New report highlights fall in number of NHS nurses in England

The number of nurses and health visitors employed by the NHS in England has fallen for the first time on a year-on-year basis since April 2013, according to an analysis by The King’s Fund.

The report, written by the charity's director of policy Richard Murray, states that there were fewer NHS nurses and health visitors in post in April this year compared with April 2016.

In April 2016 there were 285,080 full-time equivalent nurses and health visitors employed by the NHS in England but in April this year there were 284,619.

The trend continued in June this year, with 316,725 nurses and health visitors in post – 703 fewer than in June 2016.

Brexit influence

Mr Murray said a key factor in the fall has been a significant reduction in European Union (EU) nurses joining the UK register since Brexit, as well as changes to English language-testing requirements, together with an increasing number of EU staff leaving the NHS.

He said the figures point to a 'mismatch' between the number of nurses and rising demand for NHS services. Emergency admissions have risen more than 14% since 2010, while the number of nurses increased by just 0.7% over the same period. 

The analysis follows Jeremy Hunt’s announcement of plans for a 25% increase in the number of nursing student places.

Worrying trend

Mr Murray said: ‘There is good evidence that having enough nurses is essential for delivering safe care, so it is worrying that the number of nurses is going down at a time when services are already overstretched and demand for care is rising.

‘This means the NHS is less equipped to cope with the demands of a winter that was already threatening to stretch the NHS to the limit.

‘While last week’s announcement of an increase in nursing training places is welcome, it will take years for this to translate into extra nurses on the wards. Workforce planning has been neglected for too long in the NHS, and the fact that the EU referendum result appears to have tipped the balance highlights how fragile the workforce situation has become. A new workforce strategy is desperately needed.’

Union response

Commenting on the report, RCN chief executive Janet Davies said it reinforced the need for mandated nurse staffing levels. She repeated the college’s calls for UK-wide nurse staffing legislation after a 30,000-strong RCN survey of nurses found many were being left sick, burned out and ‘sobbing’ due to staff shortages.

‘The government’s boasts of increasing nursing staff are starting to ring more than a little hollow,’ said Ms Davies. ‘Since the stark warnings made by Robert Francis four years ago, Jeremy Hunt prided himself on rising numbers, but this expert analysis reveals a worrying decline.

‘Health and care providers must give urgent assurances that services are safe for patients this winter. The decline is a direct result of years of poor decisions and excessive cost-cutting – we need a new law that makes ministers and others more accountable for proper workforce planning and safe and effective staffing levels.’

A Department of Health spokesperson said: 'Patients should be told that we actually have more nurses on our hospital wards since April 2016 not fewer, which alongside last week's announcement of the biggest ever increase in nurse training places underlines our commitment to ensuring the NHS has the nurses it needs to provide the best possible care for patients, both now and in the future.

'There are also 3,193 more EU nationals working in the NHS than at the time of the referendum.

'We have been absolutely clear that they play a vital role in the NHS and want to see their excellent work continue long after the UK leaves the EU.'

In other news

• Nursing Standard podcast: ‘Workforce planning is not a game of chess, Jeremy Hunt’
• NHS will need more cash for salary rises after pay cap scrapped, ministers warned