RM |
30 |
137 |
106 |
73 |
71 |
|
RN - Children |
35 |
141 |
130 |
124 |
73 |
|
All |
492 |
2377 |
2085 |
1291 |
106 |
There is a projected over-supply of RNs - General but an under-supply in the other four nurse categories. The student nurse intake levels recommended as the result of the 2003 SNIP exercise aim to reduce the under-supply in these four nurse categories.
CONCLUSION
Across all registered nurse categories, the qualified nursing and midwifery workforce is set to grow by 13% from 42,734 in 2003 to 48,446 in 2007 - an increase of 5,712. (See projected table on all registered categories.)
Vacancies are set to decrease from 492 in 2003 to 106 in 2007 - a decrease from 1.2% to 0.2% - although there are significant projected increases in the intervening years.
|
2003 |
2004 |
2005 |
2006 |
2007 |
|
1.2% |
5.7% |
4.8% |
2.8% |
0.2% |
Across all registered nurse categories, the net figure of 106 vacancies in 2007 is made up of 953 vacancies in the Clyde Valley NHS Boards of Greater Glasgow, Argyll and Clyde and Lanarkshire and an oversupply of 847 in the rest of Scotland.
The above analysis assumes that the workforce dynamics (turnover, non-practice rates, etc.) in 2003 remain unchanged from 2004 to 2007.
Initiatives under the 'Facing the Future' banner are designed to recruit, retain and develop more nurses and midwives and the result of their success will be a reduction in the number of nursing and midwifery vacancies in the future. NHS Boards - particularly those in the Clyde Valley corridor - need to make sure that they make the most of these initiatives.