Nurse shortages leading to patients with ‘brain bleeds and broken bones’, says report

Severe nurse shortages are leaving unwell individuals "waiting hours" to receive pain relief while others are "deteriorating needlessly", experts have warned.

The Royal College of Nursing (RCN) cautioned that patients are falling from hospital beds, suffering broken bones or brain bleeds.

In a new report, the college demonstrates that a deficit of nurses can have "serious implications for patient safety".

It reveals that several hospital trusts manage hundreds of safety incidents each month tied to staffing shortages involving too few registered nurses on duty during a shift.

The report includes an analysis of NHS hospital board papers on “nursing red flags” – which are safety reports linked to staff shortages including delays to pain relief, essential medication and missed care.

It found reporting of these incidents is “inconsistent” across hospitals, but “in some cases, these safety-critical incidents are widespread with monthly trust numbers in the hundreds”.

One nurse in the East of England told the RCN: “On my unit, an elderly patient fell out of bed and suffered a brain bleed.

“Night staff were short and there was no-one outside the bay to witness the fall and help for at least ten minutes.

“Everyone was so worried about the brain injury that it took seven days to realise she actually had a broken hip as well.

“On every single shift, there’s at least one thing that doesn’t get done. This includes pain medication, particularly at night when staff have bigger caseloads, and the delays can be hours at a time.”

Another nurse in the West Midlands said: “A shift that has enough staff is considered ‘green’ and we haven’t had one in over six months.

“You just cannot give quality care if you’re looking after 10 acutely sick patients each.”

The report says there were around 23,000 nursing vacancies in England, but these figures “understate the true shortfall” as they do not account for frozen or unfunded posts.

The authors warn that staffing is “unevenly distributed across England” and highlighted how growth in the number of doctors has not been matched by the number of nurses.

Since 2009, nurse numbers increased by 33%, compared with 60% for doctors, the report states.

It adds that if nurse numbers had grown at the same rate as doctors, England would currently have more than 77,000 additional nurses.

Meanwhile, the report adds that nurse numbers have “failed to keep up with overall hospital workload”, with the authors calculating that if nursing numbers had kept pace in the growth in hospital activity then there would be 55,000 more nurses since 2009/10.

The report concludes: “Whichever approach is used, the conclusion is the same: England has a substantial shortfall in registered nursing labour, requiring at least tens of thousands more nurses and sustained long-term workforce investment.”

Professor Nicola Ranger, RCN general secretary and chief executive, said: “It’s utterly shocking that sick patients should wait hours for pain relief or vital medication while some are falling, breaking bones and deteriorating needlessly.

“The truth is patient safety incidents aren’t isolated and trusts are recording hundreds each month due to registered nurse shortages.

“The numbers are clear: we would have tens of thousands more nurses working in our NHS if we’d had the necessary investment to keep up with demand.

“Instead, our numbers have been held down, in contrast to other staff. When you have too few registered nurses, you get longer hospital stays, worse outcomes and more pressure on an already burned-out and exhausted workforce.”

The Department of Health and Social Care has been approached for comment.