Exclusive: Hospitals fail to hit staffing targets despite recruitment drive

Despite the recruitment drive, there are still not enough trained nurses to fill shifts according to safe staffing guidance, nursing directors have said.

HSJ’s analysis of staffing levels at 135 NHS acute trusts shows more than four-fifths (114 organisations or 84 per cent) failed to meet their own planned levels for registered nurses working during both the day and night in April in at least one of their hospitals. This compared with 76 per cent of trusts for the same month in 2014.

According to the figures, published on the NHS Choices website last month, all 135 acute trusts that report staffing data failed to hit their target for nurses working during the day in at least one hospital in April, compared to 86 per cent last year.

A total of 114 trusts did not meet planned staffing levels for nurses working at night in at least one site.

Each acute trust has a planned target for nurse staffing hours across day and night. They are required to publish monthly data showing the average fill rate across their hospital sites on NHS Choices.

Out of 227 hospital sites reporting data, 198 missed their target for nurses working during the day – almost nine out of 10 hospitals in England. Meanwhile, 159 hospitals, or 70 per cent, missed the target for nurses working at night.

More than two-thirds of hospitals failed to have sufficient numbers of nurses across day and night shifts. Forty-two hospitals had one in 10 daytime nursing shifts unfilled, and 16 had a daytime fill rate of less than 85 per cent.

The decline in performance follows the publication last year of staffing guidance for acute wards by the National Institute for Health and Care Excellence. This forced some trusts to plan to have more nurses on hospital wards, HSJ has been told.

This has exacerbated a national shortage of qualified nurses, with trusts recruiting more nurses from overseas in response to the 2013 Francis report. Since then, the number of full time equivalent qualified nursing, midwifery and health visitor staff has increased by more than 12,000, according to the Health and Social Care Information Centre.

Northampton General Hospital had the lowest fill rate for nurses during the day at 79 per cent. Director of nursing Carolyn Fox told HSJ the trust planned to recruit 173 nurses by February next year, with 63 already in place.

She said: “The recruitment of nurses is most certainly a national issue and the availability of registered nurses isn’t what it once was. The NICE guidance is not necessarily a bad thing because it has increased the requirement of registered nurses and… it will have a fantastic impact on patient care in the future.”

Barbara Stuttle, chief nurse at Colchester General Hospital, which filled only 81 per cent of its nursing day shifts, said the trust was recruiting nurses from overseas to fill gaps. It has recruited 95 extra nurses since January and plans to recruit 90 more this year.

She said: “It is extremely challenging times at the moment - the nurses just aren’t there. A few years ago [nurse training places reduced nationally] and this is the consequence of that. The NICE guidance around staffing levels has helped but in some areas it has increased the requirement for registered nurses, which is a good thing.”

In many trusts where nurse staffing levels were below target, they have turned to unqualified healthcare assistants to fill gaps. More than 120 trusts were overstaffing on HCAs by up to 140 per cent.

Royal College of Nursing policy director Howard Catton said he was “shocked” by “the gap between where we are and what trusts have determined we need”.

He added that new immigration rules, forcing some non-EU nurses to leave the country by next April if they earn less than £35,500 a year, should be changed and more nurses needed to be trained.

An NHS England spokeswoman said: “The NHS continues to work with partners including Health Education England to support the recruitment of new and returning nurses, to retain nurses already in post, and to help hospitals reach their planned staffing levels.”

A Department of Health spokeswoman said the government was “fully committed to making more staff available”. She added: “If individual hospitals do not have enough staff to deliver safe care, the chief inspector [Sir Mike Richards] will step in and take action.”

Five hospitals did not report data to NHS Choices: Essex County Hospital; Queen Elizabeth Hospital, Hertfordshire; Heatherwood Hospital; New Cross Hospital, Wolverhampton; and Queen Elizabeth Hospital, Birmingham.