There hasn’t been a national NHS workforce strategy since 2003, meaning years of low funding and workforce planning have taken their toll on our healthcare system. Looking at hospitals, mental health services and community providers as a whole, the NHS is lacking almost 84,000 FTE staff. FTE means full time equivalent – essentially one FTE is one staff member working full time.
The NHS is the largest employer in England and employs nearly 1.2m FTE staff.
Specific areas under great strain include GPs (lacking 2500 FTE GPs), which could increase to 7000 within five years, and Nursing. The government has pledged to provide 6000 extra GPs in its latest manifesto. Brexit is having an impact, with the number of nurses from Europe leaving the register rising by 1000 per year from 2015/16 to 2019/20, with the number joining from the EU falling by 90% in the same period.
Despite the government’s pledges, the number of GPs has fallen by 1.6%.
There are more than 41,000 registered nurses’ positions vacant currently – more than one in ten posts.
The number of nurses and health visitors working in the community continues to decline.
Staff at the moment are working under a great degree of pressure, often having to cover the work that could be better done by multiple people. Services are finding it tough to recruit, train, or retain enough staff. At least 5000 nurses each year are being recruited from overseas – a process that is at risk from government policy.
We need to train many more staff in the UK. The government has pledged to train an extra 50,000 nurses in the five years from 2020-2025, and has reintroduced nursing student bursaries to help attract applicants to the profession, as well as investing in additional training places. Attention must be paid to the churn of staff already working in the service – due to burnout, poor remuneration, or other factors, many are intending to leave. People’s perception of a healthy working environment has changed a huge amount in recent decades, and no longer are they willing to see themselves as making a complete ‘sacrifice’ of their own life and good health in order to treat others – instead NHS workers should feel that they are valued professionals who are cared for, in order to care for others.
Ironically, the more that leave, the worse working conditions become – creating an ever growing problem. Therefore the NHS must provide more opportunities for flexible working (especially as many employers begin to provide this option, including public bodies like the Civil Service).
Better leadership is needed across the NHS, focusing on reducing incidences of bullying, intimidation or harassment, and on eliminating, as far as is possible, unfair working hours or difficult working conditions. Supportive team working, input from all areas, and a staff body that feels listened to and motivated are crucial to making it through a difficult period in the NHS’s journey.
Looking specifically at nurses, we find that of the roughly 40,000 nurses positions open, around 33,000 are filled by locum or agency staff, who are very expensive. Due to shortages, many nurses feel unable to provide the level of care that they feel they could, if adequate staffing levels were in place.
70% of nurses will leave the NHS within their first year of qualifying. 28% of EU nurses have quit since Brexit.
Given the government’s pledges regarding Nursing, these figures make for hard reading.
Much more needs to be done to attract nurses to the NHS – both in terms of domestic students, who would benefit greatly from having their tuition fee bursaries reinstated, and from not being seen as ‘free labour’ whilst they study, and in terms of foreign workers who continue to form much of the NHS’s backbone- but are increasingly feeling that they are being driven out, due to a perceived tendency toward xenophobia in the UK as a whole, manifested in the Brexit vote.
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