3. Will the Minister make a statement on staff retention in the Welsh NHS? OAQ54384

Yes. Recruitment and retention is a priority for the Welsh Government and the national health service. Health boards and trusts are leading on initiatives to improve retention, such as return to practice and improving staff well-being. The Welsh Government has also put in place a range of measures to increase the supply of healthcare professionals.

Thank you, Minister. Through written Assembly questions, I have unearthed an alarming fact about the number of nurses in Wales: 4,727 have left the Welsh NHS since 2016/17. And get this: in 2018/19, there were more leavers than joiners. We need more registered nurses to deliver care, and as the Royal College of Nursing in Wales has advised, this requires a focus on both recruitment and addressing retention. As it stands, however, increasing recruitment is not sustainable without improving retention rates. So, Minister, will you commit to investigating why there is such a high number of leavers in Wales, and will you develop an NHS workforce strategy that is focused on providing safe working conditions and more flexible working to actually help our hardworking nurses across Wales?

The Member may have picked up and forgotten, when reading out her supplementary question, that we talked about the NHS workforce strategy in response to two questions earlier on today. I recognise that, last year, the last year for which we have figures, there were 65 more leavers than joiners in terms of the nursing workforce; that is in contrast to a steady trend of increases in nursing numbers. Between 2009-18, nursing numbers have gone up by 3.8 per cent in total. The Member reflects figures of people who have left the service, but, of course, we are recruiting each year as well. The Member will also know that we have regularly rehearsed within this Chamber the work that we are doing on looking to recruit further nurses. The ‘Train. Work. Live.’ campaign has been successful. In fact, the Royal College of Nursing themselves have been complimentary about that particular campaign. It's also a matter of fact that, in the last five years, we've increased nurse training places by 68 per cent in Wales. So, we are doing all that we can and should do to increase the number of nurses coming into the profession, as with, indeed, the work that we are doing—the Member referred to some of it—on making sure we have more flexible patterns that reflect the reality of someone's work to try to make sure that we retain the nurses that we currently have as well. The big factor, of course, that will affect some of our ability to recruit nurses in the future is our continuing relationship with Europe, where we still recruit and have a number of European Union and wider economic area nurses within the NHS family.

Minister, I'm very pleased to hear the answer you've just given and the efforts the Welsh Government are putting into developing and training more nurses across the area. I speak to nurses—it's not just nurses, but other professionals across the health service—and I want to praise the work that they do, because many of them, if not all of them, go above and beyond their normal working conditions and actually put a lot of effort in, but it takes a toll on the nurses and other staff. They get to a point where they just can't take any more, and they have to, therefore, look to get out early.

You've talked about flexible working. I've raised this with my own health board on occasion. Will you look at opportunities, because some of the nurses who are leaving and going to agencies do it because they want to have greater control over the hours they work? They want to have the ability to have, actually, a better work-life balance with their families. Therefore, will you look at the flexibility of working contracts so that nurses can, actually, have that within the NHS, without having to go to an agency to have that work-life balance that makes the difference to them? It shows that they are cared for and they are well respected by the system, not just by the patients.

I recognise the points that the Member makes. This is something at different points in the training cycle of members of national health service staff, but also when they're at different points in their working life. That's why it's been important for me to retain the NHS bursary. We've seen the impact of removing the bursary in England, where, in particular, it's had a catastrophic impact on recruiting learning disability nurses, who are often more likely to be mature nurses.

There's also the point about that flexible working pattern that'll be important at various different points in someone's life, whether it's about caring responsibilities for adults or children, or, actually, just people wanting to be in a different stage of their life towards the end of their career as well, because we do rely on staff goodwill to provide the service

So, yes, that is part of what we are looking at, not just about the future and into the distance, but it's part of what health boards are already trying to address today. But it goes back to one of the points that I made to Dai Lloyd about our ability to make the system-wide reform that we think we could and should do, and how quickly we're able to do it, because this is a priority in the here and now, and not just in two or three years' time.