A quarter of NHS wards routinely operate at unsafe staffing levels that threaten the safety of patients, according to a study. Researchers from the University of Southampton said that lessons learned from the Mid Staffordshire scandal in 2013 have been somewhat lost because of a lack of investment in staffing and a chronic shortage of nurses.


registered nurses among nursing staff (2013)


registered nurses among nursing staff (2017)

Following the Francis Inquiries, which examined the scandal at Mid Staffs where neglect contributed to the death of patients, the National Institute for Health and Care Excellence (NICE) recommended that a level of eight patients per registered nurse should trigger a review of staffing.

But the latest study, which included questioning 91 directors of nursing in NHS trusts, found one in four NHS wards regularly work at this unsafe staffing level.

Nursing numbers have increased since the Mid Staffs inquiry, but the corresponding growth in patient numbers means there has been no improvement in staffing levels.

One of the biggest challenges has been the national shortage of registered nurses (RNs). The ongoing national shortage of RNs, and failure to increase supply sufficiently, has not been addressed. This failure has prevented safe staffing levels from being achieved.

Professor Jane Ball, lead author of the study
The Mid Staffordshire scandal was quoted in the study Credit: Rui Vieira/PA Wire/Press Association Images

Mid Staffordshire showed us the dire consequences of nurse shortages and yet those precious lessons have been forgotten so quickly. It will trouble patients and the public today to hear the experts warn again of the deadly risks being run and that some parts of the NHS have one in five posts vacant according to this report. Now that there are 40,000 unfilled nurse jobs in England, it is time for ministers and the NHS to get a firm grip on the situation before it deteriorates further. The legacy of the Francis Report was a once-in-a-generation opportunity to increase nurse staffing levels across all health and care settings but any short-term progress in hospitals has fallen away. Rising patient numbers are outstripping small nurse increases. These increases must be matched by rises in registered nurses if we're to keep the full and appropriate mix of skills in care settings. The Government should commit to a new law for England to provide accountability for staffing levels for safe and effective care, and provide an additional investment of at least £1 billion in nurse education to retain the existing workforce and train the next generation of nurses.

Patricia Marquis, the Royal College of Nursing's director for England

The Care Quality Commission requires that all healthcare providers have appropriate staffing levels and our Long Term Plan sets out how we will ensure the NHS stays the safest healthcare system in the world. There are over 15,800 more nurses on our wards since 2010, 52,000 more in training and we are improving staff retention by promoting flexibility, wellbeing and career development.

Department of Health and Social Care spokesperson

Nursing vacancies have reduced by 3,000 in the last year, and as part of the NHS Long Term Plan we have launched the largest ever national recruitment campaign to encourage people to consider a career in the health service, which reversed the decline in nursing degree applications as thousands more applied for these posts, while upcoming proposals will set out how we can grow the NHS workforce.

NHS Improvement spokesperson