Coalition cuts blamed for shortage of 20,000 NHS nurses

FOI requests reveal ‘hidden workforce crisis’ at odds with official statistics

Spending cuts have created a shortage of 20,000 NHS nurses, the Government has been warned, as fears grow that hospital wards may struggle to cope as winter approaches.

Freedom of Information requests submitted by the Royal College of Nursing (RCN) to dozens of NHS hospitals in England have exposed a “hidden workforce crisis” that has been missed by government statistics.

While official figures say that just 3,859 full-time nurse, midwife and health visitor posts have been lost since the Coalition came to power in May 2010, the RCN said that thousands more nursing vacancies have been created because hospitals have not been replacing staff that have retired or moved on due to reduced budgets.

Staffing shortages have been highlighted in a number of reports into NHS care. Robert Francis drew attention to understaffed wards at the Mid Staffordshire NHS Trust in his report into one of the worst care scandals in the health service’s history.

Howard Catton, the RCN’s head of policy, said that Government figures had not been “fully reflecting the shortages [that nurses] are experiencing at ward level”.

The report came as Downing Street confirmed that the Prime Minister is personally overseeing the NHS’s response to what A&E doctors have warned could be “our worst winter yet”. Many trusts missed their A&E targets last winter and there are fears that amid rising demand and reduced resources, the system may struggle to cope with expected spikes in admissions.

Andy Burnham, Labour’s shadow Health Secretary, said the RCN’s report raised “a worrying prospect that the NHS is going into winter with 20,000 fewer nurses than it should have”.

The RCN found that, out of 61 trusts that provided data, the average “vacancy rate” for nursing posts was 6 per cent – up from just 2.5 per cent in 2010. Across the NHS, such shortages would amount to nearly 20,000 fewer nurses than needed to provide the best possible care to patients.

Vacancy rates are determined by the difference between the number of nurses that hospital managers estimate they need and the number that they actually have. The Government used to collect the data, but temporarily stopped doing so in 2011 as part of a drive to save money on bureaucracy in the NHS. At some hospitals, the vacancy rate for nursing posts is as high as 16 per cent.

A simultaneous 15 per cent cut to the number of nursing student places since 2010/11 has led to many NHS trusts seeking to recruit from overseas, the RCN said.

The Department of Health said it would soon resume collecting vacancy data and said the health watchdog the Care Quality Commission would take action against any hospitals found to be operating without enough staff.

However, Mr Catton said that, by failing to monitor vacancy rates, the Government had missed warnings on staffing levels. He said: “We are concerned. We think it’s an important indicator of the workforce. It’s akin to the petrol gauge in your car. It tells you what you’ve actually got but also how much you need.”

Q&A: Why A&E departments are under pressure

Q | What are A&E wards supposed to be for?

A | The Royal College of Emergency Medicine warned last week that A&E must not be interpreted as “anything and everything”. It means accident and emergency – the NHS recommends that, generally, patients should visit for “life-threatening emergencies”.

Q | Why are they becoming overcrowded?

A | Demand has increased and beds in other hospital wards are in short supply. Opinions differ as to why demand is up. Britain has an ageing population, and older people are more likely to need emergency care. There has also been a shift in patients with more minor conditions going to A&E when before they would have seen their GP. Jeremy Hunt, the Health Secretary, controversially blamed this on GPs giving up responsibility for out-of-hours care in contract renegotiations in 2004 – an accusation they strongly denied.

Q | What are the alternatives to visiting A&E?

A | For non-urgent medical complaints the best place to go is still the GP surgery – and there are still 250 million GP attendances every year, compared to 21 million A&E attendances. In the past few years many walk-in centres and minor injury units have opened, which allow patients with minor conditions to see a doctor or nurse without an appointment. These kinds of wards are included in A&E statistics and account for the bulk of the recent increase in attendances. Increases at type 1 – or major A&E wards – has actually been relatively small.

Q | So why did so many miss their targets last year?

A | A&Es are expected to deal with 95 per cent of patients – either treating you and sending you home, or admitting you to hospital – in less than four hours. Last winter the number of people having to wait longer than that hit nine-year highs, ringing alarm bells about an A&E crisis. Nigel Edwards, a senior fellow at the King’s Fund health think-tank, believes that problems in A&E “are very often caused by our inability to discharge people from hospitals”. He points to a lack of capacity in the social care system, so when an elderly patient seeks emergency care at a hospital, it struggles to find somewhere safe for them to go after they have been treated.

