Expert advice

Workforce: Nursing numbers – running hard but not keeping up

Rising staffing levels are failing to keep up with growth in patient admissions, and it is not possible to be confident of having enough NHS nurses now or in the future

Rising staffing levels are failing to keep up with growth in patient admissions, and it is not possible to be confident of having enough NHS nurses now or in the future


Picture: Alamy

The NHS is labour-intensive, with most of its running costs relating to staffing.

As the largest group of NHS professional staff, nurses are an obvious target for cost-cutting. In recent years this has led to understaffing by keeping funded posts vacant, dilution of skill mix and the trimming of continuing professional development (CPD) budgets.

Using staffing as a target for cost saving can all to easily undermine quality, potentially risking patient safety. This we know. But as the United Nations High-Level Commission on Health Employment and Economic Growth has stressed, we need to shift the focus.

This means not seeing the health workforce as a cost, and understanding that investing in staffing can have multiple health, employment, gender equality, social inclusion and economic benefits.

The connection between nurse staffing and costs was highlighted again in a report from the University of Southampton that presented an analysis of nurse staffing trends – national and local – in NHS England.

The study found that wards remain understaffed, despite new policies coming into force as a result of the 2013 inquiry into care failings at Mid Staffordshire NHS Foundation Trust.

Key messages

While the total number of nursing staff in acute care has increased since the inquiry, concurrent growth in the number of patient admissions means there has been no net improvement in registered nurse staffing levels. We are running hard but not even standing still, with staffing levels falling behind.

Two key messages emerge. First, ‘more’ nurses does not necessarily equate to sufficient nurses. Second, ‘safe staffing’ cannot be ensured only at local level – there needs to be a sufficient overall national supply of staff to enable local demands to be met.

Assessing if we have fewer or more nurses than we had before is not the point. We need to be confident that we have enough nurses now, and in the future. At present, we cannot have that confidence.


James Buchan is professor in the faculty of health and social sciences at Queen Margaret University, Edinburgh

 

 

Find out more

More from James Buchan

This article is for subscribers only

Jobs