May 16, 2023

A Brief History of NHS Nursing Numbers (but mainly 2022)

Contents

  1. Introduction
  2. NHS Workforce Statistics Data
  3. The Nuffield Trust Data
  4. House of Lords Library Analysis: Vacancies
  5. House of Commons Library Analysis: Turning Data Into Diagrams
  6. The Kings Fund Analysis: Nurses Leaving
  7. NHS Staff Survey: From the Horse’s Mouth
  8. The Health Foundation: Future Projections
  9. Summary
  10. Sources

1. Introduction

Everywhere you read, there is a lot of conflicting data when it comes to NHS nursing numbers.

For example: 

Because of this, it’s sometimes difficult to gain a true picture of the UK nursing landscape.

The aim of this article is to collate the data available from the most reliable sources to give you an honest assessment of the market, saving you the time having to cross reference all the same sources.

Because in truth, it seems incredibly hard to get access to the numbers we all need to make informed – and business-critical – decisions. 

So here we go. 

The NHS in England employs 1.5 million people, with employee costs accounting for around two-thirds of NHS providers’ expenditure. The NHS is the country’s biggest employer and one of the largest employers globally.

To put this in perspective, Only the US Defence Department, the Chinese army, Walmart and McDonalds employ more people. 

2. NHS Workforce Statistics Data

NHS Workforce Statistics is provided by NHS Digital, whose teams design, develop and operate national IT and data services that support clinicians at work, help patients get the best care, and use data to improve treatment.

According to the latest monthly data from NHS Statistics, in October 2022 the NHS:

  • Employed 1.25 million FTE people
  • 670,000 were professionally qualified clinical staff (doctors, qualified nurses and health visitors, midwives, qualified scientific, therapeutic and technical staff and qualified ambulance staff)

Digging a little further with the same source on NHS England, on 30th September 2022:

  • 11.9% vacancy rate within the Registered Nursing staff group (47,496 vacancies)
  • This is an increase from the same period the previous year when the vacancy rate was 10.5% (39,931 vacancies)

And here our journey with NHS Statistics ends – although we will revisit their data later in our report.

3. The Nuffield Trust Data

The Nuffield Trust is an independent health think tank which aims to improve the quality of healthcare in the UK by providing evidence-based research, policy analysis, informing and generating debate.

Switching to their October 2022 explainer data commissioned by the BBC, the 1.25 FTE employees above is made up of:

  • c345,000 nurses and midwives and 16,500 practice nurses
  • 25% of NHS staff are of Asian, black or another minority ethnicity, compared to 13% of all working-age adults in the UK
  • On any given day, around 17,000 nursing and midwifery posts (4%) may be unfilled
  • During the peaks of the Covid-19 pandemic, the number of staff absent from work on one day reportedly reached over 120,000
  • Staff shortages are distributed unevenly across the country, with the highest percentage of full-time equivalent vacancies in London (10.9%) and the lowest in the North East and Yorkshire (6.1%)
  • The number of full-time equivalent nurses has fluctuated in recent years but, on average, numbers have increased by less than 1% a year between 2009 and 2020 (from 278,500 to 298,600 in February 2020)
  • However, since the start of the Covid-19 pandemic until March 2022, the number of nurses substantially increased by over 21,100 (7%)
  • Percentage change in number of nurses by nursing type, March 2010-2022:
  • In 2015, nurses were added to the list of shortage occupations by the Migration Advisory Committee (a non-departmental public body that advises the Government on migration issues), albeit initially on a temporary basis. This list was refreshed in October 2019, in which nursing still featured as a role experiencing significant shortages12.
  • Number of hospital staff per 1000 population in OECD countries:
  • The population in England is expected to increase by a further 5% to 60 million by 2041
  • In the nursing professions there is a large cohort fast approaching pensionable age. 27% are aged between 45 and 54 and more than one in six (17.6%) are aged 55 and over. In midwifery the position is also stark, with four in 10 midwives already over 45 and eligible to consider retirement at 5549.
  • Between July 2017 and July 2018, 1,584 more EU nurses and health visitors left their role in the NHS than joined

4. House of Lords Library Analysis: Vacancies

Perhaps the best summary of all the available data occurred in the House of Lords on 15th December 2022, where it was scheduled to debate the following question for short debate:

“Lord Allan of Hallam to ask His Majesty’s Government what steps they are taking to support public sector workers in the NHS and the social care sectors, given reports of staff shortages and the effects of inflation on NHS and care budgets.”

