Specialist nurse numbers in England are set to be half what they were two decades ago, according to new analysis from the Royal College of Nursing (RCN) on the eve of the Darzi review.
Figures analysed by the NHS show that district nurse, health visitor and school nurse numbers have declined significantly between 2009 and 2024, falling by 45%, 32% and 31% respectively in England.
Projections by the RCN suggested that the situation is set to worsen and warned that without a funded intervention by the government, the number of district nurses will be down 61% by the end of this parliament in 2029, compared with 2009.
In addition, the RCN projects that health visitor numbers will fall by 44% and school nurses by 42% in the same period.
In total, the workforce across the three specialties is set to half in size (49.78%) – from 18,070 in 2009, to 8,995 in 2029, the RCN said.
The warnings come on the eve of the ‘state of the NHS’ in England, led by former Labour minister Professor Lord Ara Darzi.
The RCN submitted evidence to the review as part of an ‘expert reference group’, highlighting issues including social care, nurse-to-patient ratios, student nursing numbers, mental health support and barriers to hospital discharge.
The government’s recent focus on moving more care into the community and to shift further towards prevention will require further integration of NHS and local authority commissioning to support key services such as health visiting and public health nursing.
The RCN has renewed its calls on the government to invest in the nursing profession by introducing a loan forgiveness scheme for nurses working in public services, alongside state-funded degrees to boost recruitment. It also wants to see improved nurse pay on a ‘long-term basis’ to support with retention.
RCN general secretary and chief executive Professor Nicola Ranger said: ‘A shift to delivering preventative care is vital for patients and our NHS. Prevention helps keep people healthy in their communities, eases the pressure on hospital services and is much more cost effective.
‘But the nurse numbers we need to deliver this shift have collapsed and we’re set to have thousands fewer than we did 20 years ago. That is shocking.’
She added: ‘We made clear in our evidence to Lord Darzi that district nurses, health visitors and school nurses are crucial to supporting people of all ages to stay healthy and independent, providing advice and interventions to prevent conditions worsening.
‘They couldn’t be more important to the government’s correct plan to move care into the community.’
The government was approached for comment.
