The end of growth? Analysing NHS nurse staffing.

AIM: To present an overview of UK National Health Service nurse staffing changes across the last 10 years.

BACKGROUND: National Health Service funding is now being constrained as part of the overall measures to reduce UK public expenditure. This has implications for future staffing levels and deployment. Government and professional associations are disagreeing about the current extent of actual and likely National Health Service nurse staffing decline.

DESIGN: The paper reviews 'official' data and evidence on National Health Service staffing to assess actual National Health Service nurse staffing trends in recent years, highlights the results of scenario modeling of future National Health Service nursing numbers and relates this to national policies on staffing.

DISCUSSION: The available evidence now points to nurse staffing growth having tailed off and a likely pattern of overall decline in National Health Service nurse staffing is emerging. This is a policy concern in the UK, but also in many other countries.

IMPLICATIONS FOR NURSING: Whilst there has been a 'recession benefit' to the UK nursing labour market, this supply side boost cannot continue indefinitely. Any continued trend towards reduced intakes to training and reduced staffing levels will intensify the debate about the appropriate staffing levels and skills mix.

CONCLUSIONS: We have seen significant National Health Service nurse staffing growth in the last 10 years, which is likely now to reverse. The real measure of the effectiveness of local and national National Health Service nursing workforce policy is not how many nurses are employed, it is that sufficient are deployed to provide safe care.