Jobs figures point to dilution of skills in emergency departments By Jennifer Sprinks


Emergency departments are budgeting for more band 5 and 6 nurses than they can recruit, but are not accounting for sufficient band 7 and 8 nurses, according to research. Data was gathered by independent researcher and analyst Keith Hurst who looked at the levels of nurse staffing in emergency departments in 33 trusts and boards across England and Scotland. He looked at the budgeted, actual and recommended number of whole-time equivalent (WTE) nurses, using a patient acuity tool developed for emergency departments. His research found that emergency departments are budgeting for more band 5 and 6 nurse posts than they can fill and more than they need based on patient acuity. In contrast, the emergency departments are not budgeting for enough senior nurses based on need, leaving a 15% gap between the budgeted and actual numbers of band 7s.

use of some grades as a replacement strategy for more senior grades.’ Mr Catton said the research shows emergency departments have difficulty recruiting staff, particularly band 5s, of which there is an average shortfall of 23%. He added that emergency departments are trying to plug the band 5 gap with temporary staff, such as agency or bank nurses. On average organisations budget for 29.96 WTE band 5 nurses, and recruit just 23 WTE. This figure is even short of the recommended 27.27 WTE level. Meanwhile, there are 11.18 WTE budgeted for band 7, with an actual

9.49 WTE recruited, which falls far short of the recommended 13.56 WTE. The research also shows the number of band 8 nurses employed needs to be doubled to hit recommended levels. Dr Hurst told Nursing Standard the data probably reflects recruitment and retention problems combined with financial pressures. He found similar shortfalls for junior doctors and consultants. ‘This shortage of medics has an effect on the nursing workforce,’ he said. ‘If the gap between actual and recommended is high for doctors, then the only people who can pick up the slack are nurses.’

There are also recruitment problems for band 4 assistant practitioner posts, with a 48% shortfall identified between budgeted and actual WTE staff. However, bands 1 to 3 staff numbers in post exceed the number budgeted for. The findings were presented by RCN head of policy Howard Catton at a nurse staffing conference in London. Mr Catton said: ‘This suggests there are some challenges, not just in terms of recruiting people in the right numbers but in getting the right skill mix as well. ‘In an attempt to get the numbers in, there could be a worrying dilution of skill mix. There is also potentially the


Staff shortfall

O’GRADY PAYS TRIBUTE TO OUR WINNERS RCN Nurse of the Year 2015 Amanda Burston was joined by four fellow Nursing Standard award winners on ITV1’s Paul O’Grady Show to celebrate International Nurses’ Day. She spearheaded an emergency department domestic violence service and told Mr O’Grady she wants to improve nurse training in domestic abuse. Ms Burston (back row, left) appeared on the show with category award

winners Sarah Hartfree, Dorcas Gwata, Tanya Strange and Gillian Robinson. Ms Hartfree, a paediatric rheumatology specialist nurse, described her work with children: ‘They live each day with pain, yet they never moan. My focus is to make sure they can do the things they want to do.’ Mr O’Grady said: ‘Seeing the incredible and valuable work you do is humbling.’ To read more about our winners go to

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