That means more beds are taken up, and it takes longer to move people out of A&E into another ward, which in turn means it can take longer for doctors to see people who come to A&E, because resources are taken up by patients who, ideally, would already be in another ward.

Q | Why is the Government so concerned about A&E performance this winter?

A | Because admissions always go up in the winter months. The the Christmas bank holidays put pressure on the system, with many social care and other services shutting down, leaving hospitals to cope on their own. The great fear of any winter season – and one which played a part in the Government’s decision to inject an extra £250m of funding for A&Es this winter – is the risk of a major flu outbreak.

Suggested Topics
Start your day with The Independent, sign up for daily news emails
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksAn introduction to the ground rules of British democracy
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Recruitment Genius: Cleaner

£15000 - £16500 per annum: Recruitment Genius: If you've got first class custo...

Recruitment Genius: Mobile Applications Developer / Architect - iOS and Android

Negotiable: Recruitment Genius: This is a great opportunity to join a medium s...

Recruitment Genius: Telesales Account Executive - £40K OTE

£11830 - £40000 per annum: Recruitment Genius: Working in a friendly, sales ta...

Recruitment Genius: Web Designer

£15000 - £27000 per annum: Recruitment Genius: One of the UK's leading web des...

Day In a Page

John Palmer: 'Goldfinger' of British crime was murdered, say police

Murder of the Brink’s-MAT mastermind

'Goldfinger' of British crime's life ended in a blaze of bullets, say police
Forget little green men - aliens will look like humans, says Cambridge University evolution expert

Forget little green men

Leading evolutionary biologist says aliens will look like humans
The Real Stories of Migrant Britain: An Algerian scientist adjusts to life working in a kebab shop

The Real Stories of Migrant Britain

An Algerian scientist struggles to adjust to her new life working in a Scottish kebab shop
Bodyworlds museum: Dr Gunther von Hagens has battled legal threats, Parkinson's disease, and the threat of bankruptcy

Dying dream of Doctor Death

Dr Gunther von Hagens has battled legal threats, Parkinson's disease, and the threat of bankruptcy
UK heatwave: Temperature reaches 39.8 degrees on Central Line - the sweatiest place in London

39.8 degrees recorded on Tube

There's hot (London) and too damn hot (the Underground). Simon Usborne braved the Central line to discover what its passengers suffer
Kitchens go hi-tech: From robot chefs to recipe-shopping apps, computerised cooking is coming

Computerised cooking is coming

From apps that automatically make shopping lists from your recipe books to smart ovens and robot chefs, Kevin Maney rounds up innovations to make your mouth water
Jessie Cave interview: The Harry Potter star has published a feminist collection of cartoons

Jessie Cave's feminist cartoons

The Harry Potter star tells Alice Jones how a one-night stand changed her life
Football Beyond Borders: Even the most distruptive pupils score at homework club

Education: Football Beyond Borders

Add football to an after-school homework club, and even the naughtiest boys can score
10 best barbecue books

Fire up the barbie: 10 best barbecue books

We've got Bibles to get you grilling and smoking like a true south American pro
Wimbledon 2015: Nick Bollettieri - Junk balls and chop and slice are only way 5ft 1in Kurumi Nara can live with Petra Kvitova’s power

Nick Bollettieri's Wimbledon Files

Junk balls and chop and slice are only way 5ft 1in Kurumi Nara can live with Petra Kvitova’s power
Ron Dennis exclusive: ‘This is one of the best McLaren teams ever – we are going to do it’

‘This is one of the best McLaren teams ever – we are going to do it’

Ron Dennis shrugs off a poor start to the season in an exclusive interview, and says the glory days will come back
Seifeddine Rezgui: What motivated a shy student to kill 38 holidaymakers in Tunisia?

Making of a killer

What motivated a shy student to kill 38 holidaymakers in Tunisia?
UK Heatwave: Temperatures on the tube are going to exceed the legal limit for transporting cattle

Just when you thought your commute couldn't get any worse...

Heatwave will see temperatures on the Tube exceed legal limit for transporting cattle
Exclusive - The Real Stories of Migrant Britain: Swapping Bucharest for London

The Real Stories of Migrant Britain

Meet the man who swapped Romania for the UK in a bid to provide for his family, only to discover that the home he left behind wasn't quite what it seemed
Cheaper energy on the way, but it's not all sunshine and rainbows

Cheaper energy on the way, but it's not all sunshine and rainbows

Solar power will help bring down electricity prices over the next five years, according to a new report. But it’s cheap imports of ‘dirty power’ that will lower them the most