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Editorial Graham Scott EDITOR

@NSeditor

We have more front line nurses, but at what cost? The coalition government is proud of its claim that there are more nurses in England’s health service now than when it came to power. After two years of cuts, there has been a steady increase in numbers as employers have sought to ensure they avoid a repeat of the staff shortages that contributed to the Mid Staffs care scandal. Expressed as full-time equivalents, there are an additional 6,434 registered nurses, midwives and health visitors in the English NHS than there were in 2010. However, behind the headline figure is a rather more complex picture, as the RCN exposed at the weekend in a report released as part of its Frontline First campaign.

EMPLOYERS ARE DESPATCHING SENIOR STAFF AROUND THE WORLD TO SEARCH FOR NURSES

The overall rise in nursing numbers is dominated by welcome increases among health visitors, midwives and school nurses. In contrast, the district nursing, mental health and learning disability workforces have experienced significant cuts, while the number of nursing staff employed on grades 7 and 8 has been reduced markedly. The RCN’s analysis of workforce statistics shows that the NHS has 2,800 fewer senior nurses now than at the time of the last election. The health service’s notoriously haphazard approach to workforce planning hasn’t been helping, either. A fall in the number of student commissions in 2010 and 2011 is of course being felt now, as fewer qualify. The consequence? Employers are despatching senior staff around the world in an increasingly desperate search for suitable nurses. This government’s record is not markedly different from others’ down the years. It should be commended for investing in midwives and health visitors, as the public health benefits should be felt for decades ahead. But the 3% reduction in total community nurse numbers makes no sense, and cuts in mental health and learning disabilities run counter to the administration’s own policies. With the general election likely to result in another coalition, let’s hope that whoever is health secretary from mid-May onwards resolves to implement a robust system that produces a nursing workforce with the numbers, skills and experience to meet patients’ needs. See news page 9

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We have more front line nurses, but at what cost?

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