Children’s hospice nursing shortage hitting care for sickest children
- Survey of children’s hospices shows nurse vacancy rate higher than NHS - has grown since 2015.
- The number of children and young people who use lifeline children’s hospice services is increasing.
- Yet the nursing shortfall means that children’s hospices are being increasingly forced to cut back the vital palliative care they can offer to families.
- The UK’s health workforce planners do not assess the demand for children’s nurses among children’s hospice organisations or include them in their wider nursing vacancy rates.
- An urgent UK-wide summit is needed to discuss the children’s palliative care nursing workforce with the UK’s governments, the NMC, the Council of Deans of Health and the agencies who are responsible for commissioning nurse education places across the UK.
Our new survey shows that the UK’s children’s hospices have a growing shortage of nurses. The gaps mean that children and young people with life-limiting and life-threatening conditions - Britain’s sickest children - are missing out on lifeline palliative care, including short breaks which can help prevent their families from separating.
The snapshot survey of 24 UK children’s hospices shows that the average nurse vacancy rate was 11% in mid-December 2016 (an increase of 1% on the rate in 2015) and higher than the overall NHS nurse vacancy rate of 9% in England, Northern Ireland and Wales. This represents over 130 full time posts unfilled.
Many hospices report that it is getting harder to fill nursing posts, with nearly two thirds (65%) of the unfilled posts vacant for more than three months. A quarter (25%) remain vacant for over a year. The survey suggests there is an increasing shortage of experienced nurses to care for children with rare and complex health conditions: the number of vacancies was highest at salaries equivalent to NHS Band 6 (in 2015 it was Band 5).
The number of children with life-limiting and life-threatening conditions who rely on children’s hospice services is increasing. Yet the nursing shortfall means that children’s hospices are increasingly being forced to cut back the vital palliative care they can offer to families. The majority of services say that vacancies are having an impact on care - including a reduced offer to families or reduced short breaks (58% of respondents compared to 43% in 2015). Nearly one fifth (17%) stated that they were being forced to close beds. For the first time, three (13%) services reported that vacancies affected their ability to provide 24/7 care. Short breaks are a lifeline to families and can reduce parental stress and the risk of family breakdown. Together for Short Lives is very concerned that a reduction in short breaks and hospice care could have a big impact on family wellbeing.
Barbara Gelb OBE, CEO of Together for Short Lives, said: “I am deeply concerned by nursing shortages we have found; it’s a growing problem. And it’s shocking that children’s hospice services are having to reduce vital services as a result - they provide lifeline palliative care to Britain’s sickest children, helping to manage their pain and symptoms and maximising their quality of life and end of life care. Over a third (36%) of families caring for seriously ill children break down3 and children’s hospice services play a crucial role in giving them desperately needed breaks from caring. That’s why I’m calling on the UK’s governments, health workforce planners and universities to urgently work with us to find a way of boosting the supply of nurses to children’s hospices services now - so they don’t reach crisis point.”
For the first time, Together for Short Lives has also surveyed university child nursing undergraduate degree courses to find how they are teaching children’s palliative care. A small sample of 15 (25%) course leads responded. Although there were many positive signs that courses included elements of best practice in their curricula, over a quarter of those who responded (27%) stated that they had not devised children’s palliative care competencies for their students. Together for Short Lives found that a third of universities which responded (33%) are planning to increase their children’s undergraduate nursing course intake in the future.
Barbara Gelb OBE continued: “It is vital that universities help meet the children’s hospice nursing shortfall by educating enough children’s nurses and including children’s palliative care on their curricula. Together for Short Lives makes an open offer to work with the Council of Deans of Health and undergraduate children’s nursing course leads to make sure that education programmes for children’s nurses equip them to care for our sickest children. Children’s palliative care nursing is an amazing profession and we want more people to have the opportunity to experience this incredibly rewarding career.”
Read Together for Short Lives full report: The state of the UK children’s hospice nursing workforce - a report on the demand and supply of nurses to children’s hospices.
Together for Short Lives launched the #YouCanBeThatNurse campaign last Autumn to highlight what a rewarding role children’s palliative nursing is and to encourage school leavers, student nurses and existing registered nurses to consider a career in the sector. You can watch the #YouCanBeThatNurse film here.
For job and volunteering opportunities in children’s palliative care please visit our jobs page.