The economic downturn could be the greatest threat to patient care and nursing in living memory, the Royal College of Nursing (RCN) has warned.
Unfilled vacancies, reduced budgets for public health and training, low morale and swingeing job cuts were all highlighted as risk factors which had come from previous recessions.
A discussion attended by health experts has been published by the RCN, and contains discussion on the effects of previous recessions on public healthcare.
RCN chief executive Dr Peter Carter says: "It is vital that health care workers are not left out in the cold as has happened in the past. The NHS has made excellent progress in recent years - it would be devastating for these gains to be lost.
"As we approach the next general election it is important that all political parties realise the impact these decisions could have on the 1.3 million people working for the NHS."
The report recommends that patient care must be central for nurses and policy makers, and having the right skills mix is crucial to delivering this care.
The paper will be submitted to the Prime Minister's Commission on the Future of Nursing and Midwifery in England.