Staffing ratio warning as nurse vacancies remain above 40,000

Nurses are caring for “unsafe” numbers of patients, the Royal College of Nursing (RCN) has warned, as the NHS in England has now gone a year with more than 40,000 nurse vacancies.

The latest data, released today by NHS England, shows 43,339 full-time equivalent (FTE) registered nurse vacancies as of quarter one of 2023-24 – a rise of 8% from the previous quarter.

The number of missing nurses has now sat above the 40,000 mark since quarter one of 2022-23, when vacancies jumped to 46,241.

“Each nurse has to care for too many patients, sometimes as many as 15 [or] 20 each"

- Patricia Marquis

The vacancy numbers have remained high despite there being more nurses than ever before working for the health service.

Separate workforce data also released today by NHS England shows that, as of May 2023, there were 334,690 FTE nurses and health visitors in post across hospital and community services.

This number represents a rise of 0.2% from the previous month and 20% compared to September 2009 when the record began.

However, the workforce is growing too slow to keep up with demand, health leaders have warned.

RCN director for England, Patricia Marquis, said nurses were caring for up to 20 patients at one time and that the staffing ratios overall are currently unsafe.

“As we head towards another challenging winter there are still over 40,000 nursing vacancies in the NHS in England,” said Ms Marquis.

“It is leaving our health and care system underprepared for the months ahead.

“Each nurse has to care for too many patients, sometimes as many as 15 [or] 20 each – this ratio of nurse to patients is unsafe for all concerned.”

The fall in student nurse numbers means “today’s staff find it hard to see how the current pressure will abate”, she added.

For 2023-24 there has been a 16% drop in applications and a 13% decline in the number of students accepted onto nursing courses across the UK compared to the previous year.

Ms Marquis called for details from the government on how it plans to achieve the increase in nurse numbers laid out in the NHS Long Term Workforce Plan for England.

For all professions, the new data released today placed the number of FTE staff vacancies across England’s NHS at 125,572 – an increase of 12% from the previous quarter.

However, similarly to nurses, the number of FTE staff in post has also increased, from 1,280,377 in April 2023 to 1,285,543 in May 2023 (0.4%).

Danny Mortimer, deputy chief executive of the NHS Confederation, said: "These latest figures show a rise in NHS staff vacancies since the last quarter, with the vacancy rate now at over 125,000.

“Although this rise is less than what it was this time last year and despite an increase of full-time equivalent staff working in the service, healthcare leaders are still concerned that investment in staff numbers and action on efficiency cannot keep pace with demand for services.”