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

Nine out of 10 largest hospital trusts in England short of nurses, warns RCN


More than nine in 10 of the 50 largest NHS hospital trusts in England are not staffed with nurses to the level planned by their own management, according to the Royal College of Nursing.

Despite their best efforts to fill shifts with bank and agency staff, acute trusts were still falling short of filling their nursing rotas, warned the college, following analysis of data published on the NHS Choices website.

“Patients stand a better chance of survival and recovery when there are more of them on the ward”

Janet Davies

It found 91% of the 50 largest trusts in England failed to have the number of registered nurses they had planned to have on wards, during the day, on 150 individual hospital sites.

Since 2014, all hospitals in England have released information on their nurse staffing levels to NHS Choices. The college said its analysis of the current data on the NHS Choices website confirmed that acute trusts were putting more unregistered support staff on shift to cope with the shortage of registered nurses.

More than half of the largest hospitals (55%) brought more unregistered support staff onto the shifts, according to the RCN’s analysis.

The over-reliance on support staff was worse at night, it said, with 67% of hospital trusts increasing numbers on night shifts compared to what they planned due to the registered nurse shortage.

The practice of substitution raised questions about safety, noted the RCN. Research has shown that mortality rates rise significantly when the ratio of registered nurses to healthcare assistants is lowest.

A study, in the journal BMJ Open, found that where registered nurses had six or fewer patients to care for, the death rate on medical wards was 20% lower than where they had more than 10.

Hospitals with more unregistered nursing support workers may have had higher death rates, noted the RCN.

The RCN said its analysis of the data supported recent research highlighting that there were 40,000 nurse vacancies across the NHS in England.

Janet Davies, chief executive and general secretary of the RCN, described the figures as “startling” and said they showed “our largest hospitals still do not have enough nurses”.

“They are resorting to filling wards with unregistered healthcare assistants, especially at night, just to cope with the shortage,” she warned.

“Nurses have degrees and expert training and, to be blunt, the evidence shows patients stand a better chance of survival and recovery when there are more of them on the ward,” she said.

Royal College of Nursing

Pay rise above 1% ‘needed to ease nurse crisis’

Janet Davies

“It is unfair on the healthcare assistant too – they should not be left in a situation they have not been trained to handle,” she said the RCN leader.

She called on the government to “redouble its efforts” to train and recruit more nurses and “stop haemorrhaging” experienced ones, who she said were “fed up, undervalued and burning out fast”.

She added that ministers were still failing to reassure overseas nurses from the European Union of their right to remain, warning that the NHS “would go under if they drifted away”.

“All nursing staff, regardless of where they trained, should go to work confident that there will be enough trained nurses to give safe care and feel valued with fair pay for their work,” said Ms Davies.


Readers' comments (10)

  • this country does not deserve a nursing profession, the fewer nurses there are the better until the Nmc and bullying pathological managers are all sacked and nurses automatically given assistance to take NMC referrers to court when as the case with the majority there is no case to answer

    Unsuitable or offensive? Report this comment

  • Can I see a show of hands from all those who is surprised by this.

    Unsuitable or offensive? Report this comment

  • They wouldnt allow a plane to fly if the staffing levels were as poor as we have to put up with on a daily basis.

    Unsuitable or offensive? Report this comment

  • The managers should be more intelligent in retaining good nurses that sacrifice to work rather than bullying there own colleagues with help of the HR.

    They should be more confident and courageous to defend the profession and disallowing bad advice against their own colleques.

    I wish nurses all over the world could be more intelligent in supporting their colleagues and protect this high demanding profession.

    Are we able to see how the medical team support themselves?But why nurses don't?

    Unsuitable or offensive? Report this comment

  • At the end of the day no one really cares about nurses, I can't wait to retire.

    Unsuitable or offensive? Report this comment

  • ...

    Unsuitable or offensive? Report this comment

  • A sister ex colleague of 30 years, like me handed in her resignation last week. NO EFFORT was made to try and persuade her to stay, what could they do to keep her. I had the same experience. The NHS is becoming a shambles of its own makers. Those who have put heart and soul, often lost relationships as a result are leaving and they will never be 'replaced' the skills and knowledge we have lost to a future generation no degree will ever prepare you for. 'WE' knew this was coming inteh 80's and are not really shocked at how soon. Instead of training nurses for the world, we rely on them coming to us, now with the current climate they are leaving quicker than they came. The ward my colleague is leaving will likely close as many staff are no planning to leave and they can't staff the bigger sister Hospital, I will still be around to say I told you so should I see my old manager, that is if she lasts.

    Unsuitable or offensive? Report this comment

  • Surprised not!!! Been in the NHS since the 80's - I'm 55 next year never thought I'd do it but seriously thinking about taking my NHS pension and getting out. Nursing has a good side but overall frontline staff are treated like shit. NHs managers are generally rubbish, and reap what they sow, they never thank or support their front line staff who are run ragged. They just pile on more time wasting exercises endless audits, surveys and checklists, instead of letting the nursing staff concentrate on caring for patients Then they wonder why staff leave, turnover is high and the staff that stay around are demoralised, burnt out and fed up.

    Unsuitable or offensive? Report this comment

  • When you apply for jobs as an RN you are informed that you are not suitable. I have been a practice nurse for 17 years and before that a hospital RN . I have been nursing for over 30 years
    Yet when I applied for a post in a pre assessment clinic (doing exactly the tasks I currently do as a pn) I was told I didn't have enough experience and a Hca took the post . We already get paid a pittance! personally I haven't had a pay rise for 5 years! They will not put our wages up, while they can replace good qualified nurses with cheaper health care assistants who are then given over the top names to make the public assume they are highly qualified, making a mockery of all those nurses who have worked so hard to gain further qualifications.
    Gone are the days nurses could only interview nurses. Now it's left to a checklist from people who tell you that they wouldn't even bother to put in your cv, with little knowledge of the job you have been doing for 17 years or more.
    I may just give up rather than face another rejection letter let's face it if get more pay working in a shop!

    Unsuitable or offensive? Report this comment

  • Above comment is so accurate its scary! I was recently interviewed by two non nursing staff can you believe it and the job I applied for was a role that i have been doing for 10 years. Did I get it well I wasn't even given a phone call. I think we are wasting our time here I recently say an advert for a manage at Lidl (£50000). If it weren't for the fact that I would get bored i might just apply for this.

    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.