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Nurses' goodwill is keeping NHS running, RCN warns

College accuses government of 'nursing on the cheap', as new research finds NHS nursing directors are concerned about over-reliance on goodwill and the impact of using unregistered staff

Four in five NHS nursing directors in the UK are worried that their hospitals rely on the goodwill of staff to keep services running, according to research from the RCN.


RCN general secretary Janet Davies accused the government of 'nursing on the cheap'.

New figures from NHS trusts in England support those concerns, as they reveal that one in eight nursing posts is unfilled, suggesting care providers are hiring fewer registered staff, it says.

Data obtained by the RCN under freedom of information laws show the total number of unfilled registered nursing posts is around 40,000, almost double the oft-cited figure of 24,000.

'Lethal cocktail' 

Two thirds of trusts in England planned for a greater proportion of unregistered nursing support staff in 2016 than a year earlier, the figures reveal.

RCN general secretary Janet Davies accused the government of 'nursing on the cheap', instead of recruiting and retaining registered and experienced nurses.

Ms Davies said: 'A lethal cocktail of factors in the NHS has resulted in too few registered nurses, and patient care is suffering. Pressure and demand has spiralled upwards at the very moment nurses' pay headed the other way.

'They stay behind after 12-hour shifts to give patients extra care and go home exhausted and sometimes in tears. Too many now feel no alternative but to leave nursing.'

Safe staffing laws

The college is now calling for nurse safe staffing levels to be enshrined in law. It warns that NHS patients face falling care standards unless all four UK countries enact legislation to guarantee safe staffing levels.

'Ministers must draw a line under this false economy and address safe staffing levels in new legislation. Nursing directors should not have to fight for the funding,' Ms Davies said.

She added that, with a new generation of UK nurses being deterred by low pay, increasing pressure and new training costs, it is vital that the government ensures the NHS retains experienced nurses.

'When finances are tight, nursing budgets are slashed and patients can pay the highest price,' she said. 'Hospitals are hiring unregistered staff and delegating jobs that should be done by trained nurses - the government cannot allow nursing on the cheap.'

Financial constraints

Separate research involving directors of nursing in all four countries of the UK, carried out by ComRes for the RCN, shows four out of five are concerned their hospitals are relying on staff goodwill to keep services running.

Furthermore, four in ten are concerned about the impact of delegating nursing care to unregistered staff, while two thirds say finances are tighter than two years ago.

Almost half (49%) of nursing directors agree that financial pressures mean they cannot always make the best decisions for patients in their care.

The RCN says mental health and community care are experiencing the greatest nurse shortages. According to the data, since 2010:

  • The community nursing workforce has shrunk by 14%, or 5,178 full-time-equivalent (FTE) posts.
  • In mental health services, nurse numbers have shrunk by 12%, or 4,759 FTE posts.
  • The learning disability nursing workforce has decreased by 33%, or 1,695 FTE posts.

The RCN report also shows nurse vacancy rates of 4.1% in Scotland and 3.8% in Northern Ireland.


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