In the repeated TV broadcasts this morning and on the website, we hear/see something along these lines:
‘The public are being urged to back a campaign for tougher legislation to ensure there are enough nurses to deliver high-quality patient care. The Royal College of Nursing (RCN) Scotland said the latest NHS workforce data showed the highest number of nursing vacancies ever reported. It said its members were at “breaking point” and it was “time for change”. The nursing body (sic)* has previously called for legislation in each part of the UK to address staffing for safe and effective care.’
The RCN is a trades union with a fancy, particularly loyalist name. It is extremely partisan, as it should be, in pursuing the interest of its members, not a ‘body’ charged with the responsibility to use scientifically gathered evidence to support any claims of need for change or of a crisis in resourcing. The Nuffield Trust is a body. So is NHS Scotland or, for teachers, the GTC. The Scottish Government’s departments are ‘bodies’ of that kind. So, when the Scottish Government mention an actual increase in the overall number of nurses, regardless of vacancies at this low level, a responsible news agency should give that some prominence.
Allowing a brief interjection from that real ‘body’, the Scottish Government BBC Scotland allow only:
‘The Scottish government said the number of nurses and midwives had increased by 5.7% since 2007.’
‘Said’; are the Scottish government figures not open to scrutiny and thus trustworthy? BBC Scotland News, quickly returned to selective comment to back up the RCN case:
‘The NHS workforce figures were published by ISD on Tuesday and showed the nursing and midwifery vacancy rate was now at 5.3% – that is 3,311.2 whole time equivalent (WTE) unfilled posts.’
Context to help audiences understand:
Missing from BBC Scotland reporting, as usual, is any kind of context which might help the audience put the figures in context.
First, just how dramatic, even unusual, is a vacancy rate of 5.3% or 1 in 20 staff? Having been required to manage much worse vacancy rates in Higher Education, I struggle to see the problem with 1 in 20. I don’t have national figures, but I suspect around 5% is quite a healthy level, enabling steady staff turnover and the arrival of ‘new blood.’
Second, are Nurse numbers generally rising or falling? The Scottish Government suggest a 5.7% increase since the last days of Labour. In 2018:
‘There were 59,455.9 WTE nursing and midwifery staff in post, representing an annual increase of 0.1% (77.9 WTE). The proportion of qualified nurses and midwives remains similar to last year at 73.0% (43,364.5 WTE).’
Third, how does the NHS Scotland staffing ratio compare with other NHS areas?
How many nurses are there in Scotland? Well, as you see above, there were 59 455 nurses and midwives in Scotland. Now if NHS Scotland is very tightly stretched in terms of nurse staffing, as the RCN suggest, even a small number of vacancies would matter. Let’s have a look at UK staffing levels (can’t seem to find reliable England-only figures) as a comparison to see how they compare.
The UK has a population of 66 643 010 and 690 773 nurses and midwives and so the ratio is one nurse to 96.4 people.
Scotland has a population of 5 254 800 and 59 455 nurses and midwives and so the ratio is one nurse to 88.4 people.
While not denying the possibility of over-stretch, in some areas, this suggests that if it is, in NHS Scotland, then NHS England is in an even worse situation.
- Using the Latin ‘sic’ to indicate that an error of spelling, grammar, or logic has been quoted, in a medical context, appeals to my sense of humour (sick?).