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NHS nurse numbers fall, official figures show


Years of continuing growth in the number of registered nurses in the NHS has come to an end with the workforce now beginning to shrink, official figures show.

However, while there has been a pronounced fall in number of overall nurses employed, the healthcare assistant workforce continues to increase – fuelling existing fears that the nursing skill mix is becoming diluted.

The data from the latest NHS Workforce Census, published last week, showed the service employed 335,357 whole time equivalent nurses on September 30 last year, 650 less than 12 months earlier.

Although still higher than the 2008 total, it is the first year-on-year fall in more than a decade.

The reduction in registered staff is largely the result of a drop of 414 in the number of WTE practice nurses, which fell to 13,167 – continuing a downward trend that began in 2006 – and in bank staff, which dropped by 2,487 to 13,051.

Growth in the number of HCAs continued, but is slowing, the figures show. The 43,212 WTE staff employed in 2010 represented an increase of 881 on 2009.

James Buchan, professor of health sciences at Queen Margaret University, Edinburgh, said: “The tailing off of growth of NHS registered nurses, while expected, is the end of a long period of growth.”

He highlighted that the data did not distinguish between different grades of HCA, giving little indication of how fast growth in higher band assistant practitioners was. “They are likely to be management’s favoured skill mix solution over the next few cash constrained years,” he told Nursing Times.

Speaking on the drop in practice nurses, Royal College of Nursing primary care advisor Lynn Young said: “I don’t think this is as simple as GPs being greedy and not employing nurses. I know there are many GPs, particularly in London and the South East, who wanted to recruit practice nurses and can’t get them.”

She added: “We do have an increasing skill mix in general practice – we’re seeing an increase in healthcare assistants being brought in.”

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Readers' comments (9)

  • And watch as the mortality rates rise and the level of care drops.

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  • Yes indeed Mike.

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  • totally agree with you mike.
    it doesn't matter what grade the HCAs are. the fact is they are not qualified to the level a rn has achieved. they may well be able to take blood and cannulate and do observations but can they interpret the results and act upon?

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  • We need to look at who these nurses are. I have seen the most experienced and professional older age group nurses leave in number that quite frankly are frightening. Who will newly qualified staff look to for support and good role models. I don't think I would be the nurse I am today if it hadn't been for the older nurses I came across during my training and after qualifying. The senior nursing figures were looked up to, they motivated and inspired me to be like them, damn good nurses. In turn I have received very positive and complementary feedback from my nursing students on their placements. Without these role models nursing will continue in it's downward spiral.
    Good nurses aren't born from text books, they develop and mature professionally, a process that takes time. The NHS needs to value and protect these nurses not offer them cheap voluntary redundancy schemes.

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  • ah, some recognition of older nurses at last and an excellent post above.
    I was unable to get to sleep the other night wondering about what will happen when the last baby-boomer retires and the workforce is headed by the X-generation who have introduced so many changes into working practices in society and many, in my view, not for the better. Of course there will still be a few more elderly workers out there to give advice, as I saw a 75-year old financial advisor driving round firms for consultations on the tv yesterday.

    My experience with the new generation of nurses coming into the workforce whom I was looking forward to supporting and teaching had had already learned everything they needed to know in the school of nursing. their methods were the latest and didn't need any help or teaching thank you very much. they were supported by one supervisor (who spent most of her time on our ward in the kitchen crying but told me to leave her alone so I never found out what the problem was) so much so that each time I came back from one or two days leave and carried out a procedure or routine I was always told that I was doing it wrong or we don't do it that way any more so each time I had to bend to the new rules(which became rather tiresome and demoralizing to think that all my old team and I had been doing all our work wrong).

    I was on my own as the only remaining member of the old team - not ideal circumstances. I was more or less ignored even in the coffee breaks but quickly had to double my mutitasking efforts to carry on with my workload, do all the paper work, answer every single phone call and every other query about supplies, from patients, doctors, visitors, etc. - a nightmare as i never managed to finish what I had begun with so many interruptions and no support or help from anywhere and then started being criticized for forgetting the odd minor detail as well.

    However, if anything went wrong for these young nurses, became too complex for them to handle, or there was an emergency they expected me to drop everything and run to their aid.
    signed Drop out and Wastage

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  • Anonymous | 30-Mar-2011 2:15 pm

    sounds so true. And they skill mx will get worse many good nurses now will not be able to train as they don't have the brains (sorry to put it bluntly) to train to a degree level. I know i wouldn't. I love my job and am glad i got in before a degree course has been made madatory.

    and yes i know ways of practice keeps changing but knowledge and skill always will be unreplaceable.

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  • that should be news to me?

    we are losing staff due to retirement and not getting replacement as yet as other are at risk and they have to be offered the job first.

    There are two of us here and are clocking up the miles to cover the area, would be cheaper to get staff in quicker but as we struggle they believe we cope and take their time in replacing the well being of us (stress)

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  • I agree with Lynn Youngs comment, yes GP's may want practice nurses but they want them already qualified and are not supportative of training new nurses. Plus the rewards for working for a Gp are not the same as nurses employed by the NHS so loss of continuous service, no agenda for change poorer annual leave etc etc etc.
    HCA are necessary but the nurse carries the can!

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  • The GPs are very well off and have done very well out of government health changes, now it's time to start investing in practice nurses, you can afford it!

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