Executive Summary
Nursing care is a vital service in both the public and private healthcare
markets. Within the National Health Service (NHS), the majority of nurses are
employed in directly-managed and NHS trust hospitals or in the primary
healthcare sector. The NHS's Hospital and Community Health Services (HCHS)
division spent £6.18bn on employing NHS nurses in England in 1994/1995 and
a further £132m on agency nurses. As such, nursing care accounted for
29.8% of total HCHS current expenditure.
Nursing and midwifery is the largest staff group in the NHS, with nurses
delivering 80% of direct patient care. On a whole-time equivalent basis, the
NHS employed 247,880 qualified nurses and midwives in 1994 and an estimated
248,000 such staff in 1995. In addition, the NHS employed a further 92,550
unqualified nursing staff of nursing auxiliary/assistant status.
Within the private healthcare market, the main call for nursing staff is within
nursing homes. The recent significant increase in the demand for nursing care
by this sector is largely as a result of government policy, which has turned to
privately-run homes for its provision of care. Of the total supply of qualified
nursing care in privately-operated hospitals and nursing homes, 84% of staff
were employed by private nursing homes.
In addition to the nursing care needed in private sector establishments, which
are operated on a `for-profit' basis, nursing skills are also required by
charitable organisations, such as hospices or charity-status nursing homes and
hospitals.
Both the public and private healthcare sectors utilise nursing agencies to
provide supplementary nursing care requirements. The largest player in the
nursing agencies market in the UK is BNA owned by Nestor-BNA PLC.
Of major current importance to the nursing care service is the issue of skills
shortages. Both the NHS and private sector employers have experienced
difficulties in recruiting qualified nurses due, largely, to a cutback in the
number of student nurse places. Nurses' education has undergone a number of
reforms in recent years, including a revised form of preregistration nurse
education and training.
Current indications suggest that the supply of newly-qualified nursing staff
will continue to decline in the forseeable future. Only 9,000 qualified nurses
are expected to complete their training in 1997/1998, compared with 14,000 in
1995/1996 and 37,000 in 1983.
First Edition 1996
Edited by Richard Caines
ISBN 1-85765-570-2
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