Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

Survey: Nearly half of NHS workers say there are not enough staff to ensure patient safety


Almost half of NHS nurses and other healthcare workers say there are not enough staff on their shift to ensure patients are treated safely and with compassion, according to a new survey published by a public sector union.

Unison’s survey examined the attitudes and experiences of nurses and other healthcare professionals across one working day in September 2018, to uncover how staff felt about the pressures they are under.

“This survey shows the extent to which crisis level staffing has become normal across the whole NHS”

Sara Gorton

According to the union, the study illustrates the effect of chronic understaffing in the health service, with unfilled posts and uncertainty about the future status of many workers having an impact on patients.

As a result of the study’s results, Unison is warning the government that it must pump significant funds into the NHS to fix the problems caused by years of austerity and is calling on ministers to put a greater focus on apprenticeships to encourage people into healthcare professions.

The survey revealed that almost half (45%) of the respondents who were directly involved in patient care (6,778 out of 15,134) said there were not enough staff on their shift to deliver a safe, dignified and compassionate service.

In a report on the survey – titled Just Another Day – an anonymous account from one member of staff highlighted that instead of the four registered nurses required for the shift, they had just two to look after 26 patients.

“There was one person who was dying but we couldn’t get to her quickly enough”

Survey report

The account read: “There was one person who was dying but we couldn’t get to her quickly enough because the controlled drugs she needed for pain took two nurses to unlock from the cupboard by law and that left the ward without a nurse there. Horrific.”

Unison explained that some departments were more severely affected than others, with staff in working in acute inpatient care hit the hardest. The survey identified almost three in five (1,381 out of 2,345), stating that staffing in this area of care was insufficient.

For those working in mental health, primary care, and community health, Unison said staffing was a “serious issue”.

The survey revealed that for 45% of respondents working in mental health (996 of 2,203) said staffing was insufficient. Meanwhile, primary care saw 41% (777 of 1,893) and community health 36% (642 of 1,794).

The union highlighted how concerns over staff levels had arisen, despite the high number of bank or agency staff being used on the day.

Nearly half of respondents (47%) stated that their service relied on bank staff on the day of the survey, mainly to fill nursing roles. Though it added that healthcare assistant posts, administration and a variety of other positions were also filled with bank replacements.

“It also shows the dedication and compassion these hard-working committed staff continue to show at the most trying times”

Sara Gorton

In addition to this, Unison’s survey also saw one in seven (14%) healthcare staff rating the quality of care as “compromised” and one in six (15%) stating that patient safety was compromised the day the survey was carried out.

Other findings of the survey saw 47% of nurses and midwives reporting to have worked longer than their original shifts. The report noted that the worst affected workplaces were A&E (45%), community (42%) and acute inpatients (41%).

Nearly one in six (16%) members of staff reported that they were subjected to violence, aggression and/or verbal abuse during their shift and more than a quarter (26%) reported extremely high stress levels.

Following these results, Unison has outlined a number of specific recommendations to the government.

These include:

  • The NHS must be given a significant increase in funding to tackle the serious cuts to the service brought about by the squeeze on funding. Current resource pledges are not enough to meet patients’ needs
  • Legislation must be introduced for mandatory safe-staffing levels in England and Northern Ireland, building on the lead of Wales and Scotland
  • A renewed focus is needed on apprenticeship schemes as a way to improve access routes into healthcare professions. Changes to healthcare student finances are also essential to encourage training and recruitment to the service
  • The investment in improving pay and rewards must be continued in order to attract and retain health service staff. Stress and violence must be tackled to improve the working environment

Unison reiterated how staffing shortages were illustrated in the most recent figures for the NHS in England, issued in November 2018, which saw nearly 41,000 nurse shortages.

Unison head of health Sara Gorton said: “This survey shows the extent to which crisis level staffing has become normal across the whole NHS.

sara gorton for index

sara gorton for index

Sara Gorton

“These are long-term, systemic factors not being properly addressed,” she said. “The government must give the system the funding needed to tackle these issues.

“But hearteningly it also shows the dedication and compassion these hard-working committed staff continue to show at the most trying times,” she added.

In line with her comments, the report also highlighted cases of nurses going the extra mile to help their patients, despite the pressures they are under.

Examples of accounts from respondents include one nurse from Golders Green, North London, explaining how they dyed an elderly lady’s hair after their shift, on top of the hour they stayed late doing extra clinical work.

Another nurse, from Accrington, Lancashire reported: “I gave a crying baby a cuddle for 15 minutes, taken out of my break on a night shift, so a tired first-time mummy could close her eyes for a few minutes.”

The findings are based on responses from more than 18,000 healthcare staff from across the UK including nurses, healthcare assistants and support workers, students, ambulance service staff, cleaners and porters.

The vast majority (90%) worked in the NHS, the remainder from the private and voluntary sector.


Readers' comments (3)

  • The whole recruitment process needs improving. Why does it take so long to recruit a person why not have an open door policy so interviews could be done in a short time. In other counties you could be interviewed today and start the following week. HR are far too slow.

    Unsuitable or offensive? Report this comment

  • "The investment in improving pay and rewards must be continued in order to attract and retain health service staff." Can anyone tell me what investment they are talking about? My pay is not keeping pace with increases in rail fares, my accommodation costs, energy costs, and food costs, in spite of the retailers' claims like "Rolling back prices;" "live well for less," etc. And what's this about "pay and rewards?" Pay is all I get.

    Unsuitable or offensive? Report this comment

  • There is a huge problem, I’ve had to leave one division of the nhs in January, and I loved my job. I had a good manager and she fought for staff, but I work agency as well and there are so many departments I won’t go due to low level of staff.
    The acuity of patient is higher coupled with shortage of staff has made me fear for my NMC pin no.
    We also need to bring in registration for health care assistance, as I have found some of them not doing the job they are paid to do which again makes me fear for my pin.
    It saddens me coz my patients deteriation in care and my increased anxiety has forced me out.
    I wish someone could step in and help I feel the situation so desperate

    Unsuitable or offensive? Report this comment

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.