More than four out of five acute hospitals in England failed to meet their own targets for nurse staffing, according to analysis of latest workforce data.
- 85% of hospitals missed own target for nurses working in the daytime
- 67% of hospitals missed their target for filling night shifts
In the latest monthly safe staffing data published by NHS providers, 85% of acute hospitals – 194 out of 229 for which information was available – failed to meet their own targets for the numbers of registered nurse hours filled during the day.
More than two thirds of all hospitals also failed to meet their own targets for nurses working during the night, with 67% – 154 out of 229 – failing to have enough staff on shift.
A total of 79 hospitals missed their staffing target by only 5% or less for nurse hours filled during the day, but 45 hospitals reported more than 10% of their nursing hours were not covered.
For night shifts the majority of hospitals, 96, missed the target for nurses by 5% or less, with 43 trusts achieving a fill rate of 90-94%, and 15 trusts below the 90% mark.
Overall, 77% of acute NHS trusts – 107 out of 139 – failed to achieve their own nurse staffing targets on both day and nights, mirroring the result of a similar analysis in June 2014 that found 75% failed to meet staffing targets.
Trusts performed better for healthcare assistants, though 105 trusts still failed to achieve their planned staffing levels during the day and 52 trusts missed the target for HCAs working at night.
A total of 32 hospitals failed to achieve their staffing targets for both nurses and healthcare assistants across both day and night.
The results indicate the difficulties being experienced by acute providers in recruiting sufficient numbers of registered nurses, which have contributed to an increase in overseas nurse recruitment and a growing use of agency staff to fill gaps.
Nursing workforce expert Professor Jim Buchan, from Queen Margaret University in Edinburgh, said: “This is exposing the fact that the shortfall in nurses is real, is probably getting larger nationally and becoming more pronounced in more trusts.”
Royal College of Nursing policy director Howard Catton added that trusts were under pressure to recruit because they needed to have safe staffing levels.
“It does present a very real significant challenge,” he said. But he added that recruitment was now based on a “much better understanding of needs and demands” in the wake of the Francis report into failures at Mid Staffordshire Foundation Trust, which was published in February 2013.
Mr Catton said the competitive environment for nurses also meant trusts needed to consider the importance of retaining the staff they already employed.
The workforce data used in the analysis by Nursing Times’ sister title Health Service Journal relates to staffing levels in January and was published on a trust-by-trust basis on the NHS Choices website.
Since last summer, trusts have been required to submit monthly staffing data, as well publishing the results on their website, as part of the government response to the Francis report.
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The increased focus on nurse staffing also follows guidance from the National Institute for Health and Care Excellence last year.
NICE said hospitals employing staff on ratios of eight or more patients to one registered nurse on a “regular basis” could increase the risk of harm in adult inpatient wards. It suggested a 1:8 ratio should be a “red flag” incident requiring action by trusts.
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The hospital with the worst single figure for nursing hours during the day was Cannock Chase Hospital, formerly part of Mid Staffordshire but now run by the Royal Wolverhampton Hospitals Trust. The site recorded a fill rate of 73% across its two wards.
The trust’s deputy chief nurse Lynne Fieldhouse said: “The trust does not consider there to be a problem with nurse staffing on our Cannock site. As the figures are average they reflect the planned, reduced staffing levels at weekends when the elective surgery post-operative unit is closed.”
She added that the trust had funded additional nursing posts for the hospital, which would have skewed the baseline.
To find out how your trust faired on staffing levels, download the spreadsheet at the top of the page (see top-right).