The number of nurses working in GP surgeries fell last year in stark contrast to an unprecedented growth in the managerial sector, according to figures.
The annual census by the NHS Information Centre showed a 9.4% increase of managers and senior managers over the year, while the number of practice nurses plunged 3.6% and levels of nursing assistants and auxiliary staff dropped 6%.
This was in a year where the number of overall NHS staff peaked at 1,368,200 in September.
The Royal College of Nursing's (RCN) Dr Peter Carter welcomed the increase in NHS workers, but warned that 200,000 nurses were due to retire over the next 10 years.
"The government has been urging the health service to move care closer to home, yet it is community nurses that we're going to be losing to retirement over the next few years," he said.
"All of this points to an NHS staff shortage timebomb. Our own research shows that one in three community nurses are over 50 and one in five practice nurses are over 55. Government must invest in nursing if it's going to be a more attractive career option, because in the coming years we're going to need more rather than less practice, district and community nurses."
The census – which showed a 27.7% rise in staffing compared to 1998 – also revealed increases in the numbers of school nurses, modern matrons, GPs, community matrons, physiotherapists and radiographers.