Number of NHS nurses and health visitors falls for first time since 2013

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The number of nurses and health visitors employed by the NHS has fallen for the first time on a year-on-year basis since April 2013, according to a new analysis by The King’s Fund.

The analysis, by Director of Policy Richard Murray, shows that there were fewer NHS nurses and health visitors in post in April this year when compared to the previous April, the first year-on-year monthly fall since April 2013. The fall continued in May and June, with 282,603 nurses and health visitors in post in June, 1,071 fewer than in June 2016.

The key factor in the fall, according to the analysis, has been a significant reduction in the number of nurses from the EU joining the UK nursing register since the EU referendum and changes to language testing requirements, together with an increasing number of EU staff leaving the NHS. The number of staff leaving the NHS as a result of ill-health and work-life balance has also increased sharply over the past few years.

The analysis follows Jeremy Hunt’s announcement of plans for a 25 per cent increase in the number of nurse training places and the government’s decision to scrap bursaries for student nurses, which initial indications suggest has resulted in a reduction in successful applicants. The fall in nurse numbers raises questions about the NHS’s continuing ability to ensure patient safety – a key focus for Jeremy Hunt during his time as Health Secretary – and the ability of the NHS to cope with a challenging winter ahead.

The analysis shows that the nursing workforce has now entered a new phase, having gone through three distinct phases in recent years.

  • During the early 2000s, the number of nurses and health visitors grew significantly as NHS spending increased.
  • From the beginning of the decade to March 2013, the numbers decreased as the NHS entered a prolonged funding squeeze and implemented an efficiency drive.
  • From April 2013, the number of nurses and health visitors increased again as hospitals recruited more staff and were effectively allowed to run financial deficits following the Francis report into the failures of care at Mid Staffordshire NHS Foundation Trust.

The analysis also underlines the mismatch between increases in the number of nurses and health visitors and rising demand for NHS services, with emergency admissions increasing by more than 14 per cent since 2010, a period during which the number of nurses and health visitors has increased by only 0.7 per cent.

Richard Murray, Director of Policy at The King’s Fund, said: ‘There is good evidence that having enough nurses is essential for delivering safe care, and so it is worrying that the number of nurses and health visitors is going down at a time when services are already overstretched and the demand for care is rising.

‘This means the NHS is less equipped to cope with the demands of a winter that was already threatening to stretch the NHS to the limit.

‘While last week’s announcement of an increase in nursing training places is welcome, it will take years for this to translate into extra nurses on the wards. Workforce planning has been neglected for too long in the NHS, and the fact that the EU referendum result appears to have tipped the balance highlights how fragile the workforce situation has become. A new workforce strategy is desperately needed.’

Notes to editors

  • The monthly total of nurses and health visitors in the NHS follows a seasonal trend, where numbers rise in the autumn as newly qualified staff complete their training and then reduce during the rest of the year. To get a clear sense of monthly changes, it is best to compare the number of nurses and health visitors in  a given month to the number in the same month the previous year.
  • The number of nurses and health visitors refers to full-time equivalents.
  • The number of placed applicants to nursing at 28 days after A-level results day in 2017 was 6 per cent fewer than the previous year, a drop from 22,680 to 21,340 (the current level is similar to that of 2015).
  • For further information, or to request an interview, please contact the Press and Public Affairs team on 020 7307 2585 (if calling out of hours, please ring 07584 146035).
  • The King's Fund is an independent charity working to improve health and care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible health and care is available to all.