There are not enough nurses to safely care for patients in the UK, according to the body that represents the profession, and many of those who are working are suffering from anxiety and burnout after a gruelling nine months treating Covid patients.
A year after the prime minister pledged during the 2019 election campaign to add 50,000 nurses to the NHS, the Royal College of Nursing has accused Boris Johnson of being “disingenuous” for claiming the government is meeting this 2025 target.
Johnson claimed last week that the government had “14,800 of the 50,000 nurses already” during prime minister’s questions in the Commons.
Yet the latest NHS figures show there were 36,655 vacancies for nursing staff in England in September, with the worst shortages affecting mental health care and acute hospitals. Staff in some intensive care units (ICUs) have quit since the pandemic, with those whom the Observer spoke to choosing to work instead in supermarkets or as dog-walkers.
Dame Donna Kinnair, the RCN’s chief executive and general secretary, said: “The simple, inescapable truth is that we do not have enough nursing staff in the UK to safely care for patients in hospitals, clinics, their own homes or anywhere else.”
She said that even before the pandemic, “heavy demand” was rising faster than the “modest increases” in staff numbers.
Last week the Health Foundation thinktank said there were 5.5% more nurses in English acute hospitals compared with last year, but some of these were nurses who had previously retired or left the profession, and had returned to help during the pandemic.
The thinktank said that even if the government met its target, 50,000 nurses would not be enough to recover from the pandemic.
“With tens of thousands of vacancies in the health and care system right now, any suggestion by politicians that a small increase equals success is disingenuous,” Kinnair said. “We know many returned to support the pandemic, and 35% of our members surveyed this year said they were considering leaving the profession.”
She said the solution was “honesty and investment” from the government.
With Covid-19 surging in Wales, Northern Ireland and London, many senior NHS leaders around the UK are concerned about the strain on medical staff, who have worked in full PPE and stressful conditions for nine months.
Amanda Smith, an ICU nurse in Belfast who is also a RCN steward, has worked in Nightingale wards at several of the city’s hospitals throughout the pandemic. “We’ve lost something like 15 nurses since the first surge,” she said – about a quarter of their team. When the number of Covid patients has risen, the NHS in Northern Ireland has brought in support nurses from other parts of the region but they are not trained in some procedures such as kidney dialysis.
It means nurses are responsible for two ICU patients instead of one, while support nurses are often taking on more responsibility without extra pay.
“If you’ve got an unstable patient, the other ICU nurse could be left with three or four patients to look after on her own,” Smith said. “You’re worried you’ll miss something.” The rise in patients combined with staff shortages meant nurses felt guilty about taking breaks, she said.
“People are getting very stressed at trying to combine their home lives with work. If they have young children who are hearing all the talk of how dangerous Covid is, they worry about their mum going to work.
“And when you see somebody in a bed who’s 44 years old, you think, ‘that could be any of us’.”
A survey of RCN members earlier this year showed that 35% were considering leaving the profession.
More students are studying nursing at university, up by 20% this year according to the Health Foundation, but the government was still relying on recruiting nurses from overseas.
The Department of Health and Social Care said: “We stand by our commitment to back the NHS and deliver 50,000 more nurses by the end of this parliament. Vacancies are falling and we are on track to meet the target, with 14,800 more nurses working in the NHS and 23% more students starting nursing courses than last year.
“Looking after the wellbeing of dedicated staff is at the heart of the NHS People Plan, with a £15m investment to strengthen staff mental health support this winter. To support recruitment, we’re giving all eligible nursing, midwifery and AHP students at least £5,000 for each year of their studies.”
