| 21 August 2025
Low staffing levels are an operational concern, and a determining factor in patient safety outcomes. When the workforce thins, tasks get missed, decisions are rushed, and continuity dissipates. From increased infection risks to undetected deterioration, the evidence is clear: short staffing compromises patient safety.
The day-to-day reality of an understaffed workforce
In understaffed environments time becomes transactional, with staff delivering care by urgency rather than individual needs. Routine tasks – such as hygiene checks, nutritional support, and timely pain relief – are often delayed or deprioritised.
A recent UK survey found that over half of ‘unsafely staffed’ shifts experienced a 30+ minute delay in administering pain relief. Missed observations and delayed documentation can lead to failure to detect early signs of deterioration, particularly in vulnerable patients.
Workforce burnout and clinical risk
Understaffing puts a strain on the workforce’s personal resilience. Mental fatigue among healthcare professionals may compromise clinical judgment, and there’s evidence linking post-operative mortality rates to low staffing levels of registered nurses. The emotional toll of delivering suboptimal care can lead to low morale and burnout, increasing staff turnover, retention and recruitment challenges as well as widening staffing gaps.
Continuity of service
Consistent staffing supports better handovers, follow-ups, and familiarity with patients’ needs. Fragmented care can be detrimental to patients, especially those with long-term conditions, as it can result in medication errors, missed appointments, and poor health outcomes.
Temporary staff are important in managing shortfalls, but overreliance on bank or locums can disrupt cohesion and reduce familiarity with local protocols and patient histories. This lack of continuity and support can compromise patient safety and increase the risk of harm.
Financial strain of short staffing
Beyond immediate safety concerns, short staffing places immense financial pressure on healthcare providers. In 2023–24, the NHS spent £3 billion on agency staff, with some trusts paying up to £2,000 for a single nursing shift due to staffing shortfalls.
Other cost concerns include:
- Increased hospital readmissions and longer lengths of stay.
- Higher litigation risks, complaints, and insurance premiums due to increases to the likelihood of clinical errors, delayed care, and patient harm.
- Reduced patient satisfaction and trust in healthcare services.
How the government supports safe staffing
Government support is critical in enabling safe staffing. National frameworks, such as the NHS Safer Staffing Guidelines and the NICE recommendations, provide governance structures and funding mechanisms to ensure providers can recruit and retain the right mix of staff.
Workforce planning – a proactive solution
Effective workforce planning is fundamental to safeguarding patient safety, as it ensures that healthcare services are staffed with the right mix of skills, roles, and capacity to meet fluctuating demand. By aligning workforce capacity with service pressures and patient acuity, healthcare systems can reduce risk, improve continuity, and foster environments where safety is embedded in everyday practice. It is not just about filling gaps; it’s a proactive strategy that uses data to anticipate future needs.
Effective workforce planning supports:
- Forecasting seasonal surges and service pressures
- Recruiting and training the right mix of staff
- Retaining experienced professionals through sustainable staffing models
- Scenario modelling to prepare for shortages and unexpected demand
At Skills for Health, we support organisations in building resilient, future-ready workforces. Our workforce planning services help healthcare providers anticipate demand, model scenarios, and implement sustainable staffing strategies that protect both patients and budgets.
Get in touch to see how we can help you.