The Royal College of Nursing (RCN) has published (12 November 2013) a report into the state of the nursing workforce that raises grave concerns. The report claims that there are currently almost 20,000 nursing vacancies in England alone and warns that there are serious potential repercussions for the NHS as a whole.
The report goes on to highlight that there has been a 15% cut in the number of places for nursing students commissioned since 2010/11 and forecasts a shortage of 47,000 registered nurses by 2016. The Chief Executive of the RCN describes the situation as a 'hidden workforce crisis'.
This is set against a background of wide concerns about the health of the NHS. Its ability to cope with the increased demands of winter, particularly in acute and emergency care, is already in doubt. With widespread financial pressures and a series of recent high profile failings in which unsafe staffing levels played a major role, there is considerable focus on maximising resources while reassuring patients of their safety.
The RCN report, however, reinforces widely held fears. Andrew Clayton, associate in the clinical negligence team at Penningtons Manches LLP, says: “We have already warned that staff shortages are likely to lead to an increase in negligence claims and voiced concerns that a short-term fix by paying private hospitals to top up NHS care increases the risks to patients. Those risks clearly extend to nursing. Cuts in the number of student places and the number of nurses leaving for other careers have increased the pressure on those who remain.
“Until recently, financial constraints in the NHS had led to a freeze on the number of nursing vacancies that went unfilled but those trusts that are trying to recruit more nurses are finding it difficult. There are too few suitably qualified nurses in the UK and many trusts are looking overseas to fill these posts.“
The RCN report urges that more needs to be done to consider and plan how the NHS can deliver care now and into the future. The immediate demands of this winter threaten to detract attention from a more profound and systemic crisis if action is not taken to plan ahead for safe future staffing levels. The RCN sets out a list of its urgent priorities which include mandatory workforce planning and systems of inspection for reviewing safe staffing levels.
Meanwhile, the Nursing and Midwifery Council (NMC) warns that Directors of Nursing who fail to provide adequate numbers of nurses in their hospitals could have their fitness to practise questioned and face disciplinary action.
Says Andrew Clayton: “In the last couple of years we have seen a lot of clinical negligence claims arising from nursing issues. Some do result from bad practice or attitude but a number are at least partly attributable to resource issues. With increasing demand on the NHS, the reports of inadequate staff levels are a concern as there are likely to be more failings and, in turn, claims”.