- The Royal College of Nursing (RCN) report further exposes the crisis in nursing, its Congress will hear of the risk to patient care
- Eight in 10 (83%) said that the staffing levels on their last shift were not sufficient to meet the needs of patients
- The findings show that only a quarter (25%) of shifts had the planned number of registered nurses on shift
New findings from the Royal College of Nursing (RCN) released today for the start of its annual conference shine a light on the impact of the UK’s nursing staff shortage.
In her keynote address to the RCN’s Congress in Glasgow on Monday, the College’s General Secretary and Chief Executive Pat Cullen will speak to nurses’ growing concerns over patient safety. She will call for action and say the shortages pose a risk to patient care.
At the College’s first in-person Congress since the pandemic, over 2,000 frontline nursing staff will participate in the event in Glasgow to address the issues facing the profession.
The College’s survey of nursing staff received over 20,000 responses, revealing that for over eight in 10 (83%) the staffing levels on their last shift were not sufficient to meet all the needs and dependency of their patients safely and effectively. This has increased from less than three quarters of respondents (73%) in 2020.
The findings show that only a quarter (25%) of shifts had the planned number of registered nurses, a sharp fall from 42% in 2020 and 45% five years ago, in 2017.
These findings add to the growing evidence around the increased risk that comes with below planned registered nurse staffing levels. Research from the University of Southampton found the hazard of death increased by 3% for every day a patient experienced a registered nurse staffing shortage.
The College will today hear how its members’ experiences demonstrate the risk posed to patient care and call on members to be vigilant in sounding the alarm in their care settings.
Speaking about the report, Pat Cullen will say in her speech to RCN members:
“Our new report lays bare the state of health and care services across the UK. It shows the shortages that force you to go even more than the extra mile and that, when the shortages are greatest, you are forced to leave patient care undone.
“Don’t ever think that it is normal to not have enough staff to meet the needs of patients. It is not. Today, members are letting the full truth be known - nursing is saying loud and clear that enough is enough. If there was ever a time to break this cycle – it is now.
“It is your professional duty to be concerned about unsafe staffing and we have your back. Twenty-five thousand registered nurses left last year – a sharp rise on the year before, at the very moment we cannot afford to lose a single individual. The pressure is too great and the reward too little.
“Nursing staff are being driven out by the current way of working - the shortage of staff and too often the poor culture.
“To those from Government listening to my words - we have had enough. The patients and those we care for have had enough.
"We are tired, fed up, demoralised, and some of us are leaving the profession because we have lost hope. Do something about it - we are not going away.”
On workplace culture and diversity, Pat Cullen will add:
“I have told political leaders that our members are their employees and they expect better.
“Equality is everybody’s business and not just those at the sharpest end of the fight. The status quo is unjust - it is damaging patient care and pushing even more to the door.”
The latest Nursing and Midwifery Council data shows that 25,000 registered nurses left the register last year alone. This is an increase of 13% on the previous year and the first time the number of leavers has increased after four years of a decline in people leaving the profession. With tens of thousands of nursing vacancies, a sharp rise in leavers should not be overlooked, the Congress will hear.
The RCN is calling on UK Government and devolved administrations to take accountability for nursing workforce planning and supply in law, and immediately publish independently verifiable assessments of what population needs are to directly inform what is invested into the health and care nursing workforce.
The survey, previously carried out in 2017 and 2020, has revealed the stark impact the COVID-19 pandemic has had on staffing levels, as well as the workplace culture, diversity and morale of the UK’s health and care staff.
Nearly six in 10 (59%) respondents said they felt upset or sad that they could not provide the level of care they wanted, an increase from 53% in 2017, and 54% in 2020. While over half (51%) of respondents said they felt demoralised on their last shift, this is an increase from 43% in 2020, and 45% in 2017.
Notes to editors
In the survey with over 20,000 respondents from nursing and midwifery staff carried out by the RCN in March 2022, respondents were asked to report on staffing levels and their experience of their latest shift.
83% of respondents said staffing levels on their last shift were not sufficient to meet all the needs and dependency of their patients safely and effectively. This is an increase from 73% in 2020.
Only 25% of shifts had the planned number of registered nurses on shift.
84% of respondents working in the NHS reported that staffing levels were not sufficient, over 69% of those working in the independent sector.
59% of respondents said they felt upset or sad that they could not provide the level of care they wanted, an increase from 53% in 2017, and 54% in 2020. While over half (51%) of respondents said they felt demoralised on their last shift, this is an increase from 43% in 2020, and 45% in 2017.
Nursing staff working in the community were most likely to feel care was delivered to a high standard, with 75% of respondents rating the care as ‘good’ but over half (53%) were most likely to work unpaid overtime.
The RCN’s Last Shift Worked survey took place in March 2022. The survey received 20,325 responses from all nursing and midwifery staff working in different settings across the UK. Respondents were asked to report on the staffing levels on their last shift. The full report is available on request
The state of safe staffing legislation across the UK and devolved nations
The RCN continues to demand that the Secretary of State for Health and Care is legally accountable for the provision of health and care workforce, as well as there needing to be legal UK Government accountability for assessing workforce requirements of the health and care system to respond to changing needs of the population and for planning and supply to meet those requirements.
The Health and Care (Staffing) Act received Royal Assent in June 2019 and a 2019 RCN report outlined in detail how the Act addressed the five RCN’s principles for staffing for safe and effective care. Work towards implementation of the Act was postponed due to the COVID-19 pandemic, however, the reasons for the prior passage of the Act have been made even clearer during the pandemic. The RCN has continued to emphasise the need for the implementation and the vital role of the legislation will play in addressing the ongoing workforce challenges.
In 2021 the RCN secured the Welsh Government’s commitment to extend section 25B of the Nurse Staffing Levels (Wales) Act 2016 to children’s inpatient wards. The College is now campaigning to challenge the Welsh Government to extend safe staffing legislation into community, mental health and care homes.
Following strike action by RCN members in Northern Ireland, a new safe staffing framework was agreed with the endorsement of the full Northern Ireland Executive and pay parity with England and Wales was restored. However, the RCN remains concerned at the pace of progress of the development of safe nurse staffing legislation in Northern Ireland.