Report reveals impact of 12‐hour shifts amongst nursing staff

Research published today by NHS England shows an increase in the use of 12-hour shifts amongst UK nurses, which in some instances may potentially influence patient care.

The independent report, ‘12-hour shifts: prevalence views and impact’ was commissioned by the Chief Nursing Officer as part NHS England’s Compassion in Practice Programme and looked at links between nursing shift length  and patient outcomes using existing data sets and published evidence. Researchers reviewed 26 studies carried out between 1982 and 2014 in the UK, USA and EU, which focused on the prevalence and impact of 12-hour shifts in nursing. Amongst the data sources were Employment Surveys conducted for the Royal College of Nursing as well as the results of a survey of nurses at English hospitals conducted as part of last year’s RN4Cast study.

The research was undertaken by the National Nursing Research Unit (NNRU) at the FlorenceNightingale Faculty of Nursing & Midwifery; King’s College London in collaboration with the University of Southampton and RN4Cast Consortium.

The study, led by Jane Ball (now at University of Southampton) reported that 12 hour shifts have become more prevalent in the NHS - 31% of staff nurses on wards in the NHS reported working 12-hour shifts in 2005 compared with 52% in 2009.     

“Our work shows that in spite of limited evidence, 12 hour shifts have increased across the NHS without fully understanding the risks to patient safety and staff well-being” said Professor Jill Maben, Chair of Nursing Research King’s College London.

“This new analysis of data from England, found that working 12-hour or longer shifts is associated with care being rated as ‘poor quality’ and an increased risk that necessary nursing care is left undone. It seems clear that there are risks associated with a move to longer shifts and they need to be managed very carefully,” said Jane Ball, Principal Research Fellow, University of Southampton.

Working patterns are a key part of ensuring that the NHS taskforce has the ‘’right staff, with the right skills in the right place’[1]. 24-hour nursing care involves flexible shift patterns including 12-hour shifts. While many nurses value the flexibility that working fewer long shifts offer, the study highlights the risks of long hours in terms of performance, fatigue, stress and patient safety.

Professor Peter Griffiths, Chair of Health Services Research, University of Southampton said: “These findings mirror those of our European wide study, which shows that longer shifts are associated with nurses reporting lower quality care, more missed care and higher levels of nurse burnout. Meanwhile, the overall job satisfaction reported is no better for those working 12 hour shifts than those working 8 hour shifts.”

Jane Cummings, Chief Nursing Officer for England, said: "This report is a welcome addition to the work we are undertaking as part of the Compassion in Practice Programme and its findings will be carefully considered. It is really important that we continue to develop a body of research to inform safe staffing to support senior local professional judgements."

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Media contacts

Jessica Clinkett, Interim Senior Communications Officer, King’s College London, Tel 0207 848 3062 email: jessica.clinkett@kcl.ac.uk

Charles Elder, Media Relations, University of Southampton Tel: 023 8059 8933, email: c.elder@soton.ac.uk

NHS England, Tel 0113 825 0958 or 0113 825 095, email, nhsengland.media@nhs.net

Notes to Editors:

1. The full report ‘12-hour shifts: prevalence views and impact’ can be found here: www.england.nhs.uk/6cs/groups/safe-staffing/
2. Florence Nightingale Faculty of Nursing & Midwifery - The Florence Nightingale Faculty of Nursing & Midwifery at King’s College London has its origins in the first nursing school in the world established by Florence Nightingale in 1860. Ranked number one in London (Complete University Guide 2016), the Faculty works in partnership with leading London NHS Trusts. With close links to industry, health services and policy makers, the Faculty develops leading-edge nurses and midwives of tomorrow – practitioners, partners, and leaders in their field. The Faculty has over 1,000 full-time pre-registration nursing and midwifery students plus an extensive portfolio of undergraduate and postgraduate activities to meet the needs of a wide range of healthcare professionals seeking continuing professional development.  The Faculty is at the forefront of health services, policy and evaluation research. For further information visit: www.kcl.ac.uk/nursing
3. King's College London - King's College London is one of the top 20 universities in the world (2014/15 QS World University Rankings) and among the oldest in England. King's has more than 26,500 students (of whom nearly 10,400 are graduate students) from some 150 countries worldwide and employs nearly 6,900 staff. The university is in the second phase of a £1 billion redevelopment programme, which is transforming its estate. For more information about King’s, please visit ‘King’s in Brief’
4. University of Southampton - Through world-leading research and enterprise activities, the University of Southampton connects with businesses to create real-world solutions to global issues. Through its educational offering, it works with partners around the world to offer relevant, flexible education, which trains students for jobs not even thought of. This connectivity is what sets Southampton apart from the rest; we make connections and change the world. www.southampton.ac.uk. Research carried out by the University’s Faculty of Health Sciences is rooted in strong links between Southampton, the NHS and other healthcare organisations. Health Sciences validated its number one status in health research in the Research Excellence Framework (REF) 2014 ranking first for research intensity (Times Higher Education) and first for the overall quality of research (Research Fortnight). 100% of both the impact and research environment of Health Sciences at Southampton was judged as 4*.
5. About RN4CAST - Researchers from 12 European countries (Belgium, Finland, Germany, Greece, Ireland, Norway, Poland, Spain, Sweden, Switzerland, The Netherlands and England) are collaborating in one of the largest nursing workforce studies ever conducted in the EU.