Brexit and the reduction in European nurses applying to work in the UK are contributing to the “extensive difficulties” in recruiting workers, Homerton Hospital bosses say.

Other factors causing a vacancy rate of 7.4% at the hospital include a 22% drop in the number of new entrants to the Nursing and Midwifery Council (NMC) register and the number of nurses quitting. From 2016 to 2017, 20% more people quit than became registered nurses.

"Overall numbers of nurses on the register have been slowing and since 2017 have seen a significant dip in learning disability, community and mental health nurses," a hospital report states. "Improving nurse staffing levels continues to be a challenge when there are extensive difficulties recruiting to nursing posts not just at Homerton but across London where there are estimated to be around 10,000 vacant nursing posts.

A report titled Closing the Gap last year identified staffing as the "make or break" issue for the NHS, with nursing shortages particularly severe. There are more than 43,000 vacancies across the UK.

At the Homerton, there are 1,322 budgeted posts and 99 vacancies. As a result, a "significant proportion" of care comes from temporary staff, including agency workers, which the hospital says can have an impact on the care due to a lack of continuity, unfamiliarity with the electronic patient record system or not being able to administer IV drugs.

"The NHS and the wider UK health and care system are under immense pressure coping with unprecedented demand and diminishing resources," the report adds. "People are living longer, and with multiple chronic physical and mental health conditions.

"The contribution of registered nurses in assessing needs, planning and providing holistic patient centred care is crucial in responding appropriately to these pressures. The use of temporary staff therefore is a necessity."

A recent recruitment drive has resulted in 62 new nurses from India and the Philippines, but the hospital is concerned there are no more campaigns planned and vacancy rates might increase.

The new plan is to hire overseas nurses already living in the UK but working in health care support roles, and train them to become registered nurses.

Despite the reliance on agency workers, the hospital last month reported a surplus of more than £1.5million, more than £350,000 more than planned.