The claims

“Official statistics show that there are only 450 fewer qualified nursing staff in England than in September 2009.”
Simon Burns, 14 May 2012

“Across the whole of the NHS we have seen staffing levels reduce. But clinical staffing levels overall have gone up by nearly 4,000.”
Andrew Lansley, 14 May 2012

“Official statistics now reveal that 26,327 FTE NHS posts have already been lost since…April 2010.”
Royal College of Nursing,  14 May 2012

The background

The Royal College of Nursing (RCN) claims 61,000 NHS jobs will have been cut across the UK by 2015.

It’s the biggest projection yet of the effects of public spending cuts on frontline healthcare workers.

We can’t FactCheck that figure because it’s just a prediction, but the RCN says 26,000 NHS staff have been lost already across Britain, with thousands of nurses among them.

That suggests that we are on track for a major fall in numbers by the next election, with many frontline staff among the casualties.

But health minister Simon Burns said today: “We do not recognise these figures. Official statistics show that there are only 450 fewer qualified nursing staff in England than in September 2009 while the number of managers has been slashed by 15 per cent.” 

The health secretary, Andrew Lansley, appeared to contradict his junior later when he said: “The number of qualified nurses has gone down by nearly 3,000 in two years in England.”

Speaking at the RCN conference, he also admitted that the NHS as a whole was losing staff, but insisted that levels of clinical staff are up by nearly 4,000 – a claim that provoked accusations of lying from union delegates.

The analysis

Simon Burns

The Royal College of Nursing uses these rolling monthly workforce figures from the NHS Information Centre. January this year is the latest month in the series.

Technically, the stats do prove Mr Burns right, but only if you start the clock ticking in September 2009 – some eight months before the coalition came to power – and look at headcount rather than the usual measure of fulltime equivalent (FTE) posts.

The Department of Health told us the minister wanted to make an annual comparison, and the year-on-year numbers are counted from September from September.

This slightly odd timeframe allows him to start counting from a statistical low point for staffing levels: there were only 307,749 FTE posts in September 2009, much lower than later months.

If you start the clock at a more logical point like March 2010, when many NHS trusts began to implement spending plans in anticipation of cuts, or in May 2010, the month of the general election, the numbers are much higher – 311,787 and 310,793 posts respectively.

The latest staffing total we have, for January 2012, is the equivalent of 308,199 qualified nurses, midwives and health visitors.

So there’s been a cut of about 2,600 since the last election, and there were 2,790 fewer nursing staff posts in January this year compared with the same month last year.

Andrew Lansley

That means Mr Lansley is correct to admit to a fall of “nearly 3,000” nursing staff.

He’s also right that overall clinical staff levels have risen, but only if you choose your time frame carefully. Between January 2010 and January 2012 there’s a rise of 3,600. And from May 2010 to January this year we’re up by 4,141.

But there’s been a fall of 1,423 over the most recent 12 months that we know about.

Continued rises in the number of fully qualified doctors appear to be behind the overall buoyancy of clinical staff levels, and it’s hard for the coalition to take credit for that.

If it takes from three to seven years to train a doctor, the increases now must be the result of the last government’s policies.


The royal college is also right to say about 26,000 posts have gone across the UK so far since the end of March 2010, according to these figures.

If that trajectory continues, it’s not impossible that the total cuts by 2015 will be in the 60,000 ballpark.

We should point out that the 26,000 includes cuts in Wales, Scotland and Northern Ireland, but Messrs Burns and Lansley are only directly responsible for England, where staff numbers fell by just over 17,000 in the 12 months to January 2012.

And clearly, that figure is for all staff, clinical and non-clinical. As we have seen, levels of clinical staff as a whole have been maintained and the government is right to say that the axe has fallen more heavily on managers and admin staff than on doctors and nurses.

Managers and senior managers have suffered a bigger percentage hit than most categories of clinical staff, and in general the NHS is shedding non-clinical staff in greater numbers: more than 10,000 posts in “infrastructure support” went in the 12 months to January 2012, compared to 1,423 clinicians.

The verdict

Mr Burns didn’t tell an outright lie but his use of September 2009 as a baseline seems a little disingenuous to us.

We’re also a bit dubious about another one of the claims he made today: “The number of nurses to beds in hospitals is going up.”

Again, that’s technically true. If you divide the number of nurses by the stats for available beds, and compare September 2009 with January 2012, the ratio improves from 2.14 nurses per bed to 2.23, by our reckoning.

All this demonstrates is that bed numbers have been cut faster than nurses under the coalition, despite the fact that we already some of the lowest figures for hospital beds per head of population in Europe.

Not all healthcare experts agree that shrinking numbers of bed space is always a bad thing, but Mr Lansley apparently did when he was in opposition, calling Labour’s cuts “madness”.

Mr Lansley deserves more credit for owning up to real cut in nursing numbers of almost 3,000, and he’s right about an overall rise in clinical staff over the last two years, depending on when you start counting.

Where does all this statistical sleight-of-hand leave us? There is some evidence that trusts have been trying to protect clinical staff, although that may be cold comfort for nursing staff and much-maligned NHS managers, both of whom are being hit.

And the recent fall in clinical staff over the year to January 2012 looks ominous.

By Patrick Worrall