The NHS is relying on less qualified staff to plug workforce gaps due to a huge shortage of nurses, a new report says.
Support staff, such as healthcare assistants and nursing associates, have been used to shore up numbers, says the Health Foundation charity.
The NHS has relied upon overseas recruitment, but a lack of EU nurses due to Brexit means it is now taking more from countries including India and the Philippines.
At present, there are almost 44,000 nursing vacancies across the NHS, but this could hit 100,000 vacancies in a decade, the report says. The analysis comes after the main political parties pledged to increase the number of nurses if they win the election.
Between March 2018 and March 2019, the NHS saw the biggest annual increase this decade in its overall workforce, the new report says. But, it argued, this masks an ongoing shift in the mix of clinical staff employed in the NHS.
In 2018/19, while doctor numbers grew 2.5 per cent, the number of full-time equivalent nurses grew by just 1.5 (4,500 nurses). And the NHS employed 6,500 more full-time equivalent support staff for doctors, nurses and midwives - a 2.6 per cent increase.
The report said: “The last decade has also seen a major change in the mix of nurses and clinical support staff (including healthcare assistants and nursing assistants).
“In 2009/10 there were equal numbers of nurses and support staff, with one clinical support staff member for every full-time equivalent nurse in the NHS.
By 2018/19, the number of support staff per full-time equivalent nurse had risen 10 per cent to 1.1 full-time equivalent per nurse.”
The report said most changes to the skill mix - meaning the ratio of fully qualified to less qualified staff - are implemented well and led by evidence, but added: “It is important that quality and safety are at the forefront of any skill mix change.”