Only Enough is Enough: A Call for Safe NHS Staffing Levels

By Jason Brady

A recent report published as part of UNISON’s campaign Only Enough is Enough lays bare the challenges facing hospitals in terms of staffing shortages and the impact on patient care.

Survey Findings: The Reality for NHS Workers

UNISON gathered data from ten hospital branches across England and Cymru/Wales, surveying staff over the course of October and November 2024. A total of 1,470 shifts were recorded, providing insight into the ongoing staffing crisis.

Key Findings:

Only 31% of shifts were reported as safely staffed in 2024, down from 37% in 2023. Red flag events occurred on 56% of relevant shifts, highlighting critical safety concerns. 71% of shifts reported delays or omissions in important nursing tasks, with unsafe staffing contributing significantly.

Roles of Respondents:

Healthcare Support Workers (43.5%) and Registered Nurses (31.2%) made up most survey participants, reflecting the frontline impact of staffing shortages.

Settings Most Affected:

Medical inpatient care (27%), surgical units (17.8%), and care of the elderly (12.3%) reported the highest levels of unsafe staffing, raising concerns about patient outcomes in these high-risk areas

Reporting Concerns: A Declining Confidence in Employers

One of the most alarming trends from the report is the drop in staff confidence regarding reporting safety concerns. In 2023, 71% of staff escalated safety issues, but this dropped to 64% in 2024.

Even more concerning, of those who escalated concerns, only 21% felt their employer took appropriate action, down from 25% in 2023. When action was taken, it typically involved redeploying existing staff, bringing in agency workers, or temporarily closing beds, none of which provide a sustainable long-term solution.

Jason Brady, Partner & Head of Blackwater Law said: “When there are staffing shortages at hospitals this can put patient safety at risk which can lead to preventable patient harm.  Such harm can be caused because of negligence in these circumstances which can have a significant impact on patients and their families.”

Blackwater Law medical negligence solicitors successfully represented Mrs Lockey in her claim against University Hospitals of North Midlands NHS Trust.

surgeon with instruments

Day vs. Night Shift Struggles

The findings also reveal a greater proportion of night shifts were unsafely staffed compared to daytime shifts. Night staff were more likely to report concerns but less likely to see effective employer responses, compounding the risk to patients during overnight care.

The Urgent Need for Action

Despite an increase in NHS staffing numbers overall, patient demand and complexity are rapidly outpacing workforce improvements. With unsafe staffing levels rising from 63% in 2023 to 69% in 2024, urgent action is needed to ensure hospitals meet the required standards for patient safety.

UNISON’s analysis of NHS board reports shows a worrying lack of oversight on staffing issues. Many trusts fail to allocate time to accurately assess safe staffing data, meaning risks to patient care go unnoticed at leadership levels.

Key issues include:

  • Lack of dedicated nursing workforce plans.
  • Poor oversight of red flag events.
  • Limited data presented at board level to inform decision-making.

Conclusion: Safe Staffing Is Non-Negotiable

The Only Enough is Enough campaign is more crucial than ever in 2024. The continued deterioration of staffing levels means patient safety is at risk, and healthcare professionals are being left without the support they need to deliver effective care.

For NHS organisations, adherence to safe staffing policies should be more than a tick-box exercise, it must be a priority backed by action and accountability. Without meaningful change, both staff and patients will continue to suffer the consequences of inadequate hospital staffing.

Thomas Kamlow - Solicitor at Blackwater Law
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