The RCN’s Employment Survey (2025) found that 70.4% of nurses work beyond their contracted hours at least once a week, with over half of this time (52.1%) unpaid. More than a third (34.8%) work extra hours several times a week, and 13.5% do so on every shift. Many nursing staff report being unable to take breaks or annual leave because of unsafe staffing levels.

Respondents described the significant toll that long hours and chronic understaffing have on their health, personal lives, and ability to deliver safe, effective care. Among those who regularly work additional hours, defined as at least one hour per week, around half state that this time is unpaid.

The RCN’s Last Shift Survey (2022) further highlights that staff are not getting basic rest breaks, including time for food, drinks, or even using the toilet. Many also begin shifts early or stay late to complete essential tasks. These patterns affect work–life balance, with nurses reporting ongoing worries about work, as well as feelings of depression, burnout, guilt, and exhaustion.

An investigation by the Health Service Safety Investigation Body (2025) links long shift lengths and lack of breaks to staff fatigue and reduced patient safety. RCN Workforce and Employment Standards emphasise employers’ responsibilities to ensure safe working hours and rest breaks.

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References

Health Service Safety Investigation Body (2025) The impact of staff fatigue on patient safety. Available at: hssib.org.uk/patient-safety-investigations/the-impact-of-staff-fatigue-on-patient-safety (Accessed 9 March 2026).

Royal College of Nursing (2025) State of the Profession: RCN Employment Survey Report 2025. Available at: rcn.org.uk/Professional-Development/publications/rcn-employment-survey-2025-uk-pub-012-342 (Accessed 9 March 2026).

Royal College of Nursing (2022) Nursing Under Sustainable Pressures: Staffing for Safe and Effective Care in the UK. Available at: rcn.org.uk/-/media/Royal-College-Of-Nursing/Documents/Publications/2022/June/010-270.pdf (Accessed 9 March 2026).

Further Information

Royal College of Nursing (2026) Working time and breaks. Available at: rcn.org.uk/Get-Help/RCN-advice/working-time-rest-breaks-on-call-and-night-work (Accessed 9 March 2026).

Royal College of Nursing (2025) RCN Employment Standards for Independent Health and Social Care Sectors. Available at: rcn.org.uk/Professional-Development/publications/rcn-employment-standards-for-independent-sectors-uk-pub-011-603 (Accessed 9 March 2026).

Royal College of Nursing (2025) Nursing Workforce Standards. Available at: rcn.org.uk/Professional-Development/publications/rcn-nursing-workforce-standards-uk-pub-011-930 (Accessed 9 March 2026).

Stock SJ (2024) Unpaid breaks: how practical action tackled a hidden problem. Available at: rcn.org.uk/magazines/Action/2024/Sep/Unpaid-breaks (Accessed 9 March 2026).