MORE than nine in ten of England’s 50 largest NHS hospital trusts are not staffed with nurses to the level planned by their own management, warns the Royal College of Nursing (RCN).
RCN analysis confirms that hospitals are putting more unregistered support staff on shift to cope with the shortage of registered nurses. The data released by the NHS shows that substitution is particularly prevalent on night shifts when two-thirds of the largest hospital trusts put more healthcare assistants on the wards than planned.
The practice raises questions about mortality rates. When the number of fully trained and registered nurses is reduced and the number of unskilled is increased, mortality rates rise significantly.
Since 2014, all hospitals in England have released information on their nurse staffing levels on the NHS Choices website. Despite best efforts to fill shifts with bank and agency staff, NHS trusts are still falling short of filling their nursing rotas. 91% of the 50 largest trusts in England failed to have the number of registered nurses they had planned to have on wards, during the day, on 150 individual hospital sites.
The data supports the RCN’s recent research highlighting 40,000 nurse vacancies across the NHS in England. More than half of the largest hospitals (55%) brought more unregistered support staff onto the shifts. The over-reliance on unregistered support staff is worse at night, with two thirds (67%) of hospitals increasing numbers on night shifts compared to what they planned due to the registered nurse shortage.
A study of staffing levels in NHS hospitals, published in the online journal BMJ Open, found that in hospital trusts where registered nurses had six or fewer patients to care for, the death rate for patients with medical conditions was 20% lower than in those where they had more than ten. Hospitals with more unregistered nursing support workers may have had higher death rates.
Janet Davies, Chief Executive and General Secretary of the Royal College of Nursing, said: ‘These startling figures show that, despite the government’s rhetoric, our largest hospitals still do not have enough nurses and that is putting patients at risk.
‘They are resorting to filling wards with unregistered healthcare assistants, especially at night, just to cope with the shortage. Patients can pay the very highest price when the government encourages “nursing on the cheap”. It is unfair on the healthcare assistant too – they should not be left in a situation they have not been trained to handle.
‘Nurses have degrees and expert training and, to be blunt, the evidence shows patients stand a better chance of survival and recovery when there are more of them on the ward. In light of these figures, the government must redouble its efforts to train and recruit more qualified nurses and stop haemorrhaging the experienced ones who are fed up, undervalued and burning out fast.’