It’s no secret the Winter Crisis is being exacerbated by NHS staff shortages, despite years of the Conservative Government pledging to tackle the problem. Nine out of ten hospital bosses say the staffing shortages have been endangering patients, but where is the NHS People Plan?
From Hunt’s now infamous pledge to recruit an extra 5,000 GPs in 2015, through to the General Election promise to find an extra 50,000 nurses in the coming decade, the Government has failed to meet growing demand.
Figures released at the end of February showed there were 38,785 nurse vacancies in December 2019, down from nearly 43,500 in the previous quarter, and 8,734 medical vacancies across NHS hospitals.
Nursing recruitment most urgent
These figures reflect the Government’s own urgency in improving nursing recruitment, as outlined in its own Interim NHS People Plan published in June 2019.
An approaching retirement cliff is expected to make the problem worse, with 50% of practice nurses aged over 50. A survey by the NMC revealed that the majority (52%) of people leaving the nursing and midwifery register was due to retirement, while the next most common reason for leaving given by over a quarter (26%) was staffing levels.
While the Interim Plan outlines the importance of recruiting via nursing degree courses, it admits the lead time for this makes overseas recruitment essential in the short to medium term. However, with a global shortage of nurses expected to reach nine million by 2030 according to the WHO, it is unclear how successful this will be.
Data revealed by the NMC showed that while the number of nurses and midwives joining the UK register from countries outside of the EU has increased 8,877 in the past two years, the total number of midwives and nurses from the EU has dropped 4,989.
Government claims that the decision to scrap the student bursary in 2017 would increase higher education places for nursing students by 25% have not been realised, and total applications and acceptance onto nursing courses dropped in 2018. A quarter of nursing students do not complete training with many citing financial pressures.
Suggestions by the Government that nurses could retrain as doctors or train to carry out surgery received criticism from many in the profession. Jon Gardner, Registered Nurse and activist behind the #Nurses4RealChange campaign in the General Election said: “Nurses are more than capable of being trained to perform minor surgery – we already are in some places, i.e. minor procedures in community.
“My concern is that any ‘new’ posts leave existing posts unfilled. We must keep the government to its promise of 50,000 more nurses and not be called upon as a fix for other professional shortages.”
Failure to recruit GPs
Similar failures to recruit GPs are problematic as a crisis in primary care is leading to increased pressure in emergency departments as patients are forced to go “where the lights are on”.
Despite promises as far back as 2015 to recruit 5,000 more GPs by 2020, there were 1,000 fewer GPs last year than in 2015, and this situation is expected to worsen with a predicted loss of 1,869 fully qualified FTE GPs in 2024 than in 2019, according to one analysis. Various attempts to introduce schemes such as the GP Retention Scheme, GP Career Plus, the Local GP Retention Fund, and the GP Health Service have not reversed this pattern, and one multi million pound programme to attract and retain GPs in Scotland acquired just 18.
Retention is a big problem and getting worse, with many pointing the finger at work pressures for the staff crisis in primary care. The NHS Staff Survey showed 40.3% of staff reported feeling unwell as a result of work-related stress, a statistic that has worsened over the past five years.
Calls by health thinktanks to clarify future immigration policy and improve accessibility to overseas healthcare workers to tackle the crisis were largely ignored. In recent months the Government rolled out plans to increase the migrant NHS charge and introduce a points-based immigration system. Alia Butts NHS Psychotherapist and member of Keep our NHS Public’s NHS Staff Voices group said:
“At a time when the Government should be putting in more money and resources into the NHS, the promise to reduce necessary workers the opportunity to join the NHS workforce is dangerous and needs to be opposed.”
Lack of funding
A report by the Health Foundation last year argued that lack of joined up thinking and funding around workforce planning in the NHS meant the situation was unlikely to improve. The Government’s own sums on the cost of 50,000 nurses and 6,000 GPs don’t add up. They also aren’t enough to improve staffing levels enough to meet demand, which will also grow significantly in coming years.
A pattern of putting in one hand and taking from the other has characterised the Government’s half hearted attempts to improve staffing. While the Prime Minister repeated claims his Government had reinstated the student bursary at PMQs at the end of February, he failed to acknowledge that same Government had introduced student fees and ultimately NHS staff debt burden.
While the finalised NHS People Plan was due to be published in the next couple of months, NHS England admit there is still no expected publication date for it. If actions speak louder than words, this reveals depressing truths about Governmental priorities.
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