Is there a workforce and staffing crisis in the NHS? Here’s the evidence.
For the defense (the ‘no there’s not’ bridgade at Richmond House and around the corridors of power), here’s the latest from the DH:
“A Department of Health spokeswoman said: ‘The truth is that latest NHS Digital figures show there are over 32,300 more professionally qualified clinical staff working in the NHS since 2010 and we are increasing training places for doctors and nurses by 25 percent.”
Well thank goodness for that! Here was me worrying about all those patients in dire need of being looked after by amazing frontline staff who are on their knees from work pressures, national targets, and a culture from non-medics at the top of the Service who keep on preaching (under the “WE CAN DO THIS” famous chant) to staff to keep at it! I mean, it would make you weep, wouldn’t it?
Here’s the case for the prosecution, with apologies for its lack of brevity:
● Around 42,000 nurse vacancies across the NHS, around 11,000 doctors short of a full complement, and another 40,000+ associated healthcare professionals (really important people who help doctors and nurses care for patients) posts vacant. That’s roughly 100,000 staff and around 10-15% of the NHS workforce, depending on whether you count the army of non-medics currently trying to manage the system
● Most Trusts in the country have turnover rates of between 10%-17%, and things are getting worse. Here are just two stories to make your toes curl:
- One of the biggest Trusts in Western Europe confirmed, via their Chief Nurse at the time, that of the 1,100 nurses they had recruited THAT YEAR, around 700 had left (yes, you heard that correct – they lost around 64% of nurses they had recruited within 12 months of recruiting them!). And the reasons given by those departing nurses? The job was not what they had been led to believe it was; work pressures given the state of the overall operation and workforce; and not feeling valued
- More recently, I found, buried in the verbiage that counts for Board papers these days, a workforce report that confirmed another Trust has been so careless with its staff, that 12.5% of new joiners within the year have left, mostly to work for another Trust (although only 19% bothered to participate in the ‘exit interview’ process, against a target of 50%, which in itself tells you all you need to know about what they think of Trust management) – so all the time, cost and effort to recruit bright, shiny new staff to the cause, was all a complete waste of time, with patient care and safety suffering as a result
● The current Agency staff bill for 2017-2018 is set to top the £4bn that was spent by the System last year, trying to ‘keep the lights on’:
- That’s £60 of tax for every single UK citizen, every year, just to hire short-term, ex-NHS staff who have had enough working for the NHS and now work for Agencies who pay them twice as much as they used to get for half the crap they had to put up with (anyone fancy a job?)
- This bill is growing exponentially, every year, which kind of makes sense if you think about how a death spiral works: the pull of the vortex is eventually too strong as fewer and fewer try to do more and more with less and less; so staff up and leave to sunnier climes and things get worse next year
- NHSI set Trust caps this year that put upon Finance Directors were meant to stay within, on the promise of an STP bung if they were good boys and girls; so how’s that gone? Look at any Board paper anywhere in the country and see if there is a single Trust within its cap, and if there is, put that CEO in charge of the whole system! When a Trust is faced with the decision to close wards or run with unsafe staffing levels, they are always – I hope – going to err on the side of caution and hire expensive locum staff to plug the gap, although it doesn’t lead to safer care ironically
- The UK continues to pillage other national healthcare systems (India,Philippines, South Africa, Eastern Europe) to plug the gaps in our system, so hopeless are our own workforce planners, and where’s the fairness in all that?
Still not sure which way to vote? Here’s the kicker to help you decide.
Go ask the staff themselves. If you’ve ever worked an A&E department on a weekend, ever been with an ambulance crew on a category 1 call and sat outside an A&E department for 60 minutes, if you’ve ever worked on an older people’s ward with its myriad challenges, if you’ve ever tried to find a bed for an acute admission at 4am in the morning, or have ever staffed a ward of 40 beds as a junior nurse with only 2 colleagues to help you all night until the 8am handover, you’ll know the answer as to whether there’s a crisis or not.
There is. Despite the rubbish spouted by the DH, or any of the other national bodies in the NHS. It’s a very real crisis and its growing beyond the point where its containable. The only thing keeping the whole thing together currently is the professionalism and dedication of the staff themselves, but that seemingly inexhaustible well of goodwill is dangerously close to running dry, when it does, we’re all in big, big trouble.
Crisis? What crisis....?
Gordon Forbes - firstname.lastname@example.org