NHS patients across the UK will be at risk of falling care standards unless all four countries have legislation to guarantee safe staffing levels, according to the Royal College of Nursing.
The RCN said it was making the call for safe staffing to be enshrined in law – the first time it has done – because of a “lethal cocktail” of factors that was creating record nursing vacancies.
“A lethal cocktail of factors in the NHS has resulted in too few registered nurses”
New figures from NHS trusts in England reveal that 11% nursing posts are unfilled and suggests that care providers are increasingly hiring fewer registered nursing staff. The number of vacant nursing posts has doubled since 2013, according to the college.
A Freedom of Information request by the RCN found two-thirds of hospital trusts in England planned for a greater proportion of nursing support staff in 2016 than a year earlier.
The data is contained in a new RCN report – titled Safe and Effective Staffing: the Real Picture (see attached PDF below) – published today as it starts its annual conference in Liverpool.
Separate research in all four UK countries, carried out by ComRes for the RCN, suggested 82% of NHS nursing directors and deputy nursing directors were worried their hospital relied on the “goodwill” of staff to keep services running.
”NHS on a collision course in terms of the timeliness, quality and safety of care patients receive”
The responses from 90 directors or deputy directors of nursing support the findings of its FOI, said the RCN, with 40% concerned about the impact of delegating nursing care to unregistered staff.
The survey found that 64% thought finances had got worse, compared with two years ago, and 49% said financial pressures meant they could not always make the best decisions for patients.
One in nine unfilled nursing posts in England equates to around 40,000 in total, with mental health and community care experiencing the greatest shortages.
NHS Digital figures show the nursing workforce in the community fell by 14% (5,709 whole-time equivalent posts) between May 2010 and September 2016, and mental health nurses by 13% (5,142 posts) over the same period.
The trend is at odds with plans to move care closer to home, argued the college.
The RCN report also warns that nurse vacancies are increasing in Scotland and Northern Ireland to 4.1% in Scotland and 3.8% for Northern Ireland.
Janet Davies, chief executive and general secretary of the RCN, said: “A lethal cocktail of factors in the NHS has resulted in too few registered nurses and patient care is suffering.
“Pressure and demand has spiralled upwards,” she said. “Nurses stay behind after 12-hour shifts to give patients extra care and go home exhausted and sometimes in tears. Too many now feel no alternative but to leave nursing.
“There is no certainty about the next generation of UK nurses joining either – deterred by low pay, pressure and new training costs – so the government desperately needs to keep the experienced ones we have,” she said.
“When finances are tight, nursing budgets are slashed,” said Ms Davies. “Hospitals are hiring unregistered staff and delegating jobs that should be done by trained nurses.”
She called on ministers to “draw a line under this false economy” and address safe staffing levels in new legislation. “Nursing directors should not have to fight for the funding,” she added.
Legislation on safe nurse staffing levels has already been passed in Wales and is in the process of being implemented, while Scotland recently announced that it will also follow suit.
- Scotland launches consultation on nurse staffing laws
- Scotland will be next to introduce nurse staffing legislation
- Welsh nurse staffing levels bill receives royal assent
Commenting on the RCN findings, the NHS Providers organisation, which represents trusts, said the figures were further evidence of the “severe workforce pressures” that the health service faced.
Saffron Cordery, its director of policy and strategy, said: “The huge gap that is growing between the supply of trained staff and the increasing demand for services has set the NHS on a collision course in terms of the timeliness, quality and safety of care patients receive.
“The reductions in mental health and community nursing numbers since 2010 are particularly worrying, as we seek to ensure that mental health is placed on an equal footing with physical health, and work to provide more NHS care for patients closer to home,” she said.
Ms Cordery added that an “important part of the problem” was the seven years of pay restraint for nurses and other Agenda for Change staff.
“This must end, and politicians must be clear about when during the lifetime of the next parliament it will happen and how,” she said.