Specifically, recent data has revealed that the number of vacancies in the NHS and social care sectors has increased since September 2020. Health bodies and organisations have warned that such shortages have affected, and will continue to affect, patients. In recent years, successive governments have introduced measures to tackle staff shortages, including commissioning the NHS to publish a long-term workforce strategy and publishing a white paper on reforming adult social care.

  • Nursing vacancies increased from 39,931 (10.5%) the previous year
  • The number of overall and nursing vacancies had increased (from 105,838 to 133,446 and 42,679 to 47,496 respectively) between September 2018 and September 2022
  • In June 2022 the House of Commons Health and Social Care Committee revealed almost every healthcare profession was facing shortages including dentistry, emergency medicine, intensive care, oncology, radiology, and speech and language therapy.

5. House of Commons Library Analysis: Turning Data Into Diagrams

Similarly to the House of Lords, the House of Commons turns the endless spreadsheets of NHS Statistics into meaningful data in their NHS Key Statistics: England, November 2022 research briefing.

These graphs speak for themselves:

6. The King’s Fund Analysis: Nurses Leaving

The King’s Fund is an independent charitable organisation working to improve health and care in England.

It’s October 2022 blog analyses the June 2022 NHS Statistics data, with the following findings:

  • there has been a large increase in nurses leaving the NHS
  • this trend is being driven by younger workers
  • June 2021 – June 2022 saw 34,000 NHS nurses leaving their role, a 25 per cent increase
  • This is an additional 7,000 leaving compared to the previous year
  • The largest increase in numbers leaving was seen among younger nurses, two thirds of leavers were under 45 years of age.

7. NHS Staff Survey: From the Horse’s Mouth

To try to understand why more nurses are choosing to leave, we can look to the most recent NHS Staff Survey.

The NHS Staff Survey is one of the largest workforce surveys in the world and has been conducted every year since 2003.

The statistical results of the 2021 NHS Staff Survey give invaluable insight into the experiences of over 600,000 people working in the NHS in autumn 2021.

Most pertinent to our question of why nurses are leaving: 

  • 34% of nurses often think about leaving
  • 52% have felt unwell as a result work related stress
  • 40% feel burnt out because of their work.

8. The Health Foundation: Future Projections

Where does all this leave us?

The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. 

Despite their NHS Workforce Projections 2022 report focusing on the Community Health Service, according to The Health Foundation:

  • An overall workforce supply-demand gap of around 103,000 FTE across the NHS HCHS and general practice in 2021/22 (around 7% of estimated FTE workforce demand). This gap is projected to increase to around 179,000 FTE by 2024/25 before declining gradually to a still substantial 156,000 FTE in 2030/31 (around 9% of projected demand).
  • In all scenarios, they project a persistent shortfall of general practice nurses
  • While the government appears to be on track to meet its 50,000 nurses target by 2023/24, this would still leave the NHS short of around 38,000 FTE HCHS and general practice nurses relative to projected demand in 2023/24. In the longer term, in the current policy scenario the NHS is projected to have a persisting shortfall of around 36,700 FTE nurses in 2030/31.

9. Summary

Whichever way we look at it, the future of NHS nursing numbers could be rosier, and it is our mission to help achieve that.

Creating this research has helped Novello Healthcare plan where we need to focus our attention in the years to come, and we trust it is similarly useful to you across the many fields it covers.

Although we are able to deliver nurses at 48 hours notice, we hope this report demonstrates our long term vision over many years.

Should you wish to discuss any area in greater detail with us, please contact our CEO Jane Couper.

10. Sources

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