'Greatest workforce crisis' ever


The cross-party Parliamentary Health and Social Care Committee has concluded that the NHS and social care sector face "the greatest workforce crisis in their history." 

The Committee's report, 'Workforce: recruitment, training and retention in health and social care', published today (July 25), is a damning reflection on the Government's management of the NHS and social care. It criticises the Government for its failure to publish the promised workforce plan, which has been postponed again and is now expected in Autumn this year. This failure to undertake proper workforce planning also risks the Government's primary objective for the NHS at the moment, to tackle the Covid backlog. However, industry estimates from The Health Foundation estimate that to achieve this objective, over 4,000 more doctors and almost 19,000 more nurses will be necessary. "The clearest and most urgent need is action on workforce planning," the report states.

Indications are that contrary to boosting the workforce, the NHS and social care are losing staff. Although the Government has made some progress on its target of 50,000 more nurses, the then Secretary of State for Health and Social Care admitted to the Committee that he was not on track to deliver the additional 6,000 full-time equivalent (FTE) GPS promised in the Conservative Party's manifesto. The NHS lost 717 FTE GPs between March 2019 and March 2022. In addition, in July 2021, the Committee recommended that NHS England needed an additional 2,000 midwives and 500 obstetricians to operate at a level considered to be safe by the staffing tool, 'Birthrate Plus'. The recommendation was supported by the Ockenden report and accepted by the Government, but in spite of this, the NHS lost 552 midwives between March 2021 and March 2022.

At the same time, sickness and stress-related absences are taking their toll. In August 2021 alone, according to the British Medical Association, the NHS lost two million FTE days to sickness, including more than 560,000 days to anxiety, stress, depression or another psychiatric illness. The result is that even more staff are thought to be considering leaving the health service.

Just last week, the REAL Centre's projections of future NHS workforce supply and demand in England to 2030/31, published by The Health Foundation, predicted a growing gap in supply of two core staff groups - registered nurses across all sectors, but focusing on the NHS Hospital and Community Health Service (HCHS), and general practice patient care staff, including GPs and general practice nurses. Its analysis points to an overall workforce supply-demand gap of around 103,000 FTE in 2021/22, which is projected to increase to around 180,000 FTE by 2024/25 before declining gradually to a still whopping 160,000 FTE in 2030/31.

"Overall, our report lays bare the scale of the challenge facing policymakers in addressing endemic NHS workforce shortages. Although there is no ‘silver bullet’ solution to England’s workforce shortages, this report adds to a growing body of evidence signalling the need for a comprehensive, fully funded and long-term workforce strategy."

The Health and Social Care Committee states: "The persistent understaffing of the NHS now poses a serious risk to staff and patient safety both for routine and emergency care. But most depressing for many on the frontline is the absence of any credible strategy to address it."

Its report puts forward several recommendations around staff recruitment and retention, including expanding medical schools, reducing administrative barriers to international graduates, removing the financial barriers that prevent many health care assistants from progressing into nursing roles, reviewing working conditions and the pension arrangements that limit the hours doctors can work. 

The situation in social care even more serious that that of the NHS, and the Committee repeats its recommendation that annual funding for social care should be increased by £7 billion by 2023-24.

Responding to the Committee's report, UNISON General Secretary, Christina McAnea said: “The Government's had years to improve the workforce situation but has done little. Only last week ministers could have acted to stop the exodus of porters, healthcare assistants and other NHS staff with an above-inflation wage rise. But chose not to.  

“Instead, the Government refuses to invest in the staff so critical to the NHS. Th​at means longer waiting lists and ambulance delays, with even more patients forced to fork out for private tests and treatment. 

“​Rishi Sunak says tackling the NHS backlog is the UK's biggest public services emergency. But this won't happen without proper investment in the NHS and social care workforce. ​That must begin with a decent pay rise for all staff."

In the meantime, Rishi Sunak, on the campaign trail to become leader of the Conservative Party and Prime Minister, has pledged to make tackling the NHS care backlog his number one, public service priority. 

Claiming that the NHS is safe in his hands, Mr Sunak plans to establish a Backlogs Taskforce which will apply learning from the Covid experience to support Trust leaders in speeding up triage and treatment of patients. He also pledges to cut waiting lists by next year and reduce waiting times by September 2024, increase community-based diagnostic services and speed up the approval process for clinical trials. However, there is so far no mention of how the crisis in the NHS and social care workforce will be tackled or how the numbers of staff will be found to enable the ambitious targets to be achieved.

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