From the TUC

Can a workforce strategy solve the NHS’ staffing crisis?

17 Feb 2017, by in Public services

Staff shortages in the NHS are nothing new. It has been a chronic issue affecting the NHS since cuts made to training budgets in 2010 and 2011; heightened by existing pay restraint, staff morale and workload issues. But recent events and detrimental government policy are only exacerbating the situation. The TUC is calling for a workforce strategy that responds to those challenges.

The ONS shows that between 2013 and 2015 there was a 50% increase in nursing vacancies from 12,513 to 18,714. That number currently stands at 24,000. It’s no surprise, then, that every single UK hospital now has a shortage of nurses.

The NHS Support Federation and TUC report is illustrative:

  • 75% of A&E nurses said their shift did not meet the NICE recommended ratio of at least two registered nurses to one trauma patient.
  • The Royal College of Midwives (RCM) found midwives were driven away from the NHS by excessive workloads and poor staffing levels, many citing safety as an issue. 80% of heads of midwifery reported vacancies in their unit.
  • The Royal College of GPs (RCGP) warned that by 2020 the UK will face a shortfall of nearly 10,000 GPs, with one in 15 practices closing. At the same time, it’s been discovered that 15% of all A&Es are now facing closure.

There’s also increased pressures on the NHS, presented by a growing population and a higher proportion of over-65’s, often with long term conditions. With workforce shortages – staff have consistently complained of deteriorating patient care. Patients have been left unwashed, unmonitored and without crucial medications. It sets alarm bells ringing and reminds us of the Mid-Staffordshire scandal.

The government should be learning from its history. But is it? The worry is that numbers in staffing will only dwindle further by recent regressive issues.

End to student bursaries

The government’s abolition of NHS bursaries led to a 23% fall in applications to nursing and midwifery courses in the first year. All non-repayable NHS bursaries have been replaced with income-contingent loans. Students enrolling from 2017 are required to pay the full tuition fee of £9,000 – an estimated increase of 71% total costs incurred by a single student.

As well as overall reduction in applications due to the cost, many students either suffer from in-course attrition and drop-out or don’t pursue the profession upon completion.

The benefit to Higher Education Institutions (HEI) is also uncertain. That’s because any income generated from tuition fees will be used to fund bursaries. The Exchequer will also only be better off by £534m per cohort, and that’s only if students in nursing, midwifery and in Allied Health Professions achieve comparable post-graduate earnings as other graduates. Furthermore, the desired cost savings could all be wiped out altogether with the medium-term dependency on Agency staff.  And that’s been the story for some time!

Decline in EU applicants

And then there came Brexit…

There’s been a decline in both domestic (5%) and EU applicants (7%) for nursing vacancies. The EU numbers are particularly worrying – coming after four years of 5-7% growth in applications. Could EU nurses be turning their backs on Britain?

Figures show that since the Brexit referendum there’s been a decline of nurses registering to work in the UK by 90%. By 2020, moreover nearly half of the workforce will be eligible for retirement – only intensifying the NHS’s staffing crisis. The NHS simply could not cope without the contributions of EU nurses, and without comparable growth in domestic applicants which are also tailing off. Doubts surrounding EU workers’ status are also affecting morale of the entire workplace. Patient care and safety will suffer until the government takes heed to recruitment and retention issues.

Time for a workforce strategy?

The solution might seem obvious, but we need a comprehensive workforce strategy. That addresses:

  • The impact of wage stagnation on recruitment and retention, morale and motivation
  • Future recruitment, including student commissions
  • Pay and reward of staff delivering NHS services across the UK
  • Positive approaches to improve productivity: including better rates for bank and overtime work; implementing the recommendations of the Boorman Review; and investment in staff

In the coming two years we will continue to press the case for an optimal workforce that serves patients well. This can’t be achieved without promoting the NHS as an attractive employer, with better terms and conditions that support recruitment and retention of staff, and many more initiatives that can be found here.

These ideas might just save the NHS from the staffing crisis it finds itself in! Because where would the NHS be without its workforce?

3 Responses to Can a workforce strategy solve the NHS’ staffing crisis?

  1. David jenkins
    Feb 17th 2017, 10:06 pm

    Get the tories out, their deliberately under staffing the NHS and under funding

  2. John
    Feb 18th 2017, 2:20 am

    Thankyou for this concerning article Amina Khatun. As a UK a citizen, (but I left Britain several years ago) I still try to keep tabs on the main UK news issues & I am quite saddened to read articles like this to see how the NHS is being mis managed with the ‘front line troops’ always suffering, particularly if I am correct, from 2010. Yes in any organisation there is always room for improvement, but definitely & importantly not at the expense of staff / team moral & recruitment.

    I shall always remember in my younger days being told by an experienced manager that ‘a management (not technical) consultant was a person who borrowed your watch to tell you the time’. I just wonder how much of the Government led NHS mangement changes have been like this?

    Finally, if your Conservative government is determined to find taxpayers money to justify the expenditure of a new Trident missile system, should it really not be getting its expenditure priorities in order? Perhaps that should have been a National referendum as opposed to Brexit!

  3. Michael Glover
    Feb 18th 2017, 9:06 am

    I was fortunate to become a full-time student at the age of 40 after many years as a TU and craftskill activist, a skill with big political history, working with wood.

    I went into youth and community work with young people in trouble at home, with the police or in school. Many would still be alive today if they had left school and entered a working community where the skills of life were passed on through their work colleagues and the organisation they worked for.

    Most who worked and lived through the pre-years and post-years of 1979, other than the likes of Arron Banks, would recognise the changes from a social ethos to a management ethos in the workplace and society too.

    The rise of MBAs was not just an academic accident, as an undergraduate many ‘new’ students boasted of doing a MBA, which seemed to carry some sort of social standing to it.

    Post-Brexit and Trump it is easy to see the effects of that change and rational for it with the rest just allowed to fall by the wayside. The social ethos was smashed, community, work or otherwise too, and the pillar of ignorance as a strength the rant of the day, ask Arron, a fine example of the process, life as an accident, though deliberate.