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NHS loses more nurses but HCA numbers up


The number of nurses working in the NHS has fallen again, with employers turning to cheaper healthcare assistants to plug the gaps, latest figures suggest.

Latest workforce data from the NHS Information Centre shows that for the 12 months between September 2011 and 2012, the number of registered nurses in England dropped by 2,283 – equivalent to 0.7%. But the number of healthcare assistants jumped 5.1%, a rise of 2,691, during the same period.

There is also strong evidence that trusts are also using more agency and bank staff.

Unions have increasingly raised concerns about reductions in qualified staff, changes to skill mix ratios and the resulting impact these trends may have on patient care.

Overall, the figures showed that a total of 1.36 million people were working in the NHS in England at 30 September 2012, down by 3,238, or 0.2%, compared to 2011.

NHS Employers director Dean Royles said: “The NHS is under enormous financial pressure so it’s hardly surprising that we have seen a reduction in workforce numbers.”

But Royal College of Nursing director of policy told a Healthcare Conferences UK event last week that he was “deeply worried” by the nursing workforce trend.

“There is evidence that we have entered back into the ‘bust phase’ of what nursing always does – boom and bust in terms of the size of the nursing workforce,” Mr Catton told delegates at the Nursing Staffing Levels and Skillmix conference in London.


Sign our Speak Out Safely petition to support a transparent and open NHS. We are calling on the government to implement recommendations from the Francis report that will increase protection for staff who raise concerns about patient care.


Readers' comments (8)

  • This is all very worrying, and does not bode well for safe care in hospital. Don't get ill!

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  • I agree with the comment above and I just don't think that those who have, for some unknown reason, taken charge of the nursing profession or many outside the profession have the faintest idea of the highly complex roles (including all the supplementary roles they have taken on or had dumped on them) that nurses have in patient care. I am sure they have the perception of nurses as some type of fancy bedside carer/maid, general ward manager and administrator and doctor's assistant who can be replaced by anybody, possibly with a little training, and the cheaper the better. They also appear to have no understanding of how much time the care of each patient requires, and especially the more dependent and elderly patients, and how many staff are needed to do this effectively and to the highest standards. They have a notion obviously of cost-effectiveness which does not seem directly related to needs and demands but apparently very little of safety (in numbers) and clinical excellence to provide the best possible outcomes.

    I shouldn't need to have to apologise for repeating this elsewhere but do anyway at the risk of boring my professional colleagues but in the hopes some non-clinical managers will also take on board the points I make.

    the other way of getting cheaper labour is recruiting from abroad, and whilst I have no objections to nurses from overseas with whom I have worked with many highly trained and excellent ones, it also has to be remembered that there are many trained in the UK which have also cost taxpayers vast sums of money who would welcome these jobs and it is a total brain drain, utter waste and an insult to all the effort they have put into their training and careers not to employ them.

    I would say though in defence of the British economy, at the current time which we do not wish to see end up as some of those of the Med. countries in the Eurozone, that the problems of the enormous pressure of the costs of the huge nursing workforce must be urgently addressed and would question whether this pressure is really the issue it is made out to be or whether it is due to poor management of financial and labour resources with too much of the former being poured into management which does not seem to be effective at that! Waste must be eliminated so that funds are directed to the front line where they are meant to be for the sake of patients and their safety and well being.

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  • I fully agree with the above comment. The problem is, many of the nurse managers don't care about the patients or their staff.

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  • 4.19pm I agree; they don't give a monkeys.

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  • When will they ever learn?
    When will they e-ever learn.
    (Peter Paul and Mary)

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  • will politicians and their families go into hospital, NHS or private, and will they ask for their care to be delivered by HCAs or Nurses?

    the answer should be simple? pay peanuts, get... empty packets!

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  • Very true

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  • I am currently an adult nursing degree student and also a qualified operating department practitioner with over fifteen years experience.
    The trust that I am assigned to has created a band 4 Higher level care support worker role whereby unqualified staff can do the majority of nursing tasks. In essence, they practice everything (catheterization, E.C.G.'s, phlebotomy, b.m's, etc) plus all of the menial tasks such as putting stock away, cleaning commodes and also personal care and feeding etc. This is not an exhaustive list!!
    The only thing that they are not allowed to practice is drug administration.
    My main concerns are :
    1) why am I bothering to do a degree in nursing when there will not be any nursing tasks for me to do.

    2)The HCA is very good at performing these tasks in a mechanical fashion without indoctrination of supporting rationale.

    3) They are not registered with any governing body, therefore the onus lies with trained staff if a problem occurs.

    4) They are being utilised as a cheap labour force without recognition of their work and capabilities.

    5) Why were the enrolled nurses phased out when there was obviously a need to retain them and their professional qualification.

    6) Nursing is training students to become non clinical managers when the whole point of training is to become a nurse!!! TO CARE FOR PATIENTS NOT USELESS REAMS OF PAPERWORK TO ILLUSTRATE HOW EFFECTIVE NON NURSE CARERS PRACTICE IS !!!

    7) The general populace are unaware that the Hca performing the nursing task is not a nurse and has no theoretical input from a school of nursing .

    8) New nurses have adopted a culture whereby physical contact with a patient as in feeding/ washing/pressure area care is non-existent.

    9) Nursing has elevated itself to such a position that it no longer condones good old fashioned nursing principles....where the patient was always at the centre of the profession. The degree has done nothing for the profession. Patients do not care how many letters you have after your name, they appreciate compassion and empathy...something that hopefully the Francis Report will try to ameliorate.

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