© 2 01 5 M A H ea lth ca re L td Lies, damn lies and statistics!’ The origins of this quotation remain a mystery, rather like the saying, ‘There are three degrees of falsehood: the first is a fib, the second is a lie, and then comes statistics’. While both may have originated in the 19th century, two centuries later the sentiments remain. April 2015 saw the publication of the final Royal College of Nursing’s (RCN) Frontline First campaign to monitor the impact of the coalition government’s budgetary efficiencies and their effect on the nursing workforce. It is common knowledge that the NHS faced mammoth financial cuts of £20 billion when the coalition government took office in 2010 (RCN, 2015). With about 70% of NHS provider costs attributed to staffing, frontline staff would necessarily take a direct hit. However, with various interpretations on the numbers, the picture is complex, and it is important to interrogate the figures and consider the impact The Government claimed that we have ‘more nurses than ever before’ (RCN, 2015). What has been interesting is that the publication of the second Francis Report (2013) halfway through the coalition’s term of office seems to have had a significant impact on staffing levels. Between 2010 and 2012, staff numbers dropped dramatically and from 2013 they began to rise again, particularly in the acute sector—the so-called ‘Francis effect’ (RCN, 2015). However, there were losses of qualified nurses in the community, in mental health and in learning-disabilities nursing; a rise of 33% in healthcare assistants (HCAs); a significant rise in the number of overseas recruitment; and a 150% increase in the spend of agency nurses, presenting an extremely volatile nursing workforce (RCN, 2015). Education matters. In their observational study of nine European countries, Aitken et al (2014) found a significant impact of qualified nurses’ educational level and workload on the quality of care. An increase in a nurses’ workload by one patient increased the chance of a hospitalised patient dying within 30 days of admission by 7%. They also found that an increase in nurses holding a bachelor’s degree is associated with Elizabeth Rosser