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Apr 23

Too few nursing staff on duty to provide safe NHS care

  • 23 April 2025

Not enough nursing staff are on duty in hospitals to ensure patients are protected from harm such as falls, medication errors or other risks, says UNISON today (Wednesday).

Healthcare workers who do clinical jobs* said not enough staff were present to deliver safe care on two thirds (69%) of shifts, according to surveys carried out by the union.

The proportion has risen from 63% when the research was previously carried out in 2023 and will add to ongoing concerns about the state of the NHS, says UNISON.

Staff reported the highest proportion of safety concerns after shifts on maternity wards (81%), in rehabilitation units helping people recover from injury, illness or disability (81%), or those looking after the elderly (82%).

The findings are based on more than 1,400 shifts completed at over 40 hospital sites by clinical staff in England, Wales and Northern Ireland and give a comprehensive snapshot of the situation, says UNISON.

A ‘red flag’** event, involving a serious risk to safety, occurred on more than half (56%) of all shifts. But these were significantly more common where the shifts were not thought to be sufficiently staffed (67%) than those that were (16%).

A delay greater than 30-minutes in providing pain relief was reported on more than half (54%) of ‘unsafe’ shifts, compared with 12% where enough staff were present.

Around three in five workers (64%) reported staffing gaps to employers, a fall from 71% in 2023. For those that did so, only one in five (21%) said they received a satisfactory response from their employer on how they would address the staffing issue to ensure safe patient care. This was down from a quarter (25%) in 2023.

For those staff who didn’t report concerns, more than half (54%) said they weren’t confident their employer would act so they did nothing.

Separately, UNISON analysed NHS board papers and staffing policies in the hospitals where surveys were conducted.

This revealed that only one in twelve of the hospitals sampled in England were fully implementing safety measures brought in after the Mid Staffordshire NHS Foundation Trust scandal*** to prevent such staff failings from occurring again.

UNISON national nursing officer Stuart Tuckwood said: “These figures show staffing levels across the health service are alarmingly low on a regular basis.

“Nursing staff are often unable to provide vital care or administer pain relief to their patients on time.

“Workers are desperate for help from their employers, but there’s little action when they report their concerns.

“These figures should be a wake-up call for health service leaders given the state of NHS finances and talk of cuts. Urgent investment is needed in hospital staffing to ensure patients are kept safe.”

Notes to editors:
– Staff in 42 hospitals across England, Wales and Northern Ireland were asked to complete anonymised surveys at the end of their shifts in October and November 2024. Surveys were completed for 1,470 shifts, with some staff filling in more than one report. For the full data click here.
– *The majority of clinical staff who filled in the surveys were nurses and healthcare assistants. Allied health professionals and registered midwives also completed them.
– **‘Red flag’ events are serious safety incidents. Research has shown that these are closely linked to poor staffing levels, based on evidence produced by the National Institute for Health and Care Excellence.
– *** Hundreds of patients are estimated to have died as a result of poor care at Stafford Hospital between January 2005 and March 2009. The failing are regarded as one of the biggest scandals in the history of the NHS. In 2009, a report by the Healthcare Commission exposed the problems at Stafford, which was run by the Mid Staffordshire NHS Trust.
– Other findings included 33% of staff reporting that patient vital signs were not assessed or recorded as they should have been in the care plan when staffing was not sufficient, against 6% where it was.
– UNISON is the UK’s largest union, with more than 1.3 million members providing public services in education, local government, the NHS, police service and energy. They are employed in the public, voluntary and private sectors.

Media contacts:
Dan Ashley M: 07789 518992 E: d.ashley@unison.co.uk
Fatima Ayad M: 07508 080383 E: f.ayad@unison.co.uk

The article Too few nursing staff on duty to provide safe NHS care first appeared on the UNISON National site.

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