Staffing shortages

170,000 registered nurses left the register between 1990 and 2000 There were nearly 9,200 whole time equivalent long-term vacancies at 31 March 2001

The research found 24% of registered nurses are set to retire in the next five years.

Only one in eight nurses is under 30, compared to one in four 10 years ago.

The problem is particularly acute in community nursing, where the average age is now 48.

Some 12% of district nurses are aged over 55 and eligible to retire at any time.

Looking overseas

The RCN said recruitment of overseas nurses had become a vital way to boost numbers. Last year 40% of new entrants were foreign recruits.

But it warned the UK cannot continue to rely on a ready supply of nurses from other countries as competition from other markets - including the US - intensifies.

RCN General Secretary Dr Beverly Malone said: "To attract nurses and especially to keep them for the long term, the government needs to invest seriously in the workforce through a modernised pay and careers structure.

"The chancellor's spending review is critical to delivering this investment over the next three years.

"Nurses want better career opportunities, the chance to take on new roles, support to develop their skills and a fairer pay system.

"We all know that nurse shortages impact on patient care. Without enough nurses, the government's plans to modernise the NHS would be at serious risk."

Government response

A Department of Health spokesman said the NHS Plan promised that by September 2004 there would be 20,000 more nurses, midwives and health visitors working in the NHS.

Our objective is to improve the working lives of nurses to make nursing an even more attractive career and to keep them working in the NHS

Department of Health

"That is exactly what has happened, well ahead of schedule.

"But there is no room for complacency. What we don't want to see now is these additional nurses coming into the NHS through the front door only to find more leaving through the back door.

"That is why we are now switching the emphasis from nurse recruitment to nurse retention.

"Our objective is to improve the working lives of nurses to make nursing an even more attractive career and to keep them working in the NHS."

Tories

Dr Liam Fox, shadow health secretary, said the Tories had repeatedly called on the government to take urgent steps to restore the attractiveness of nursing as a profession.

He said: "In particular, we have stressed the importance of retaining existing staff.

"It is all well and good for the government to trumpet increases in nurse recruitment.

"But until ministers change their ways - by creating an environment in which nurses can provide care in the way they were trained to do - many of the benefits, which this brings, will continue to be frittered away."

The RCN report - Behind the Headlines - was produced by the Faculty of Social Sciences and Health Care at Queen Margaret University College, Edinburgh.