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The UK has 50% MORE nurses and midwives than it needs, claims study

Britain has more than enough nurses and midwives – despite claims of crippling shortages, claims one of the world’s biggest scientific studies.

Health leaders have repeatedly warned of the danger of dwindling numbers of nurses, with 42,000 posts currently vacant across the UK.

But researchers behind the Global Burden of Disease Study have now calculated there are 153 nurses per every 10,000 people in Britain.

The optimum level of nurses and midwives is considered to be 100 per every 10,000 people, according to the study published in prestigious medical journal, The Lancet.

And the scientists even say Britain’s amount may produce ‘diminishing returns’, meaning money spent on hiring extra staff could be wasted. 

But the Royal College of Nursing hit back at the suggestion there are too many nurses, saying hospital patients die alone because wards are ‘brutally understaffed’.

The Global Burden of Disease Study suggests the UK has at least enough nurses and midwives to provide quality healthcare, with 153 per 10,000 people, and claims having more than 100 per 10,000 produces ‘diminishing returns’ in the accessibility and quality of care

The GBD study, conducted by thousands of researchers led by the University of Washington, examined healthcare staff levels in more than 140 countries.

And the scientists decided the optimum number of nurses and midwives for a nation is 100 per 10,000 people – in 2017 the UK had an estimated 153.

‘Additional increases in health worker density resulted in diminishing returns on the Healthcare Access and Quality Index,’ the study authors wrote.

The study’s findings are controversial because the struggling NHS – which experts warn is heading for another winter crisis – claims it has suffered a staff shortage for years.

And data released in July suggested the shortage of nurses and midwives may be getting worse as more job posts are going unfilled.

There were almost 11,500 nurse and midwife jobs advertised in March 2018, 37 per cent more than the 8,392 in February 2015.

A spokesperson for the Royal College of Nursing today told MailOnline: ‘The public would struggle to believe there are too many nurses when they heard this week that a leading cancer centre [The Cedar Centre in Ilford, London] faces closure because it can’t recruit enough of them.

‘Nurses even report that some patients die alone because wards are so brutally understaffed. The evidence shows that mortality rises when staffing levels fall too.

‘This study shows the UK lags behind other countries in terms of healthcare resourcing.

‘With 42,000 nurse vacancies in England alone, we are paying the highest price and must fill these gaps urgently.’ 

Last year, when the GBD data was collected, more NHS nurses and midwives quit their jobs than joined the workforce.

The number of staff quitting before reaching retirment age rose by more than 50 per cent between 2013 and 2017.

But the number of nurses and midwives registered to work in the UK has risen by 4,000 in the past year, according to figures this week from the Nursing and Midwifery Council.

At the end of September there were 693,618 nurses and midwives in the UK, with a rise being driven by more nurses training in Britain and outside the EU. 

NHS England refused to comment on the figures in the study. 

Britain has the seventh highest ratio of nurses to patients in the world, behind Norway in first place with 226 for every 10,000 people.

Norway is followed by the Netherlands, Bermuda, New Zealand, Germany and Canada, with Iceland, Switzerland and Sweden completing the top 10.

But the difference between rich and poor countries is stark – the Central African Republic has just three nurses to every 10,000 people.

While Ethiopoia, Democratic Republic of the Congo and Afghanistan all have just four nurses per 10,000.

The African nations of Guinea, Lesotho, Niger and Mali, alongside the Solomon Islands and Nicaragua, make up the remainder of the 10 worst in the world.    

Nearly half of countries worldwide are suffering from staff shortages.


  1. Norway (226)
  2. The Netherlands (218)
  3. Bermuda (209)
  4. New Zealand (196)
  5. Germany (184)
  6. Canada (164)
  7. United Kingdom (153)
  8. Iceland (150)
  9. Switzerland (149)
  10. Sweden (147) 

Source: The Global Burden of Disease Study


  1. Central African Republic (3)
  2. Ethiopia (4)
  3. Democratic Republic of Congo (4) 
  4. Afghanistan (4)
  5. Guinea (5)
  6. Lesotho (5)
  7. Niger (6)
  8. Solomon Islands (6)
  9. Nicaragua (6)
  10. Mali (7)

Source: The Global Burden of Disease Study 

Many have fewer than a third of the recommended number of doctors, nurses and midwives.

The UK has fewer than the optimum number of doctors – with 27 instead of the study’s recommended 30 – backing up similar claims of a shortage of GPs in the NHS.

Although the country has more pharmacists than the threshold set by the GBD researchers, with six per 10,000 people, a figure higher than the recommended five.

