The nursing profession is confronted by a ‘wicked problem’ – a complex challenge with no straightforward solution. The NHS 10 Year Plan is at risk of failure without enough nurses. Yet nurse shortages persist, leading to dissatisfaction and demotivation among nurses, prompting more to leave and worsening the crisis. The issues that the nursing profession faces in 2026 are certainly not new. It’s the complexity and interrelationships of these issues that has so far confounded the search for solutions.
Unravelling the problem
The RCN consistently points out that shortages in the nursing workforce result in compromised quality and safety of care. Two further effects of the shortage of staff and skills are that nurses themselves become dissatisfied and demotivated, not only because they are working to cover staff shortages but also because they don’t feel they are performing well. So, what do they do? They leave and the shortage grows worse.
International migration, once a key solution to populating the workforce, has halved due to visa restrictions and increased racism.
Domestic universities are cutting nursing programmes. In 2025, the University of Nottingham confirmed that it would be suspending its children’s nursing and mental health nursing programmes, with a view to the permanent closure of these courses. Other higher education institutions in England and Wales have also announced cuts.
Once nurses are educated, they must be able to find employment and, rather incredibly in this climate of shortage, it seems they cannot. In 2025, to tackle this issue, the government guaranteed graduate employment for nurses, but with no significant extra funding (Nursing Standard, December 2025). Spending constraints in NHS trusts mean that jobs are not always advertised (Nursing Standard, 2025).
A perfect storm
The NHS 10 Year Health Plan just cannot be implemented unless the complex issues facing nursing are tackled. Studying solutions to ‘wicked problems’ has taught me that there is no simple fix and that is clear here. A new approach is needed.
Here’s my suggestion:
- Plan a series of iterative consultations around the UK with nurses over the next year – and other health staff if possible – to hear their ideas to solve the problems where they are.
- Build ‘what if’ scenarios that support resilience. Everyone is invited to consider: what if there is a national emergency? A local disease outbreak? A major disaster? Revisit the teams who have been consulted and present the scenarios – what will they do? Are their solutions on the right track.
- Bring service users into these consultations and really listen to what matters to them. Is it wait times, quality of service, staying at home – all of these?
- Find out what policy-makers and service users really know about the evidence that links well-qualified nurses to better health outcomes. How many people receiving care from nurses actually know that they are more likely to recover if they have a well-qualified nurse caring for them?
- Bring in the economists. They can look at what good choices will truly SAVE the NHS.
- Pay deep attention to leadership and management of clinical teams. Is it compassionate? Does it call out racism and inappropriate behaviour of any sort?
As I write this, I realise my suggested approach will be seen as lengthy, expensive and complicated. This is why planning is often a process that is short-changed and why we have ended up with the wicked problem that we now face in nursing.
Successful solutions to complex problems must be found through collaboration with all those with an interest in the issue, to identify creative approaches and a willingness to change.
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