One in five jobs vacant as recruitment crisis hits casualty units

About one-fifth of nursing posts in some accident and emergency departments are vacant, a survey has revealed.

The problem is particularly acute in London and the South-east, where agency or bank nurses make up as much as 40 per cent of staff on some shifts.

The survey of 20 hospital trusts by Nursing Times magazine – which said the statistics were a "serious" cause for concern – showed that some casualty departments were enduring severe recruitment problems at the busiest time of the year.

Chelsea and Westminster Healthcare NHS Trust has a 19.3 per cent vacancy rate, with the percentage of agency staff on a typical shift up to 28 per cent.

Ashford and St Peter's Hospitals NHS Trust has a 17.6 per cent vacancy rate. And the North Bristol NHS Trust has 16 per cent of posts unfilled, with 40 per cent of agency or bank nurses on some shifts.

Seven trusts polled in Scotland, Wales and Northern Ireland had vacancy rates of less than 12 per cent. Three trusts – Central Manchester Healthcare, Birmingham Heartlands and Solihull, and Carlisle Hospitals – had no vacancies.

A spokesman for the North Bristol NHS Trust warned that treating patients safely was becoming increasingly difficult because of the rising number of agency nurses. Skilled nurses were being lost to NHS Direct and walk-in centres, which offered staff a more attractive lifestyle, he said.

The findings come as nurses continued to condemn the Government's above-inflation 2002 pay rise of 3.6 per cent. The award, which is aimed at attracting new recruits, has been criticised for not going far enough to tackle the problem.

Tom Bolger, the assistant general secretary of the Royal College of Nursing, said: "This spot-check on the state of emergency services certainly gives cause for concern. Too often temporary nursing staff are allocated in an ad hoc way and may have to care for patients in unfamiliar situations."

Dr Liam Fox, the shadow Health Secretary, said: "This is a further blow to the Government's claims that things are improving. Not only are patients having to wait longer in accident and emergency to be seen, but it appears they may not then be seen by the most appropriate staff. And this from a Government that has been claiming there is no crisis in recruitment."

A Department of Health spokeswoman said yesterday: "We are investing £40m to fund an additional 600 accident and emergency nursing posts and are working to boost nurse numbers in areas like London and the South-east."

The latest figures showed that a quarter of the 10,000 extra nurses and midwives that joined the NHS in the year ending September 2001 were in London, with 1,300 in the South-east, she said.

"Nationwide, the latest provisional figures show there are 27,000 more nurses and midwives in the health service than in 1997. However, one effect of this expansion is that vacancies may initially rise in some areas as more posts are created."