The ability of NHS acute trusts to employ sufficient numbers of nurses on hospital wards has worsened this year compared with 2014, despite record levels of recruitment.
Despite the recruitment drive, there are still not enough trained nurses to fill shifts according to safe staffing guidance, nursing directors have said.
“The recruitment of nurses is most certainly a national issue and the availability of registered nurses isn’t what it once was”
Analysis of staffing levels at 135 acute trusts showed 83% failed to meet their own planned levels for registered nurses during both day and night shifts in April in at least one of their hospitals. This compared with 76% of trusts for the same month in 2014.
According to the figures, published on the NHS Choices website last month, all 135 acute trusts that reported staffing data failed to hit their target for nurses working during the day in at least one hospital in April, compared to 86% last year.
A total of 114 trusts did not meet planned staffing levels for nurses working at night in at least one site.
- Majority of hospital trusts missed their own nurse staffing targets
- Four out of five hospitals miss own nurse staffing targets
Each acute trust has a planned target for nurse staffing hours across day and night. They are required to publish monthly data showing the average fill rate across their hospital sites on NHS Choices.
Out of 227 hospital sites reporting data, 198 missed their target for nurses working during the day – almost nine out of 10 hospitals in England – according to the analysis by Nursing Times’ sister title Health Service Journal. Meanwhile, 159 hospitals, or 70%, missed the target for nurses working at night.
More than two-thirds of hospitals failed to have sufficient numbers of nurses across day and night shifts. Forty-two hospitals had one in 10 daytime nursing shifts unfilled, and 16 had a daytime fill rate of less than 85%.
Many trusts where nurse staffing levels were below target had responded by filling gaps with healthcare assistants. More than 120 trusts were overstaffing on HCAs by up to 140%.
“It is extremely challenging times at the moment – the nurses just aren’t there”
The decline in performance follows the publication last year of staffing guidance for acute wards by the National Institute for Health and Care Excellence, which led some trusts to plan to have more nurses on shifts.
The situation was exacerbated by a national shortage of qualified nurses, with trusts recruiting more nurses from overseas in response to the 2013 Francis report. Since then, the number of whole-time equivalent qualified nursing, midwifery and health visitor staff has increased by more than 12,000, according to the Health and Social Care Information Centre.
Northampton General Hospital had the lowest fill rate for nurses during the day at 79%. Director of nursing Carolyn Fox said the trust planned to recruit 173 nurses by February next year, with 63 already in place.
She said: “The recruitment of nurses is most certainly a national issue and the availability of registered nurses isn’t what it once was.
“The NICE guidance is not necessarily a bad thing because it has increased the requirement of registered nurses,” she said. “It will have a fantastic impact on patient care in the future.”
Barbara Stuttle, chief nurse at Colchester General Hospital, which filled only 81% of its nursing day shifts, said the trust was recruiting nurses from overseas to fill gaps. It has recruited 95 extra nurses since January and plans to recruit 90 more this year.
She said: “It is extremely challenging times at the moment – the nurses just aren’t there. A few years ago [nurse training places reduced nationally] and this is the consequence of that.
“The NICE guidance around staffing levels has helped but in some areas it has increased the requirement for registered nurses, which is a good thing,” she added.
“The NHS continues to work… to support the recruitment of new and returning nurses, to retain nurses already in post, and to help hospitals reach their planned staffing levels”
In many trusts where nurse staffing levels were below target, they have turned to unqualified healthcare assistants to fill gaps. More than 120 trusts were overstaffing on HCAs by up to 140%.
Royal College of Nursing policy director Howard Catton said he was “shocked” by “the gap between where we are and what trusts have determined we need”.
An NHS England spokeswoman said: “The NHS continues to work with partners including Health Education England to support the recruitment of new and returning nurses, to retain nurses already in post, and to help hospitals reach their planned staffing levels.”
A Department of Health spokeswoman said the government was “fully committed to making more staff available”.
She added: “If individual hospitals do not have enough staff to deliver safe care, the chief inspector [of hospitals Sir Mike Richards] will step in and take action.”
Five hospitals did not report data to NHS Choices – Essex County Hospital, Queen Elizabeth Hospital in Hertfordshire, Heatherwood Hospital, New Cross Hospital in Wolverhampton, and Queen Elizabeth Hospital in Birmingham.