But the workforce in all those sectors is expected to grow over the next decade, the Nursing Times reports.

‘The balance of physicians, nurses, midwives and pharmacists in a country’s workforce underpins the types of care that are available to the population,’ said the study’s lead author, Professor Rafael Lozano, of the University of Washington.

‘While increasing the overall number of health workers will be important for many countries, it’s vital that this growth ensures a varied workforce composition,’ he said.

By 2030, the country is expected to up those numbers to 34 doctors (a 25 per cent increase), 168 nurses and midwives (nine per cent more) and eight pharmacists (18 per cent). 

Country Nurses/midwives per 10,000 people (2017 estimates) Country Nurses/midwives per 10,000 people (2017 estimates)
Norway 226 Kyrgyzstan 32
Netherlands 218 Bosnia and Herzegovina 31
Bermuda 209 Guyana 31
New Zealand 196 Algeria 31
Germany 184 Marshall Islands 31
Canada 164 Mauritius 31
United Kingdom 153 Tanzania 30
Iceland 150 Peru 29
Switzerland 149 Colombia 29
Sweden 147 Fiji 27
Cuba 146 Indonesia 27
The Bahamas 141 Kenya 27
Finland 137 Iran 26
Ireland 136 Tunisia 26
Belgium 133 Botswana 26
Czech Republic 132 Moldova 25
Australia 128 Argentina 25
Andorra 128 Ecuador 25
Qatar 123 Egypt 25
United Arab Emirates 118 El Salvador 24
Virgin Islands, US 114 Paraguay 24
Japan 113 Turkey 24
Slovakia 109 Cambodia 24
Belarus 105 South Africa 23
Austria 104 Comoros 22
Ukraine 100 Sierra Leone 22
Singapore 100 Honduras 21
United States 100 Sri Lanka 20
Denmark 100 Cape Verde 20
Kuwait 98 Kiribati 19
Slovenia 93 Djibouti 19
Spain 92 Zambia 19
Puerto Rico 92 Ghana 19
Croatia 88 Guatemala 18
Luxembourg 88 Cameroon 18
Russia 86 Morocco 17
France 85 Bhutan 17
Barbados 85 Myanmar 17
Bahrain 83 Uganda 17
Guam 80 Syria 16
Bulgaria 79 Tonga 16
Brunei 78 Philippines 16
Malta 75 Vietnam 16
Portugal 75 Nigeria 16
Saudi Arabia 75 Palestine 15
Armenia 73 Equatorial Guinea 15
Kazakhstan 73 Madagascar 15
Mongolia 73 Malawi 15
Italy 73 Sao Tome and Principe 15
Lithuania 71 Haiti 14
Azerbaijan 69 Federated States of Micronesia 14
Antigua and Barbuda 69 Gabon 14
South Korea 68 Eritrea 14
Greenland 67 Iraq 13
Thailand 67 Cote d’Ivoire 13
Poland 66 Liberia 13
Oman 66 Vanuatu 12
Latvia 65 Laos 12
Israel 65 Burundi 12
Estonia 62 Costa Rica 11
Albania 58 North Korea 11
Cyprus 58 Samoa 11
Brazil 58 Congo 11
Uruguay 56 Rwanda 11
Malaysia 56 Namibia 11
Suriname 55 Mauritania 11
Northern Mariana Islands 55 Togo 11
Turkmenistan 54 South Sudan 10
Saint Lucia 54 The Gambia 10
Mexico 53 Guinea-Bissau 10
Chile 52 Sudan 9
Trinidad and Tobago 52 Pakistan 9
Hungary 50 Timor-Leste 9
Jamaica 49 Somalia 9
Tajikistan 48 Burkina Faso 9
Greece 48 Senegal 9
Montenegro 47 Yemen 8
Panama 45 India 8
Maldives 45 Nepal 8
Macedonia 44 Swaziland 8
China 44 Zimbabwe 8
Romania 43 Benin 8
Dominica 43 Bangladesh 7
Dominican Republic 43 Papua New Guinea 7
Lebanon 43 Angola 7
Libya 43 Mozambique 7
Jordan 42 Chad 7
Taiwan (Province of China) 42 Mali 7
Grenada 41 Nicaragua 6
Uzbekistan 40 Solomon Islands 6
Bolivia 40 Niger 6
Saint Vincent and the Grenadines 40 Lesotho 5
Serbia 39 Guinea 5
American Samoa 39 Afghanistan 4
Georgia 37 Democratic Republic of the Congo 4
Seychelles 37 Ethiopia 4
Venezuela 36 Central African Republic 3
Belize 35 Source: Global Burden of Disease Study