Hunt promises 3,700 more nurses, but numbers continue to decline By Kat Keogh and Sally Gillen Nurse numbers in England have fallen by almost 2,500 since the start of the year, despite a government pledge to hire thousands more staff. New figures from the Health & Social Care Information Centre reveal that 306,025 nurses, midwives and health visitors were working in England in August this year – down from 308,483 in January. Health secretary Jeremy Hunt announced last week that hospitals will recruit 3,700 nurses in England by the end of March as part of the government’s response to the Francis report into failings at Mid Staffs. The RCN claims staffing problems run deeper than official figures suggest and warns of a ‘hidden crisis’, with nearly 20,000 nursing posts currently unfilled in England.

Recruitment drive

RCN head of policy Howard Catton said he welcomed the recruitment drive, but fears that the proposed number is not enough. He added: ‘I suspect that a number of these 3,700 posts are not actually “additional” nurses, but posts kept vacant or frozen deliberately that are now being recruited for in the glare of the Francis report.’ Hospital trusts that have recruited nursing staff this year include Pennine Acute Hospitals NHS Trust, which invested £3 million in more than 100 nurses and healthcare assistants. United Lincolnshire Hospitals NHS Trust hired 165 staff nurses between April and August. But despite the recruitment drives undertaken by foundation trusts, their own watchdog, Monitor, forecasts thousands of job losses in the next two years. Monitor predicts that England’s foundation trusts

will shed up to 4,000 full-time equivalent posts by 2016. Queen Margaret University Edinburgh workforce expert James Buchan said: ‘The claimed short-term gain of 3,700 by next March would redress the recent decline, but it is the long-term sustainability of the workforce that we need to focus on,


given continued increases in patient acuity, patient numbers and high bed occupancy.’ Government-commissioned healthcare reports by Robert Francis, Don Berwick and Sir Bruce Keogh all concluded that unsafe staffing levels contributed to poor care at Mid Staffs and at least 14 other hospitals. But ministers failed to introduce mandatory staffing levels in its response to the reports, arguing that each type of ward has different requirements.

Hospitals will instead publish staff numbers for every ward and the National Institute for Health and Care Excellence is developing staffing tools, which will be available to inpatient wards by July 2014. Last week, England’s chief nurse Jane Cummings published a ‘how to’ staffing guide. It includes advice on publishing daily reviews of the actual staff available on every shift compared with the planned numbers. The Safe Staffing Alliance, a group of leading nurses brought together by Nursing Standard, says patient care is at risk when there are more than eight patients to one nurse. Safe Staffing Alliance member and National Nursing Research Unit deputy director Jane Ball said that publishing nursing numbers would be meaningful only if they were accompanied by patient numbers. ‘It is wonderful that safe staffing has been such a key part of the response – the alliance has been instrumental in that,’ she said. ‘However, safe staffing is about the number of nurses on duty relative to the number of patients and their needs.’

Nurse posts by Health Education England area East Midlands   East of England  Yorks and Humber  Wessex  Thames Valley  North west London  South London  North, central and   east London Kent, Surrey and Sussex  North East  North West  West Midlands  South West 

Aug 10 Aug 11 23,521  23,337  28,154  28,049  32,991  32,550  14,154  13,737  10,653  10,667  13,549  13,389  17,872  18,008  20,174  20,444 

Aug 12 23,424  27,561  31,850  13,614  10,783  13,960  17,816  20,068 

Aug 13 23,561  27,525  31,623  13,960  10,508  14,315  17,778  19,956 

Change ▲   40 ▼  629 ▼ 1,368  ▼  194 ▼  145 ▲  766 ▼  94 ▼  218

20,369  19,555  48,866  33,196  24,002 

20,787  19,619  47,155  33,153  23,357 

21,012  19,827  47,862  33,152  23,501 

▲  643 ▲  272 ▼ 1,004 ▼  44 ▼  501

20,717  19,306  47,528  33,126  23,592 

Figures include midwives, school nurses and health visitors – full-time equivalents Source: Health & Social Care Information Centre

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Hunt promises 3,700 more nurses, but numbers continue to decline.

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