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International Workforce Forum 2024

Professor Nicola Ranger 14 Mar 2024

Nicola Ranger reflects on issues facing nursing globally and the solutions to meet those challenges in the UK. 

At the end of February, I joined leaders from 13 national nursing associations at the International Council of Nurses (ICN) 2024 International Workforce Forum. I was pleased to have the opportunity to join senior nursing colleagues from around the world to discuss the issues facing our profession globally – as well how different countries are approaching the solutions to these shared issues. I came away from the event feeling inspired by this spirit of collaboration, but also deeply concerned at how far behind the UK is in addressing the challenges we face as a profession.  

As well as being a delegate, I was there to present on safe staffing, highlighting the critical situation in the UK and the urgent need for action to ensure a maximum number of patients per registered nurse for the benefit of patient safety. We’re all too aware of the acute shortage of nursing staff in the UK, but last year, the ICN said it considers the lack of nurses a global health emergency – and nothing has changed. 

At our own safe staffing summit in December, we heard strong evidence of the benefits of setting nurse-to-patient ratios. And at this forum, colleagues shared their experiences of campaigning for safe nurse-to-patient ratios to improve patient care and it was encouraging to hear from nurses where ratios have been secured – provinces in Canada, states in the US, and Australia – where huge strides have been made and the impact on nursing staff and patient care is now well-evidenced. What became apparent to me though, is how far behind the UK is in terms of investing in, and valuing, the nursing workforce.  

Meanwhile a recent report published by the Organisation for Economic Co-operation and Development (OECD) showed nursing, on average, is a more highly paid career in most other OECD countries compared to the UK. In other OECD countries, full-time nurses working in hospitals can expect to earn 20% more than the average wage of full-time workers. In the UK, nurses working in hospitals earn approximately 10% less than the full-time national average. On pay, the UK ranks joint bottom alongside 3 others on the list of 35 countries, whereas New Zealand, the USA and Australia all rank significantly higher.   

Nurses in the UK - safety critical, highly skilled, degree educated, experienced nurses - are being failed by those in power. We must not stand for this. We can’t sit back and accept the status quo anymore. We must fight for the future of our profession.  

The forum recommended a two-pronged response to the workforce crisis. The first priority is to ensure the safety of our nursing staff and patients, demanding governments write measures into legislation and policy – and then holding them to account for the implementation of those measures.  

At the RCN we’re already campaigning for safe staffing, fair pay and to improve how nursing is valued. As a profession, we need to be able to recruit and retain new nursing staff, but that’s not going to happen until our value is recognised and rewarded. It’s never been clearer that we all need to use our voices to add power to our campaigns for change and for me, the priority is setting limits on the safety critical maximum number of patients per registered nurse in every care setting across the UK.  

The second priority is to improve the collection of nursing workforce data. This provides the vital evidence we need to drive forward change and prove the benefits. The RCN collects data from our members about the experiences of nursing staff in the UK so it was interesting to hear from the World Health Organisation (WHO) about its State of the World’s Nursing global survey, which will give a vital overview of nursing numbers across countries. The 2024-25 report will provide up-to-date evidence and policy options for nursing. It will be interesting to see how it compares with the 2020 report that collected data pre-COVID.  

Knowing we’re all experiencing the same challenges isn’t a comforting thought, but what it does mean is that brilliant nursing minds all around the world are working on solutions. Evidence that shows different approaches working in comparable countries can only help us to drive forward change here. And while we have a long way to go, I am confident that we can and will achieve this together.  
Headshot of Nicola Ranger

Professor Nicola Ranger

General Secretary and Chief Executive

Professor Nicola Ranger joined the RCN in December 2022. She was previously Chief Nurse and Executive Director of Midwifery at King’s College Hospital NHS Foundation Trust in London. Before that, she held Chief Nurse posts at both Brighton and Sussex University Hospitals NHS Trust and Frimley Health NHS Foundation Trust.

She has also held a number of senior nursing roles at University College London Hospitals NHS Foundation Trust and Surrey and Sussex Healthcare NHS Trust. Earlier in her career, she worked at America’s George Washington University Hospital in Washington and at Mount Sinai Medical Centre in New York.

Page last updated - 14/03/2024