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Slump in district nurse workforce amid overall nursing rise

  • Workforce data shows year on year increase in qualified nursing staff in September 2015
  • Data also shows significant falls in district nursing, mental health and numbers of nurse consultants

The NHS is continuing to recruit record levels of qualified nursing staff, according to the latest workforce data – but some groups such as district nursing have seen double digit falls.

The number of full-time qualified nursing, midwifery and health visiting staff employed in the NHS in September 2015 rose to 317,023 – almost 2,300 more than in August and more than any previous September since 2009 – according to data published by the Health and Social Care Information Centre.

“The decline shows a disconnect between health and social care policy ambitions such as moving care closer to home”

Howard Catton

September is a crucial month for nursing workforce data, as it follows the traditional seasonal decline in nursing staff during summer months and includes the influx of newly qualified nurses joining the NHS after graduating.

In September 2015, 3,508 more nursing staff were employed in the NHS compared to September 2014. The majority of the extra staff were employed in the acute sector, increasing year on year by 2,516.

Psychiatry service roles fell by 917 whole-time equivalent posts and learning disability services lost 214 staff. Community services increased by 1,405 staff, though this was largely in health visitors, which increased by 1,210.

Despite the increase in overall nursing staff, some specific roles saw significant falls concerns that policies linked to increased community care could be undermined.

According to the data, there was a year on year drop of 12% for the total number of district nurses in September 2015, a reduction of 667 whole-time equivalent staff. Since September 2010 numbers of district nurses have dropped by 35%.

The number of nurse consultants has also fallen for the third year in a row from its September peak of 1,139 in 2012 to just 881 consultants in 2015. The numbers of nurse matrons has also fallen by 1,446 since a peak of 6,559 matrons in September 2009.

The increased recruitment of nurses reflects demand for qualified nurses following the Francis report into poor care at the Mid Staffordshire Foundation Trust in 2013 and staffing guidance from the National Institute for Health and Care Excellence in 2014.

Royal College of Nursing policy director Howard Catton said the increase was “welcome” but other workforce indicators still suggested demand was “continuing to outstrip supply”.

“While it’s welcome that we have a ‘Francis effect’ and we are recruiting, that is not across the system or all care settings and is specifically in relation to acute hospitals only,” he said.


Howard Catton

“Where there have been declines, in district nursing and mental health services for example, that shows a disconnect between health and social care policy ambitions such as moving care closer to home and parity of esteem in mental health,” he said. ”All of those laudable policy ambitions are heading to a place where the nursing workforce is weak and we may not have the skills and experience we need.

“The combination of those means at best the policy ambitions will be undermined and at worst thwarted by the lack of the right numbers and skills of staff in those areas,” added Mr Catton.

A Department of Health spokeswoman said: “The number of district nurse training places in England has increased dramatically during the past two years, and we have committed to make available an additional 10,000 community and primary care staff by 2020.

“NHS England has commissioned the Queen’s Nursing Institute to assist local areas with workforce planning to ensure they have the right number of community nurses and we are running a campaign to encourage registered nurses who have left to come back to work, including in community based posts,” she said.

Qualified NHS nursing, midwifery and health visiting staff (full-time), September

 2009201020112012201320142015YOY changeYOY % change
Total 307,749 309,139 306,346 305,060 307,692 313,514 317,023 3,508 1.1%
Nurse consultant 935 1,024 1,120 1,139 974 890 881 -9 -1.0%
Modern matron 5,007 4,769 4,396 4,160 3,899 3,846 3,908 62 1.6%
Community matron 1,552 1,552 1,469 1,362 1,340 1,301 1,205 -97 -8.0%
Manager 7,786 8,267 7,846 7,681 7,856 8,224 8,794 570 6.5%
Children’s nurse 11,127 11,331 11,706 11,883 11,909 12,397 13,085 688 5.3%
Registered midwife 19,603 20,126 20,519 20,935 21,284 21,670 21,792 122 0.6%
Health visitor 8,285 8,017 7,941 8,386 9,109 10,167 11,377 1,210 10.6%
District nurse first level 7,228 7,019 6,215 5,814 5,163 5,115 4,476 -639 -14.3%
District nurse second level 623 674 722 566 575 551 523 -28 -5.4%
Qualified school nurse 1,152 1,096 1,165 1,174 1,148 1,209 1,207 -3 -0.2%
Other first level 238,593 241,159 239,766 238,751 241,639 245,779 247,541 1,762 0.7%
Other second level 5,858 4,105 3,480 3,208 2,795 2,364 2,235 -129 -5.8%

Source: Health and Social Care Information Centre


Readers' comments (3)

  • michael stone

    Moving elderly care 'into the community' seems to require more district nurses, if anything - so I can only agree with Howard Catton.

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  • Hidden costs of running own car for work purposes, such as business insurance, extra wear + tear, carrying clinical waste, parking charges/problems, servicing etc are not fully remunerated and likely that nurses have to pay themselves. Then there's being stuck in traffic just to go a few miles. Most workers in big cities prefer not to use their cars. Some haven't got driving licence or cars.
    This makes it more difficult to recruit + retain staff.

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  • lets face it once again nurses are exploited

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