A shortage of nurses in the capital is increasing with more than 8,000 posts unfilled and a particular strain on mental health services, research by the Royal College of Nursing has revealed.
The RCN London Safe Staffing Report, published this week, shows more than 14% of nursing posts are now vacant, up from 11% a year ago, with some trusts reporting vacancy rates as high as 23%.
“London still suffers from a critical shortage of nurses and only 40% of the new posts have been filled”
While the total number of posts has actually increased, many trusts are struggling to fill the new jobs. According to the RCN, 60% of these newly-created posts remain vacant.
“We have heard of trusts advertising jobs and not finding a single candidate who can attend an interview,” said the report, which warns of a looming recruitment crisis.
Overall, London trusts increased nursing establishments in 2014 by 4% – around 2,500 posts – with more than a 1,000 extra nurses working in London’s NHS, compared to a year ago.
“The number of nursing posts across London has increased sharply this year. However, London still suffers from a critical shortage of nurses and only 40% of the new posts have been filled,” said RCN regional director Bernell Bussue.
“As the cost of living continues to rise, much more needs to be done, right across the system to make sure London remains an attractive and affordable place for nurses to work so local employers can recruit enough staff to deliver high quality patient care.”
The RCN report (see top-right), which is based on information gathered via Freedom of Information requests, showed just four trusts cut posts in 2014. However, nine now employ fewer nurses than a year ago.
According to the report, Central London Community Healthcare Trust employed 11% fewer nurses and has seen a 15% reduction in qualified nursing posts since April 2013. The trust said it did not want to comment on the figures until it had a chance to look into the data featured in the report.
Overall, the research also found ongoing cuts to senior posts, with 80% of the new jobs created at band 5, while posts at band 8a and above were cut by 2%.
“With such high turnover of staff and such pressure on services the loss of leadership positions remains a worry for London nursing,” said the report.
Seven trusts had vacancy rates of 19% or more as of July, with the highest – 23% – at Hounslow and Richmond Community Health Trust.
However, the trust told Nursing Times it had taken numerous steps over recent months to reduce its vacancy rate.
“Since July, the vacancy rate has reduced by six percentage points from 23-17% and we are continuing to increase our permanent workforce month on month,” said a trust spokeswoman.
She said the trust was working hard to promote itself as an “employer of choice”, flagging up good results in the NHS staff survey in areas such as training and development. Meanwhile, a series of recruitment initiatives were planned for the new year including stands in local shopping centres.
“We are acutely aware of the pressure on the community nursing workforce,” added the spokeswoman, who highlighted the near 50% drop in numbers in the past decade.
“We will continue to make the case to commissioners and other stakeholders for a shift in resources from acute to community services,” she said.
“Overall we are delighted with the strides we are making”
Mental health provider Camden and Islington NHS Foundation Trust had a nursing vacancy rate of 21% as of July.
Claire Johnston, the trust’s director of nursing and people, said it had reduced its nursing vacancies “dramatically” to around 12%, since the RCN’s survey via a successful recruitment campaign, involving Middlesex University and the Health Education North Central and East London.
“There are areas where we still need nurses, in wards and in community services, and we are also introducing new schemes to attract able non-professionally qualified staff but overall we are delighted with the strides we are making,” she said.
Staffing in mental health of concern
The report raises particular concerns about mental health services. A survey of RCN members working for mental health providers in London highlighted concerns about safe staffing levels.
It found 69% thought their ward or unit had too few qualified nursing staff, while 70% said staffing levels were having a negative impact on patient care.
“The job is mainly firefighting and crisis management”
Mental health nurse
Sixty per cent said they were asked to care for more patients than was safe at least once a week. Staff reported they were increasingly working unpaid overtime with a quarter saying they did this every single day.
“I feel the job is becoming unsafe for both staff and patients,” said one band 6 mental health nurse working in south London. “The option of actually offering any positive treatment is becoming less and less and the job is mainly firefighting and crisis management.”
The nurse said many jobs were only completed because of the “goodwill of staff”, but added “this is starting to become thin on the ground”.
The survey also suggested many trusts were increasingly relying on bank and agency staff, with 53% of respondents saying their shift relied on them every day.
The RCN has called for a more strategic approach to long-term workforce planning and an end to pay freezes, which it claimed were vital steps to improve the staffing situation in the capital.
The union also wants to see better pastoral care for nursing staff coming to live and work in the UK for the first time, so they are able to settle in London.