Lack of nurses leaves ‘less-skilled’ support workers filling gaps, report finds

One in every eight nursing jobs throughout the NHS in England now vacant.

Ian Snug
29 November 2019
Hospital corridor with obs machine

Healthcare assistants and nursing associates are undertaking tasks that would normally be reserved for registered nurses.

The health service is increasingly having to rely on “less-skilled” support staff to fill gaps in services when there aren’t enough nurses, according to a new report.


According to the Health Foundation, a shortage of nurses is leaving clinical support staff, such as healthcare assistants and nursing associates, undertaking tasks that would normally be reserved for registered nurses.

Recruitment figures demonstrate the growth in the total number of support staff is nearly double that of registered nurses.

With one in every eight nursing jobs throughout the NHS in England now vacant, the report goes on to question the safety of using support workers in this way. Noting that while registered nurses study for three years or more to qualify, there are no such requirements to become a healthcare assistant.

Alongside the research report and ahead of the general election, the Health Foundation has called for the Government to recognise and tackle the NHS workforce crisis.


Support staff are ‘picking up the slack’.

Anita Charlesworth, Director of Research and Economics at the Health Foundation, said: “Nursing shortages continue to deepen and are inevitably impacting on the front line. Services are being forced to make do with shortfalls of increasingly pressurised nurses and rely on less-skilled support staff to pick up the slack.

“Clinical support staff play an incredibly valuable role in the NHS if they are supported in a well-planned way, but these trends appear to be largely unplanned, reflecting the failure to recruit enough nurses. Operating without a plan means there has not been enough consideration of the impact such changes might be having on patient care.

“While it is encouraging that politicians have made pledges aimed at addressing the workforce challenge, we need to be realistic on bold promises to greatly increase numbers of nurses and GPs quickly. Two obvious solutions to the nurse staffing crisis would be to train more nurses in this country and retain more existing staff.

She adds; “the UK is struggling to grow the numbers starting nursing degrees. and while there must also be action to address this – for example, by giving nurse students the cost-of-living support that they need – it will take time to have a significant impact on the numbers of nurses.


“Our projections show that, with concerted policy action, the NHS might be able to retain around 11,000 more nurses by 2023/24 than at current trends. The reality is, whatever happens with Brexit, we will need more nurses from abroad than we are currently attracting to keep the NHS running. The incoming government must therefore ensure that our migration policy does not put barriers in the way of recruiting them.”

The shortage has reached record levels.

The Royal College of Nursing (RCN) reiterated the issue but says that patients are not in danger from an increased number of support workers.

Dame Donna Kinnair, Chief Executive and General Secretary of the College, said; “The danger to patients is not from the increase in support workers, but the absence of nurses.

“The shortage has reached record levels – 43,000 nurse jobs in England are unfilled and it is patients that can pay the heaviest price. It is unfair on healthcare assistants to ask them to take on work they aren’t trained or paid for in a desperate bid to plug gaps.

“The evidence demonstrates that where more registered nurses are on shift patient outcomes improve – it is essential that employers use vital support staff to supplement the work of nurses, not replace them.


“All the election pledges we’ve heard on boosting nursing staff must be about registered nurses, educated to degree-level – this report shows why that is vital. It must become the top priority for the new government.’

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