Nurse shortage far worse than first thought, RCN analysis shows

The number of registered nurses needed to keep up with growing demand for hospitals and other services in the NHS in England could be at least twice as many as advertised. 

Testimony from nursing staff also shows how workforce shortages have led to patient safety incidents including fractures, delays to life-saving medication and brain bleeds.

Our new report, In short supply: Estimating the shortfall of registered nurses in the NHS in England, finds that there's a shortage of an estimated 55,000 registered nurses needed to deliver care safely, more than double the official number of NHS vacancies, which was 23,046 in August 2026.   

The gap is growing too. In the last year, nurse numbers grew by just 1%, but experts say a 2.5 to 5.7% increase is needed.  

We're demanding the Westminster government addresses this in the upcoming NHS Workforce Plan and for NHS trusts to be properly funded now to recruit the right number of staff in the right places.

Our report demonstrates that nurse numbers have been held down since 2009, while the number of doctors in NHS roles has grown at double the rate.  

If nursing workforce investment had kept pace with that of doctors, there would be more than 77,000 additional nurses working in the NHS in England today. 

Professor Nicola Ranger, RCN General Secretary and Chief Executive, said: “The numbers are clear: we would have tens of thousands more nurses working in our NHS if we’d had the necessary investment to keep up with demand. Instead, our numbers have been held down, in contrast to other staff.  

“When you have too few registered nurses, you get longer hospital stays, worse outcomes and more pressure on an already burned out and exhausted workforce."

Our publication also includes new analysis of hospital trust board papers with some hospitals reporting hundreds of safety reports arising from nursing staff shortages, including delays to pain relief, essential medication and missed care.

One registered nurse in a hospital in the East of England said: “Patients are staying in hospital for far longer because the quality of care they receive is worse. We’re so busy, you can only deal with the immediate task in front of you. That means you can’t do any prevention work, and they are less prepared for going back into the community and more likely to be re-admitted." 

A charge nurse in the West Midlands said their unit has not had a fully staffed shift for more than six months, with shortages causing delays to vital medication for patients including those with Parkinson's and sepsis. They added that budget pressures have left wards struggling to buy basic supplies, let alone recruit more staff. 

Nicola said: "This report is more undeniable evidence of the clear link between registered nurse staffing levels and patient harm. It's utterly shocking that sick patients should wait hours for pain relief or vital medication, while some are falling, breaking bones and deteriorating needlessly.  

“The truth is patient safety incidents aren’t isolated, and trusts are recording hundreds each month due to registered nurse shortages.” 

This pattern isn't new. In a report commissioned by the RCN, internationally renowned health care workforce expert Professor James Buchan said nursing continues to be hit hardest when budgets are tight.

He said that delivering a sustainable workforce will require a substantial increase in domestic nurse training, stronger retention, and a more consistent national workforce planning system. This is to ensure nursing isn’t the first profession to lose out in times of financial pressure.

The RCN is committed to campaigning for mandated minimum nurse-to-patient ratios. If you have staffing or safety concerns, use the RCN ratios resource and template letters to raise concerns in your workplace.