The head of the Royal College of Nursing has warned of a major health risk to patients as it emerged that 5,000 nurses have left the NHS since the coalition government came to power, while nearly 6,000 lower-paid and less well-qualified healthcare assistants have been taken on since 2010. The figures fuelled fears that cheap labour is being sought to plug holes in services.
Earlier this month the Care Quality Commission announced that one in ten hospital services it had inspected were failing to meet the standard on adequate staffing levels. Figures published this week by the NHS Information Centre show that in December 2012 there were 4,887 fewer nurses working in the NHS than in May 2010.
New figures gleaned from freedom of information requests show that the number of “healthcare assistants” has risen by 5,926 in the same period. Peter Carter, chief executive of the RCN, which has 395,000 members, including both nurses and healthcare assistants, said the figures illustrated a growing problem with the NHS.
Carter said healthcare assistants, who often receive their training on the job and have a standard day rate of £9.68 an hour, were invaluable but that all too often they received no training and were being inappropriately used as replacement nurses. A survey last year found that healthcare assistants were taking on work, including looking after intensive care patients, for which they were not always properly trained.
Carter said: “We are concerned that there is a dilution, to the detriment of patient care, of the ratio of qualified nurses to health care assistants. That has been compounded by so many employers not giving their health care assistants any training.
“So you have the double whammy of not having enough registered nurses and replacing them with people who do not have rudimentary training.”
The Department of Health said the number of full-time equivalent positions lost since 2010 was 2,811, although the total headcount was down by 4,887. It added that the number of clinical staff had risen by 1.3%, or 6,969 since May 2010.
However Carter accused the government of arguing over “semantics”, and added that as demand for care increased due to longer life expectancy, “hospitals were working at 100% capacity”. He added trusts slashing staff numbers, including nurses, whose wages range between around £21,000 and £67,000 a year.
“We are seeing more and more reports of ambulances stacking up in car parks, more and more patients on trolleys in corridors,” he said. “All the royal colleges say the wards need to operate at 85% capacity to cope with surges and that isn’t happening. It will undoubtedly impact on standards of care. You cannot cut nurses and expect places to carry on as normal.”
The shadow health minister, Jamie Reed, said: “These new figures will undoubtedly raise fears that qualified nurses are being replaced with healthcare assistants in yet another attempt to cut costs. David Cameron cannot allow the NHS to haemorrhage experienced nurses to pay for his failed economic policies.”
Health minister Dr Dan Poulter said: “These figures are exaggerated. There are now more clinical staff in the NHS than in 2010, including around 5,500 more doctors, 1,300 more midwives and more than 900 more health visitors. In contrast, the number of admin staff has fallen by over 18,000, and the money saved put back into frontline patient care.
“The NHS is changing and so will the shape of the NHS workforce change in order to meet the demands of delivering high quality patient care.
“The government does not make decisions on staffing numbers – hospitals decide how many nurses are needed to care for patients. Nursing leaders have been clear that hospitals should publish staffing details and the evidence to show that nursing numbers are right in order to deliver high quality patient care.”