Urgent action needed to address chronic undersupply of NHS staff

The NHS Confederation, NHS Providers, the British Medical Association, the Royal College of Nursing, the Academy of Royal Medical Colleges and Unison have penned a joint letter to the Prime Minister warning of the ‘very real risk’ that if NHS staff leave a vicious circle will be created where ‘staff vacancies are the greatest threat to the retention of NHS staff’.

The six organisations, which together represent most of the NHS workforce and the organisations who employ them, are calling on the Government to take rapid and speedy ‘action to address the chronic undersupply of NHS staff’, highlighting the ‘compelling case for investment which starts to deliver sustained and impactful increases to workforce numbers by the end of this Parliament.’

They also call on the Government to clearly outline the workforce requirements for delivering the NHS Long Term Plan across different parts of the country, as well to set out the areas of both ‘greatest risk and greatest need’ across the NHS workforce to effectively deliver services to patients and more transparency on which staff groups need to be bolstered.

The representative bodies say the extra funding is needed to ensure staff can deliver and do more for patients as well as covering the additional workforce costs created by the fall-out from COVID-19 fall-out including a national programme of rolling vaccinations and the growing demand for support and treatment for patients with long COVID. 

They say additional investment in workforce capacity is imperative to tackling the huge and ballooning elective care backlog – which currently stands at 4.7m – as well as enabling the NHS to deliver on its commitments to patients as set out in the NHS Long Term Plan. 

Increasing staff numbers will also help to beef up mental health services, where it has been predicted that up to 10 million people – almost a fifth of the entire population – will need either new or additional mental health support as a direct consequence of this crisis and the consequent economic downturn.

Elsewhere, the letter asks the Government to be candid about how much it will cost to educate and train more staff, how long this will take and whether new staff will be recruited from the UK or abroad.

It says that, to date, the Government has not developed a plan to address these ‘important questions’ because it ‘has not been able to commit to funding [their] implications’ and calls for this to rectified without delay.

Danny Mortimer, chief executive of the NHS Confederation, said:

“We desperately need the government to give the people working in the NHS hope that the gaps in their teams will be filled in the longer term.  It is deeply worrying that far too many NHS staff feel that they are unable to do their job properly because they simply do not have enough colleagues to support them. This, combined with the working conditions they have found themselves under during the pandemic, as well as the pressing need to tackle both the long-term impact of the pandemic on people’s physical and mental health and waiting times, means staff the NHS and its people cannot meet the needs of their patients and that we start to see a haemorrhaging of our staff.

“In terms of staffing numbers, the NHS did not go into the pandemic match fit and this fact has been thrown into even greater relief by the experience of our workforce over the past twelve months.”

Professor Helen Stokes-Lampard, chair of the Academy of Medical Royal Colleges, said:

“Improved clarity on workforce planning now would make a huge difference to the way healthcare systems and the staff within them are able to operate in future. This can only be a good thing for patients and the quality of care provided to them in the longer term, and I have no doubt that’s why so many organisations have united in calling for this.”

Chris Hopson, chief executive of NHS Providers, said:

“NHS staff have delivered for patients this past year. The government now needs to deliver for NHS staff by addressing longstanding workforce shortages. We must see a fully costed and funded national workforce plan, so we stop asking NHS frontline staff to bear an unsustainable workload shift after shift, week after week.

“The plan can’t just cover existing workforce gaps. It must set out the level of staffing needed to make the NHS a great place to work. Currently, the NHS cannot consistently give its staff a reasonable workload and the work life balance they need and deserve. That has to change.”

BMA council chair Dr Chaand Nagpaul said:

“The success of our fight against this deadly virus has been largely down to the enormous dedication of NHS staff who have worked tirelessly, often to their own detriment, to care for unprecedented levels of ill patients and save lives.

 “We already started this pandemic on the backfoot with severe staffing shortages which impacted our ability to respond to the pandemic. With a recent BMA survey finding that almost a fifth of doctors were considering leaving the NHS for another career, the future of the NHS workforce is very uncertain.  There is simply not enough staff and those staff who have been working over the past year are exhausted and in desperate need of some respite.

“With the NHS facing the largest ever backlog of care and the demands of Covid still very much a day to day to reality on the ground, the Prime Minster must listen to the concerns outlined in this letter and come up with a tangible plan. This plan must work for both the short and long-term and be matched by the appropriate investment to ensure the long-term sustainability of the NHS and future of patient care for years to come.”

Dame Donna Kinnair, RCN chief executive and general secretary, said:

“The government's unwillingness to plan and invest in the health care workforce is a dereliction of its duty to not just those workers but the public too"

“It must undertake an independent assessment of the full requirements of the health and care service in England to deliver safe and effective care, based on population need, to ensure there are enough nursing staff to meet those needs, now and in the future."

UNISON head of health Sara Gorton said:

“A lack of planning for a global pandemic left the UK and the NHS exposed like never before last year.

"Preparation for the future needs investment in both NHS services and staff. This means the resources to cope with the backlog, and the funding to give staff the proper pay rise they've more than earned. Without better wages, experienced staff will be lost and new recruits much harder to attract."

The NHS has close to 90,000 vacant posts, and high levels of staff stress and burnout as a direct impact of the pandemic threatens to further increase NHS vacancies.   Results from the biggest survey of NHS staff, published last month, show that almost two thirds of NHS staff believe there are not enough people in their organisations to enable them to do their job properly, with more than four in ten saying they feel unwell as result of their job.

The NHS is starting to see an increase in applications to degree level courses and, the Government has ambitious targets to recruit 50,000 nurses by the end of this parliament.  Failure to act on the issues outlined in our letter will result however in this, and other targets, being missed. We now urgently need a fully costed and funded long term workforce plan that addresses supply and vacancy issues and continues to improve services for patients.