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
News
peopleHowards' Way actress, and former mistress of Jeffrey Archer, was 60
Sport
Romelu Lukaku puts pen to paper
sport
News
Robyn Lawley
people
Arts and Entertainment
Unhappy days: Resistance spy turned Nobel prize winner Samuel Beckett
books
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
News
ebookA unique anthology of reporting and analysis of a crucial period of history
News
people
Life and Style
Troy Baker and Ashley Johnson voice the show’s heroes
gamingOnce stilted and melodramatic, Hollywood is giving acting in video games a makeover
News
i100
Life and Style
Phones will be able to monitor your health, from blood pressure to heart rate, and even book a doctor’s appointment for you
techCould our smartphones soon be diagnosing diseases via Health Kit and Google Fit?
News
people
Extras
indybest
Travel
Ryan taming: the Celtic Tiger carrier has been trying to improve its image
travelRyanair has turned on the 'charm offensive' but can we learn to love the cut-price carrier again?
Sport
Usain Bolt confirms he will run in both the heats and the finals of the men's relay at the Commonwealth Games
commonwealth games
Life and Style
Slim pickings: Spanx premium denim collection
fashionBillionaire founder of Spanx launches range of jeans that offers 'thigh-trimming construction'
News
Sabina Altynbekova has said she wants to be famous for playing volleyball, not her looks
people
News
i100
Life and Style
tech'World's first man-made leaves' could use photosynthesis to help astronauts breathe
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
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

SAP Project Manager

competitive: Progressive Recruitment: SAP PROJECT MANAGER - 3 MONTHS - BERKSHI...

SAP Project Manager

competitive: Progressive Recruitment: SAP PROJECT MANAGER - 3 MONTHS - BERKSHI...

Senior Investment Accounting Change Manager

£600 - £700 per day + competitive: Orgtel: Senior Investment Accounting Change...

Microsoft Dynamics AX Functional Consultant

£65000 - £75000 per annum + benefits: Progressive Recruitment: A rare opportun...

Day In a Page

Save the tiger: The day America’s love of backyard tigers led to a horrific bloodbath

The day America’s love of backyard tigers led to a horrific bloodbath

With only six per cent of the US population of these amazing big cats held in zoos, the Zanesville incident in 2011 was inevitable
Samuel Beckett's biographer reveals secrets of the writer's time as a French Resistance spy

How Samuel Beckett became a French Resistance spy

As this year's Samuel Beckett festival opens in Enniskillen, James Knowlson, recalls how the Irish writer risked his life for liberty and narrowly escaped capture by the Gestapo
We will remember them: relatives still honour those who fought in the Great War

We will remember them

Relatives still honour those who fought in the Great War
Star Wars Episode VII is being shot on film - and now Kodak is launching a last-ditch bid to keep celluloid alive

Kodak's last-ditch bid to keep celluloid alive

Director J J Abrams and a few digital refuseniks shoot movies on film. Simon Usborne wonders what the fuss is about
Once stilted and melodramatic, Hollywood is giving acting in video games a makeover

Acting in video games gets a makeover

David Crookes meets two of the genre's most popular voices
Could our smartphones soon be diagnosing diseases via Health Kit and Google Fit?

Could smartphones soon be diagnosing diseases?

Health Kit and Google Fit have been described as "the beginning of a health revolution"
Ryanair has turned on the 'charm offensive' but can we learn to love the cut-price carrier again?

Can we learn to love Ryanair again?

Four recent travellers give their verdicts on the carrier's improved customer service
Billionaire founder of Spanx launches range of jeans that offers

Spanx launches range of jeans

The jeans come in two styles, multiple cuts and three washes and will go on sale in the UK in October
10 best over-ear headphones

Aural pleasure: 10 best over-ear headphones

Listen to your favourite tracks with this selection, offering everything from lambskin earmuffs to stainless steel
Commonwealth Games 2014: David Millar ready to serve up gold for his beloved Scotland in the end

Commonwealth Games

David Millar ready to serve up gold for his beloved Scotland in the end
UCI Mountain Bike World Cup 2014: Downhill all the way to the top for the Atherton siblings

UCI Mountain Bike World Cup

Downhill all the way to the top for the Atherton siblings
Save the tiger: The animals bred for bones on China’s tiger farms

The animals bred for bones on China’s tiger farms

The big cats kept in captivity to perform for paying audiences and then, when dead, their bodies used to fortify wine
A former custard factory, a Midlands bog and a Leeds cemetery all included in top 50 hidden spots in the UK

A former custard factory, a Midlands bog and a Leeds cemetery

Introducing the top 50 hidden spots in Britain
Ebola epidemic: Plagued by fear

Ebola epidemic: Plagued by fear

How a disease that has claimed fewer than 2,000 victims in its history has earned a place in the darkest corner of the public's imagination
Chris Pratt: From 'Parks and Recreation' to 'Guardians of the Galaxy'

From 'Parks and Recreation' to 'Guardians of the Galaxy'

He was homeless in Hawaii when he got his big break. Now the comic actor Chris Pratt is Hollywood's new favourite action star