Booth RG, Strudwick G, McBride S, O'Connor S, Solano Lopez AL. How the nursing profession should adapt for a digital future. BMJ. 2021; 373

Brown L. Balancing risk and innovation to improve social work practice. British Journal of Social Work. 2010; 40:(4)1211-1228

Burdett Trust for Nursing. Nurse-led improvement projects in digital health 2021. 2021. (accessed 18 April 2023)

Care Quality Commission. The state of health care and adult social care in England 2018/19. 2019. (accessed 18 April 2023)

Castle NG, Engberg J. The influence of staffing characteristics on quality of care in nursing homes. Health Serv Res.. 2007; 42:(5)1822-1847

Castle NG. Use of agency staff in nursing homes. Res Gerontol Nurs. 2009; 2:(3)192-201

Caswell G, Hardy B, Ewing G, Kennedy S, Seymour J. Supporting family carers in home-based end-of-life care: using participatory action research to develop a training programme for support workers and volunteers. BMJ Support Palliat Care. 2019; 9:(1)

Department of Health and Social Care. Proposal to regulate to stop movement of staff between care settings. 2021. (accessed 18 April 2023)

Doraiswamy S, Abraham A, Mamtani R, Cheema S. Use of telehealth during the COVID-19 pandemic: scoping review. J Med Internet Res.. 2020; 22:(12)

Third of adult social care workforce may quit, survey suggests. 2019. (accessed 18 April 2023)

Gordon AL, Franklin M, Bradshaw L, Logan P, Elliott R, Gladman JRF. Health status of UK care home residents: a cohort study. Age Ageing. 2014; 43:(1)97-103

Government Office for Science. Future of an ageing population. 2016. (accessed 18 April 2023)

Guzman-Castillo M, Ahmadi-Abhari S, Bandosz P Forecasted trends in disability and life expectancy in England and Wales up to 2025: a modelling study. Lancet Public Health. 2017; 2:(7)e307-e313

House of Commons. Nursing workforce shortage: England (debate). Hansard. 2020. (accessed 18 April 2023)

Howarth A, Munro M, Theodorou A, Mills PR. Trends in healthcare utilisation during COVID-19: a longitudinal study from the UK. BMJ Open. 2021; 11:(7)

Lloyd M. Inappropriate placements in registered nursing homes. Nurs Times. 2001; 97:(10)37-38

Survey reveals ‘stark’ staffing challenges facing care services. 2021. (accessed 18 April 2023)

Murphy M, Scott LJ, Salisbury C Implementation of remote consulting in UK primary care following the COVID-19 pandemic: a mixed-methods longitudinal study. Br J Gen Pract. 2021; 71:(704)e166-e177

National Quality Board. How to ensure the right people, with the right skills, are in the right place at the right time. A guide to nursing, midwifery and care staffing capacity and capability. 2013. (accessed 18 April 2023)

O'Connor S, Deaton C, Nolan F, Johnston B. Nursing in an age of multimorbidity. BMC Nurs. 2018; 17:(1)

The state of integrated care systems 2021/22. 2022. (accessed 18 April 2023)

Public Health England. Infection prevention and control: an outbreak information pack for care homes - the ‘care home pack’. 2017. (accessed 18 April 2023)

Evidence based guidance for video consultations – supporting the response to COVID-19 (blog). 2020. (accessed 18 April 2023)

Spilsbury K, Charlwood A, Valizade D, Haunch K. Relationship between care home staffing and quality of care: a mixed methods approach. Innov Aging. 2019; 3

E-nursing homes: transforming access to nurses in nursing homes in response to the staffing crisis

11 May 2023
Volume 32 · Issue 9


The UK is facing a nationwide staffing crisis within adult social care, due to difficulties in recruiting and retaining registered nurses. Current interpretation of legislation means nursing homes must always have the physical presence of a registered nurse on duty within the home. With the shortage of registered nurses increasing, reliance on agency workers is commonplace, a practice impacting service cost and continuity of care. Lack of innovation to tackle this issue means the question of how to transform service delivery to combat staffing shortages is open for debate. The potential for technology to augment the provision of care was highlighted during the COVID-19 pandemic. In this article the authors present one possible solution focused on the provision of digital nursing care within nursing homes. Anticipated benefits include enhanced accessibility of nursing roles, reduced risk of viral spread and opportunities for upskilling staff. However, challenges include the current interpretation of legislation.

The UK is currently experiencing a nationwide shortage of nurses with around 40 000 nursing vacancies across health and social care in England in 2020 (House of Commons, 2020). The number of unfulfilled staff vacancies in adult social care has steadily been rising since 2014 (Care Quality Commission (CQC), 2019). A shortage of registered nurses (RNs) in nursing homes is having far-reaching effects (Mitchell, 2021). Without adequate RN cover, nursing homes are either forced to close or re-register as residential homes. This has a huge knock-on impact on the number of services that can be offered in particular regions, meaning people who cannot access services locally are forced to be separated from their families. Closures and re-registration also increase pressure on NHS services that must make up for the mismatch between service provision and need (CQC, 2019).

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content