Where Have All The EU Nurses Gone?

I work as a nurse in London and I’ve always worked in very ethnically mixed staff teams, it’s one of the joys of working here. I currently work with a Portuguese nurse who is extremely good, when she was promoted to a Band 6 role I was very happy.

I have worked with many, many EU nurses. They have been some of the best nurses I've worked with. The NHS in London would not be able to function without all the EU nurses who work here. But London isn’t the only place in this country were the NHS is reliant on EU nurses. The NHS employs 33,000 EU nurses (1), a little over 10% of all the nurses it employs (2), and these nurses have enabled many NHS services to keep going.

But it now looks as if we are to lose those EU nurses we so desperately need.

A Freedom of Information request has shown that there has been a 92% fall in EU nurses coming to work here since the Brexit referendum in July (3). Only 96 nurses applied to work in Britain in December 2016 (3), compared to 1,304 in July 2016. 2016 also saw 2,700 EU nurses leave the NHS, when only 1,600 left in 2014 (3). That is a 68% increase.

This only adds to the shortage of nurses plaguing the NHS, and leaves it facing a problem that will only impact on patient care.

Since 2010, there has been a 15% fall in the number of student nurse places being funded (4). Add to this that there is a dropout rate of 26% on nurse training courses (5) and we are not training enough nurses. We are also facing an ageing nursing population, 45% of registered nurses are now over 45 (4).

Since 2003 there has been a 50% increase in empty NHS nursing posts (6), EU nurses have been very important in filling many of the gaps in the NHS nursing workforce. Without them we would be a far worse place than we are now, but soon we may be finding out what that place will be like. We are losing our EU nurses and we should be very worried.

There is only one reason for this sudden and huge lose of EU nurses and that is Brexit. No matter how you voted in the referendum, Brexit has made Britain a very unattractive place for EU workers. This could have been eased by Theresa May offering a guarantee to all EU workers in Britain that they are safe to continue working here as long as they want to, but she has refused to do this (7). Therefore Britain is no longer seen as a safe place to work for EU nationals, and the NHS is suffering already.

What is Jeremy Hunt, Minister of Health, doing in the face of this sudden and dramatic loss of EU nurses? Is he lobbying Theresa May for special protections for EU nurses? Is he working hard to portray the NHS as still a safe and welcoming place for EU nurses to come and work in? No. He is denying that there is even a problem. He has said, in answer to MPs questions about this 92% fall, that it was not caused by Brexit but, “the reasons why there has been a drop in the number of nurses coming from the EU is because, prior to the Brexit vote, we introduced much stricter language tests.” (8) The level of his denial is breath-taking and this is the man in charge of the NHS, but he has previously bluntly ignored problems facing the NHS, why should we expect different now?

The NHS needs its EU nurses, there is no debate about that because the figures back this up, but Brexit has cast a shadow over them. If we lose them the NHS will hit a crisis that could easily eclipse the Mid Staffordshire scandal (9). But our leaders are openly ignoring this. Theresa May’s and Jeremy Hunt’s words and actions show that they are not concerned about this and are not going to take any actions to stop this.

What do we do when our political leaders ignore another crisis facing the NHS?… Pray for a revolution?

Drew Payne

When Emails Go Wrong, And Wrong, And Wrong…

On Monday (14/11/2016) my NHS email crashed (1), leaving me very frustrated because I was waiting for an email from my manager. Nothing new there, many people may say because emails crash all the time, but my NHS Email crashed because it was full of emails.

NHS Email is the secure email system for NHS staff, it enables us to safely and securely send emails that contain patients’ details, which is vital for many of our jobs.

Monday’s crash began when one person managed to send an email, entitled “Test”, to everyone on the NHS Mail system. That was 1.2 million different people (2). Now this single email alone didn’t crash NHS Mail, what happened next did. Thousands of people, annoyed at receiving this email, replied to say to remove them from this email list, but many, many of them hit the Reply All button to do so. Their email then went out to all 1.2 million people on NHS Mail. Again and again this happened and rapidly the whole system was clogged up with emails.

The distribution list on the original email was disabled (1) but the harm had already been done. The email had gone out and thousands and thousands of people were hitting Reply All when they received it. I was still receiving those damn Reply All emails at gone 9 o’clock at night on Monday.

So an email system crashed, Google Mail has crashed more than once before now. But for many NHS staff we just can’t do our jobs without our NHS Mail. The District Nurse team I work in cannot function without NHS email. We get all our referrals via email. We communicate with GPs, other District Nurse Teams, Social Workers and other healthcare professionals via email. We get all our messages from patients via email. While out visiting patients we get messages via email, we all have work IPads. We also get our list of patients we are to visit via email. My colleague Christina said it was a “nightmare” on Monday when NHS Mail crashed.

Unfortunately hitting Reply All isn’t an uncommon problem on NHS Mail. Regularly at work, I receive emails to the whole of the District Nursing Service, usually about training or a planned meeting or such, and so many people hit Reply All instead of just replying to the sender. They share their email with the whole District Nursing Service. I get to know that she is on annual leave then and he is attending another meeting and she has child care issues, and so on. Personal conversations are blasted across the service, and they are never that interesting.

Monday highlighted another major problem though, a lack of training for NHS staff. We are not born knowing how to use email, it’s not “common sense”. For many people who use NHS Mail it is only time they use email, or if they use email at home it is not often. Many NHS staff are not highly computer literate, I know from working in the NHS for over twenty years, but today we simply expect that people know how to use IT. We don’t train people to use IT, so NHS Mail crashing is going to happen again.

The NHS is facing one of its worst funding crisis in living memory (The second half of this blog explains in detail how NHS funding is falling in real terms). When funding is short the first thing that is cut is staff training. Not just IT training but training across the board. There have been cuts to training budgets in all NHS trusts, ranging from 12% in some trusts right up to 45% in other trusts (3). Not training staff will have a detrimental effect on patient care. If staff are not trained how can they implement new treatments and new patient care strategies? Plans to improve NHS productivity, new methods and models of patient care to deal with the ever increasing demand, are being seriously undermined by these cuts to training budgets (4).

Again the NHS and patient care is being short changed by this government’s short sightedness. If we want the best quality healthcare then we need the best trained staff, and cutting training budgets will never achieve this.

And last irony from Monday’s crash, the original email that was sent out to everyone on NHS Mail was sent out by IT contractor at Croydon NHS (2).

Drew Payne.