FactFiction2The claim

“The NHS (is) potentially operating on nearly 20,000 fewer full-time nursing staff than planned.”

Royal College of Nursing, 12 November 2013

The background

There’s a “hidden workforce crisis” in the NHS, according to the Royal College of Nursing (RCN). It claims that there are nearly 20,000 unfilled nursing posts in England, putting patients at risk.

RCN Head of Policy Howard Catton said many trusts were freezing vacancies and holding posts vacant to make efficiency savings.

In the wake of the failures at Mid Staffs and Winterbourne View, the importance of staffing levels must be highlighted, he said.

But Health Minister Norman Lamb has insisted that overall numbers of clinical staff have increased in the NHS – and that the chief inspector of hospitals would “be able to take action if trusts are found to be compromising patient care by not having the right number of staff on wards”.

How unhealthy are staffing levels looking? FactCheck rolls up its sleeves.

The analysis

The RCN report is based on freedom of information requests from 61 of 250 NHS trusts in England. The government stopped collecting vacancy data in 2010, but the last report for March 2010 reported a vacancy rate in nursing of 2.5 per cent.

The RCN’s research shows this has climbed to an average of 6 per cent in nursing posts – ranging up to 16 per cent in some trusts.

Its report states that if replicated across the NHS, the vacancy rate would amount to nearly 20,000 full-time equivalent nursing, midwifery and health visiting vacancies.

The RCN said that cuts in the number of student nursing places, coupled with an ageing workforce, have contributed to a “workforce crisis”.

Certainly, their estimated vacancy rate is well above previous records – which ran from 1999-2010. Rates peaked at 4 per cent in 2000 and remained on a steady course downwards from then on.

But low vacancy rates were not necessarily a good thing.

In 2007, the RCN was busy warning the government that low vacancy rates were bad news for nurses.

General Secreatary of the RCN Dr Peter Carter said: “Thousands of newly qualified nurses – costing taxpayers millions of pounds to train – cannot find jobs this year. At the same time the workload of nurses on the wards and in the community remains high.”

He said it was time for the government to put in place a long-term workforce strategy “that prevents the feast or famine characteristic of the NHS job market in recent years”.

That same year, a report commissioned by the Nursing and Midwifery Council warned that to maintain nursing numbers “it is important that recruitment and retention continues to have a high profile”.

The report also forsaw an increase in specialist and advanced roles and an emphasis on community care for an elderly population by 2015.

This scenario is playing out. Official figures show that though overall numbers of full-time nurses have dropped by 5,895 between May 2010 and July 2013, specialist nurse numbers are all on the up.

The number of midwives has increased by 1,311 – to a total of 21,443. The number of health visitors is up by 700 – to a total of 8,792. And finally, the number of school nurses has risen by 26 – to a total of 1,158.

Meanwhile, Norman Lamb is right. The number of overall clinical staff has indeed risen from 555,950 in May 2010 to 560,047 in July this year. And the number of doctors has increased by 5,275 – to a total of 103,004 in July.

The verdict

The Royal College of Nursing’s figures are based on a freedom of information request – the details of which it has declined to share with FactCheck.

While there’s no reason for us to doubt the RCN’s estimates, it is perhaps worth pointing out that alarm bell over nursing numbers was sounded in 2007 – for exactly the opposite reason: low vacancy rates.

The RCN General Secretary Dr Peter Carter warned back then of “feast and famine” in the NHS jobs market.

He also complained there weren’t enough jobs for newly qualified nurses.

And that’s despite the number of nursing students in England following a “downward trend since 2003/04”, according to the Centre for Workforce Intelligence.

Today Dr Carter called on employers in the NHS to “put an end to boom-and-bust workforce”.

While the symptoms may differ, the diagnosis remains the same. Who can we trust with the NHS?

By Emma Thelwell