Patient safety in danger unless nurse numbers increase, RCN warns

Press Release 17/09/2019

College launches advertising campaign in England to encourage public to speak out about nurse shortages

The shortage of nursing staff in England is putting patient safety in danger, the Royal College of Nursing warns today (Tuesday) as it use the first World Patient Safety Day to launch a new campaign.

The campaign encourages the public to speak out about the impact of England’s 40,000 nurse shortage. 

The RCN’s campaign is being launched on the World Health Organisation’s first annual World Patient Safety Day, which aims to ‘create awareness of patient safety and urge people to show their commitment to making healthcare safer’ [see note 2].

It calls for legislation to be brought forward in England to help address the nursing workforce crisis. Earlier this year, nurses and support workers in Scotland secured new legislation on safe staffing levels after a nurse staffing law was introduced in Wales in 2016.

The 2013 Francis Report on failings of care Stafford Hospital concluded that the main factor responsible was a significant shortage of nurses at the hospital.  Nurse numbers at NHS acute Trusts across England then increased as managers took steps to try to prevent similar scandals in the future. 

But a new analysis by the RCN shows that for every one extra nurse NHS acute Trusts in England have managed to recruit in the five years since 2013/14, there were 157 extra admissions to hospital as emergencies or for planned treatment. 

Last year the number of extra admissions for every additional nurse taken on increased to 217.  The analysis shows that the extra 9,894 nurses recruited to NHS hospitals since 2013/14 is dwarfed by the additional 1,557 074 admissions over the same period [see note 3]

Public polling carried out for the College to mark the campaign launch reveals that:

  • 71 per cent of respondents in the UK think there are not enough nurses in the NHS to provide safe care to patients
  • The top priority among those polled for any additional funding for the NHS in England was recruiting more nurses (chosen as top priority by 37 per cent of respondents in England from a list of eight alternatives)
  • 67 per cent of respondents in England wrongly think the Government has a legal responsibility to ensure there are sufficient nursing staff [see note 4]

 The campaign advertisements feature the strapline, “Nurses are the people’s people.  Now we need to fight for them” [see note 5]. They urge readers and users to sign a new petition the RCN has created, which reads: “I’m calling on the Government to invest in tomorrow’s nurses, end this crisis and make clear in law who is truly accountable for safe (and effective) patient care.”  

The College is calling on Ministers and NHS leaders in England to take the following actions:

  • Introduce legislation to ensure accountability for safe nurse staffing at all levels of health and care services in England, from the Health Secretary downwards
  • Ensure that a statutory body has responsibility for future nurse workforce planning – no one body has this function at present.  The 40,000 nursing posts currently vacant in England represent only the number for which the NHS has funding – they take no account of the number of nurses in health and care services in England will actually require in the future to meet the needs of an ageing population.
  • Invest at least £1 billion in nurse higher education in order to reverse the reduction in the number of students both applying to and taking up places on nursing degree courses.  Since the removal of the nursing bursary in 2016, applications have fallen by 29%, and the number of students starting degrees by 8%.

Commenting on the campaign launch, Dame Donna Kinnair, RCN Chief Executive and General Secretary, said:

“Today we’re issuing a stark warning that patient safety is being endangered by nursing shortages.  Staffing shortfalls are never simply numbers on a spreadsheet - they affect real patients in real communities.

“We’re calling on the public in England to fight for nurses and sign our petition calling on the Westminster Government to invest in the future workforce and make clear who is accountable in law for safe patient care. 

“Our polling shows almost two-thirds of people already fear there aren’t enough nurses to provide safe care – and they want recruiting more nurses to be the top priority for any extra funding for the NHS in England. 

“Nurses are the single most trusted professional group in the whole country, with 96% of the public placing them at the top of a list of occupations including doctors, teachers, the police and scientists Nursing staff are asking for your support in calling time on this crisis.”




1      The most recent NHS Improvement Quarterly Performance report, covering the period 1st January to 31st March 2019, revealed 39, 520 nursing vacancies in the NHS in England, a vacancy rate   of 11.1%. 

2        17th September 2019 is the inaugural WHO World Patient Safety Day

3        RCN analysis, calculated as follows:

  • Number of nurses working in NHS acute hospitals in England, 2013/14 to 2018/19: From NHS Digital, we removed the community workforce data to give the size of the NHS nursing workforce in acute settings. Then we took the figures for each year from April to March and generated an average. The average from each year were compared to establish the actual growth in the workforce.
  • Admissions to NHS acute hospitals in England, 2013/14 to 2018/19: from NHS Digital data, we calculated the total number of emergency and elective admissions each year and compared the years to establish the actual growth in admissions figure. We combined these figures to give the level of actual growth in admissions.
  • To generate the ratio, we compared the actual growth in the nursing workforce in acute settings in the NHS with the actual growth in elective and emergency admissions.

4        YouGov polling for the RCN, September 2019.  All figures, unless otherwise stated, are from YouGov Plc.  Total sample size was 1,692 UK adults, though some questions were asked only to          respondents in England, as indicated.  Fieldwork was undertaken between 6th - 8th September 2019.  The survey was carried out online. The figures have been weighted and are representative              of all GB adults (aged 18+). 

5        See sample advertisement attached, strictly embargoed to 0001 Tuesday 17th September. 

6        Ipsos MORI Veracity Index 2018

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