Clash of the manifestos: NHS staffing

"Over the last five years, we have hired thousands more doctors and nurses"—Conservative manifesto

"[We have] increased the NHS budget every year in real terms, helping fund nearly 10,000 more doctors and 7,000 more nurses"—Liberal Democrat manifesto

"The NHS is struggling with staffing shortages"—Labour manifesto

The Coalition parties are correct to say that the number of doctors and nurses in England is up since 2010. That alone doesn't tell us whether the number of staff is keeping pace with increased demand, or whether there's a "shortage" as Labour claims.

But there is some evidence to suggest that parts of the service are having problems recruiting the staff they need.

The precise rise in staff numbers depends on the time period you pick to compare from. But whichever way you cut it, staff numbers are up from 2010.

• From September 2010 to September 2014, the number of GPs (excluding retainers and registrars) rose by 1,300.
• Data for other NHS doctors is more recent. From January 2010 to January 2015, there were 8,700 more doctors and counting from May 2010 there were 9,200 more (including locums).
• In the five years to January 2015 nursing staff were up 7,000, and since May 2010 were up by 7,200. That includes midwives and health visitors.

There is a seasonal element to the data, so comparing January 2015 figures to the May 2010 figures can mislead as to the size of the rise.

These are also "full-time equivalent" numbers—the equivalent of the number of full-time positions currently filled, even if the hours are shared among part-time staff. This gives us a better idea of the level of staffing by accounting for how many hours are worked.

We don't have any central figures on vacancy rates—the latest figures were published in 2010. But there is some evidence that hospitals and other care services are struggling to fill vacancies, and that this is leading to financial difficulties.

The Trust Development Authority says that "a high number" of NHS trusts are having difficulty filling posts, and this is behind higher-than-planned spending on agency and temporary staff.
Similarly Monitor, which oversees foundation trusts, says that a failure to cover vacancies has led many of the trusts to overspend.

Both bodies put increasing use of agency staff partly down to "activity pressures"—roughly translated, that means more patients and more treatments.

They also cite an increased focus on quality of care. We particularly see this with nursing recruitment. In the wake of inquiries into poor care at Mid Staffs, there's been an emphasis on increasing the level of nursing care per patient as a way of safeguarding standards, and hospital trusts have been told that they must now publish their plans for staffing levels.

Information obtained by the Health Service Journal suggests that the majority of acute hospitals are failing to meet their own plans for nurse hours, and acute trusts are increasing their recruitment of overseas nurses in order to fill positions.

We're doing a thorough factcheck of the Conservative, Labour and Liberal Democrat manifestos. Our report will be out soon. Sign up to our newsletter to get this hot off the press.