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It’s a false economy to think you’re saving money by having fewer nursing staff. When we talk about recruiting more nurses, often we’re met with resistance around costs. However, not investing is what is financially unsustainable.

There are costs associated with having someone readmitted because the care they’ve received initially wasn’t up to standard due to lack of nursing staff, and with litigation when things have gone wrong because there aren’t enough staff. Nursing is an asset, not a cost.

The price of unsafe staffing is too high. We need the right number of nursing staff, in the right places, with the right skills and experience, to keep patients safe.

Funding restrictions and NHS budget cuts that impact nurse staffing are having a devastating impact, resulting in many nurses caring for unsafe numbers of patients, in turn causing overwhelming pressure and burnout.

And time and again we have seen that patient care – and outcomes – are put at unacceptable risk when there are too few registered nurses to deliver nursing care safely.

However, to get staffing right there needs to be an increase to the baseline of registered nurses. Evidence-based tools are useful in helping to determine where staffing is needed based on patient need.

But it’s important that such tools are used to calculate the additional staff needed, over and above mandated minimum nurse-to-patient ratios, to ensure unsafe levels are never breached.

The ¹úÄÚ¾«Æ·ÒÁÈ˾þþþø¾ Nursing Workforce Academy, part of the ¹úÄÚ¾«Æ·ÒÁÈ˾þþþø¾ Institute of Nursing Excellence, recently commissioned the internationally leading Health Workforce and Systems Research Group at the University of Southampton to conduct independent analysis of existing international research, on the impact of mandatory minimum nurse-to patient-ratios and safe staffing legislation.

This evidence-based brief pulls together the conclusions from their findings.

This evidence is another important step in reinforcing our call that acceptable levels of nurse staffing are always achieved, and in our campaign for enforceable nurse-to-patient ratios to protect patients and staff from harm. Read the evidence brief in full.

The question is not whether we can afford to invest in nursing – it’s whether we can afford not to

One of the most compelling pieces of evidence comes from a recent observational study involving more than 600,000 patient admissions across 185 wards in four NHS hospitals. The study found that relying on temporary staff – whether bank or agency workers – was less effective than employing permanent staff.

Specifically:

• increasing permanent staff (to prevent low RN staffing) reduced the risk of death by 7.7% 
• filling gaps with temporary staff reduced the risk by 4.1%.

This suggests that while temporary staff can help mitigate staffing shortages, permanent staff contribute significantly more to patient safety and outcomes.

Ensuring there are adequate levels of registered nurse staffing doesn’t just improve patient safety, but there’s evidence it’s cost effective, too. The studies show the value of reduced hospital stays and readmissions exceeded the costs of additional staff, meaning there’s a net cost saving.

The next generation of nurses need to learn from experienced mentors in the workforce, also.

However, this isn’t just about numbers. The skill mix in nursing matters as much as overall staffing levels. Simply adding more staff is not enough if those staff are not registered nurses with the right education, skills and expertise.

The roles of all members of the nursing and multidisciplinary team are important – but they are distinct and not interchangeable.

Diluting the registered nurse proportion in the workforce risks undermining patient safety, increasing costs, and worsening outcomes. Most studies in the review indicated that reduced skill mix led to worse outcomes at increased net cost.

The conclusion is inescapable: safe staffing saves lives, safeguards nurses, and strengthens health care systems in the UK. The question is not whether we can afford to invest in nursing – it’s whether we can afford not to.