This week, the Royal College of Nursing has analysed data which suggests that nine in ten of the largest NHS hospital trusts do not have enough registered nurses to provide safe and appropriate care. The Royal College of Paediatrics and Child Health (RCPCH) has published a report on the paediatric health workforce in Scotland, while Health Education England will allocate additional funding for clinical training places to universities and NHS trusts. The Government has also published two position papers on key Brexit issues in an attempt to accelerate progress in negotiations.

RCN analysis highlights hospitals’ nursing staff shortages

Analysis of data from NHS Choices, conducted by the Royal College of Nursing (RCN), has demonstrated that of the 50 largest NHS hospital trusts, nine in ten do not have enough registered nurses. As a result of these staff shortages, the RCN says that hospitals are placing healthcare assistants on wards in place of nurses, and in two thirds of the trusts analysed this happened particularly at night. The RCN has recently suggested there are 40,000 nursing vacancies across the NHS in England.

The Chief Executive of the Royal College of Nursing, Janet Davies, said that “In light of this, the Government must redouble its efforts to train and recruit more qualified nurses and stop haemorrhaging the experienced ones who are fed up, undervalued and burning out fast.” Davies also highlighted that where healthcare assistants are being used in place of nurses, they are being placed into situations that they might not have the expertise to handle.

RCPCH publishes report on paediatric workforce in Scotland

The Royal College of Paediatrics and Child Health (RCPCH) has published a report focusing on the paediatric workforce in Scotland, following its wider State of Child Health report published earlier this year. The report analyses date from nine of the 11 health boards providing child health services (81.8%), which include 14 paediatric inpatient units, 15 neonatal units and 17 paediatric outpatient services. 25% of the inpatient units which responded had to close to new admissions at some point during 2015/16 because of staff shortages, compared with 31.3% of inpatient units across the UK. These Scottish units also had to close less times on average than units across the UK, closing 0.8 times compared with 2.9 times.

However, 41.7% of neonatal units in Scotland had to close to new admissions during this period compared with 41.1% of neonatal units across the UK. The College is using the statistics to call on the Scottish Government to provide between 84 and 110 additional paediatric consultants to meet demand and workforce standards, which would meet the target for this area of the workforce to grow by 27-25%.

Universities given additional funding for clinical training places

Following the publication of A-Level results this week, Health Education England has told universities and NHS trusts that funding will be made available for an additional 1,500 clinical placements through the university clearing process. The announcement comes as part of a government drive to increase the number of training places for doctors and nurses, with the Department of Health allocating £16.4 million to increase the number of students training in the professions. This year’s allocation will be followed by funding for an additional 2,500 placements in 2018/19.

In addition to ongoing recruitment concerns, nursing professionals have argued that the replacement of the NHS bursary in favour of a student loan for nursing and midwifery students will adversely affect the number of nursing students. A letter from Health Education England stated that “All [Higher Education Institutions] running clinical undergraduate pre-registration which previously attracted bursary funding […] are eligible to have a 4.6 per cent uplift in the number of HEE funded clinical placements associated with those courses.” The number of places will have to be agreed between individual universities and trusts.

Brexit developments: Government publishes customs union and Ireland position papers

The Government has published position papers on future customs arrangements with the EU and the border between Northern Ireland and Ireland after Brexit. The papers were published in an attempt to make progress in the negotiations, with the EU having insisted that they wanted further clarity on the UK’s position on a number of key issues. The paper on future customs arrangements proposes an interim, time-limited customs agreement, which aims to avoid disruption for businesses and individuals and will take effect once the UK leaves the EU in March 2019. During this period, the Government intends to negotiate its own international trade deals, something it cannot do as a member of the EU’s Customs Union.

For a long-term customs arrangement, the Government proposed two approaches: a highly streamlined customs arrangement that would extend customs processes to all trade with EU Member States; or a new customs partnership with the EU which would see the UK align its customs regime with that of the EU. A spokesperson for the European Commission said that future customs arrangements will only be discussed once sufficient progress has been made on the terms of the withdrawal – namely on citizens’ rights, the financial settlement and the Irish border.

To address the issue of the Irish border, the Government’s second position paper stated that it would not create border posts along the Irish border. The paper argues that 80% of Northern Ireland firms which would be looking to trade across the border are small or medium sized engaging in local (rather than international) trade, and so should not be subjected to any additional checks after Brexit. There are suggestions that larger activities could have their activities monitored through CCTV systems rather than physical border checks and posts, which is seen as key to upholding good relations between the two sides.