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NHS relying more on support staff to cope with nurse shortage, report says

Health Foundation says HCAs and nursing associates are filling recruitment gaps

Health Foundation says healthcare assistants and nursing associates are filling recruitment gaps

Artwork shows a nurse writing on a board listing staff numbers. NHS England is increasingly relying on support staff such as healthcare assistants and nursing associates to make up for its failure to recruit enough nurses, a report says.
Picture: Pete Coburn

 The NHS in England is increasingly relying on nursing support staff to cope with a massive shortage of registered nurses, according to a report by a healthcare charity.

Support staff such as healthcare assistants and nursing associates have been used to shore up staffing numbers, the Health Foundation said.

Its director of research and economics Anita Charlesworth said: ‘Services are being forced to make do with shortfalls of increasingly pressurised nurses and rely on less skilled support staff to pick up the slack.’

Overall rise in NHS workforce masks shift in clinical staff mix

There are currently almost 44,000 nursing vacancies in the NHS in England, equivalent to 12% of the nursing workforce, but this could hit 100,000 in a decade, the report says.

In the year to March 2019, the NHS saw the biggest annual increase this decade in its overall workforce, it adds, but this masks an ongoing shift in the mix of clinical staff employed in the NHS.

Although the number of doctors grew by 2.5% in 2018-19, that of full-time equivalent nurses grew by just 1.5%, or 4,500 nurses, the report says.

Meanwhile, 6,500 more full-time equivalent support staff for doctors, nurses and midwives were employed in the NHS, a rise of 2.6%.

Staffing trends ‘appear largely unplanned’

Ms Charlesworth said staffing was a make or break issue in the general election. ‘Clinical support staff play an incredibly valuable role in the NHS if they are supported in a well-planned way, but these trends appear to be largely unplanned, reflecting the failure to recruit enough nurses.’

RCN general secretary Dame Donna Kinnair said the danger to patients in this situation came from an absence of nurses, not an increase in support staff.

Professor Kinnair said: ‘It is unfair on healthcare assistants to ask them to take on work they aren’t trained or paid for in a desperate bid to plug gaps.’

The impact of nusing student attrition

The report also looks at nursing education, including the findings from a joint analysis with Nursing Standard on nursing student attrition.

The analysis found attrition on nursing degree courses is stubbornly high, with one in four students dropping out of their studies before graduation between 2015 and 2018.

The report also highlights data showing that geographical areas where fewer nursing students are accepted onto courses have higher vacancies in local NHS services.


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Support staff and nurses from abroad plugging shortages in NHS workforce (Health Foundation)


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