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Up to 20,000 NHS nursing posts remain unfilled, says RCN

Trusts now struggling to recruit after job freeze to save cash; implications for patient safety

Caroline White

Tuesday, 12 November 2013

Almost 20,000 nursing vacancies remain unfilled in England, with the nursing workforce ‘cut to the bone’ in many trusts in a bid to save cash, suggests a report from the Royal College of Nursing (RCN) published today.

This constitutes a ‘hidden workforce crisis’ that could have serious consequences for the NHS and patient safety, it warns.
Figures from Running the red light show that understaffing is far larger than the official numbers would suggest. These show that the NHS in England has lost only 3859 full-time nursing, midwifery, and health visitor posts since May 2010, equivalent to 6468 individual members of staff.

The government stopped collecting data on vacancies in 2011, but freedom of information requests to NHS trusts made by the RCN shows an average 6% (ranging up to 16%) vacancy rate in nursing posts. Replicated across the NHS this would amount to nearly 20,000 full time equivalent nursing, midwifery and health visiting nursing vacancies, or up to 34,000 individuals, says the report.

Following a slew of high profile reports on the links between nurse staffing levels and patient safety, there is some evidence that trusts are now attempting to unfreeze posts, but are now having to look overseas, because they can’t recruit from the UK, says the report.

“We also know that a nursing shortage is creating serious difficulties in recruiting to these vacancies. Evidence gathered by the RCN shows that 22 per cent of trusts are having to recruit from abroad and a further nine per cent are actively considering the possibility of doing so to plug these gaps over the coming year,” says the report.

The report also highlights that the number of nursing student places commissioned since 2010-11 has dropped by 15%, and figures from the Centre for Workforce Intelligence (CfWI) indicate that the impending crisis in the supply of registered nurses will result in a likely shortage of 47,545 registered nurses by 2016.

“Despite numerous calls to action, there has been little progress so far on the scale required to stem the impending shortage. With rising demand for health care services, workforce shortages will have serious implications for staffing levels and the ability for providers to deliver safe, good quality care for patients,” warns the report.

“We sit on the verge of a hidden workforce crisis that desperately needs addressing to ensure the NHS runs properly and patients get the care they deserve,” says Dr Peter Carter, Chief Executive & General Secretary of the RCN, who adds that the findings should be a “wake-up call” for the NHS.

The report outlines a list of urgent priorities for achieving safe staffing in NHS services, including mandatory safe staffing and skill mix levels; mandatory use of evidence based safe staffing workforce planning tools; regular, formal workforce reviews; and end to ‘boom and bust’ nursing workforce planning; and proper investment in the current nursing workforce.

“Unsafe staffing levels have been implicated in a number of high profile investigations into patient safety. We call on employers in the NHS to put an end to boom and bust workforce planning and develop clear standards to ensure safe staffing levels are met, supported by robust inspection based on reliable data,” added Dr Carter.

A UNISON survey of 2,000 healthcare assistants, also published today shows that the financial squeeze on the NHS has sparked a drop in staffing levels, low morale, and insufficient training. These factors, coupled with continuing reports of violence against staff, are causing many healthcare workers to consider leaving the NHS, says the union. 

Some 85% of respondents said they have heard or personally experienced verbal abuse, with one in five revealing they have been exposed to physical violence at work. And 78% of respondents reported that staffing levels have dropped over the past year, with just 15% believe that staffing is adequate in their clinical area. 

UNISON's Head of Nursing, Gail Adams, said: "Over the past year we have seen the Francis, Keogh and Berwick reports, and revelations from the Care Quality Commission that suggest a quarter of NHS Trusts may be unsafe. Employers should be responding to these reports by ensuring that their workforce is strong and adequately staffed rather than cutting the number of posts even further."

But health minister Dr Dan Poulter insisted that the overall number of clinical staff in the NHS had risen.

“We are training 17,500 nurses every year to meet this growing demand. Overall, the number of clinical staff in the NHS has increased by nearly 4,100 and the number of admin staff has fallen by 22,800, " he said, adding that the government would shortly be announcing further plans to guide staffing decisions in the full response to the Francis report.

"We want to see consistently safe staffing levels in the NHS - there are growing signs that trusts are creating new posts following the Francis report, which is a welcome sign. The Chief Inspector of Hospitals will be able to take action if Trusts are found to be compromising patient care by not having the right number of staff on wards," he said.

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