BBC Health Correspondent James Westhead: "The worst shortage for quarter of a century"

The Royal College of Nursing claims it has evidence that the manpower crisis - there are currently 8,000 nursing vacancies in the UK - has reduced standards across the country.

A survey, conducted last month, found that many general medical wards are relying on agency staff because of the high level of vacancies.

A recent RCN report claimed the NHS in England was spending £192m a year on agency nurses.

Managers now expect a shortfall in highly qualified nursing staff, the RCN found, with registered nurses representing just under half of all nursing staff on a weekday shift.

Nine patients at a time

Nurses demonstrated about pay

Each registered nurse is now responsible for nine patients at a time, despite the fact that one in four patients are almost totally dependent on nurses.

"It is unsurprising, therefore, that the nurses in charge of the wards felt that patient care was being compromised," the RCN report states.

"Most felt that staffing levels were sufficient to provide only minimum nursing care and one in 10 did not feel there were enough nurses to provide even that.

"Nurses across the UK are desperately worried and frustrated that they cannot provide the level of care they are capable of and that patients need."

The survey also found:

• there were nursing vacancies in 71% of wards;
• there was a 12% vacancy rate for registered nurses;
• one in 10 wards reported four or more registered nurse vacancies;
• almost one in five Grade D (first level registered nurse) posts were vacant;
• more than one in 10 wards were understaffed by a fifth or more.

The overwhelming majority (95%) of nurses in charge of wards said that patient care was compromised by short staffing several times a month. One in three said care was compromised on most shifts.

Ninety-six per cent of nurses in charge of wards said that patients were put at risk by short staffing.

Big pay rise demanded

The RCN argues that the only way to address the problem is to give nurses a significant pay rise.

In its evidence to the independent pay review body, the RCN called for a pay rise of 17% to bring nurses' pay into line with that of new teachers.

However, ministers have told the independent pay review body that it should take into account government inflation targets of approximately 2.5% when deciding how much nurses should receive.

The RCN believes that the NHS would save money in the longer term by giving nurses a significant pay rise. It argues that highly qualified staff help to reduce the length of hospital stay, and the need for expensive drug treatments by providing expert care.

Christine Hancock: "Patient care threatened"

Christine Hancock, general secretary of the RCN, said: "This survey gives hard evidence that patient care is threatened by nurse shortages.

"Nurses are dedicated people, desperately trying to meet their own high professional standards, but they are not superhuman. There are simply not enough registered nurses to go round to ensure that patients get the care they need.

"The government must act decisively on the crisis in nurse shortages and that means tackling head-on the issue of pay so people enter the profession and stay in it."

The number of registered nurses working in the NHS increased by 6% between 1985 and 1996, but the number of hospital admissions rose by 23% in the four years to 1995.