Finding solutions to the developing NHS workforce crisis
The NHS is currently facing a workforce crisis. One in 12 posts (8%) are now vacant around England. This is partly a reflection of a growing global shortage of healthcare workers, but has its own particular causes: failure to train and retain enough home grown health professionals; inability to recruit sufficient numbers from abroad; trainee departures to work overseas, to other occupations and to locum agencies; as well as early retirement of senior staff driven by rota gaps, overwork, burnout and damaging pension rules. An aging population and the social impact of years of austerity have also exacerbated the crisis.
Despite promises of 5000 extra GPs, there are fewer GPs per patient for the first time since the 1960s, 40 000 nurse vacancies, and 10% of specialty medical and 32% of psychiatry training posts unfilled. The result is a vicious cycle of low morale and disillusionment driving doctors and nurses out of the NHS and deterring others from joining, which puts yet more unsustainable pressure on those who choose to stay.
The scale of the problem has finally begun to hit home with government, and an interim workforce plan has made some suggestions. But new staff and new roles will take years to materialise, and the NHS has a huge task ahead if it is even to retain its current staff. A referendum on the offer of a new contract that provides an 8.2% pay rise over four years and improved working conditions for junior doctors is being held between the 14th and 25th of June.
Other recommendations for more motivated and safer hospital doctors include the return of ‘the firm’. The firm is a shorthand for many of the things that the best employers have always known: that for people to flourish in their work they need nurture, support, community and a sense of belonging, and the assurance that your leader knows who you are and will support you when things go wrong.
The reduced working hours and early retirement of experienced senior doctors is largely a reflection of the pension taper, which has resulted in massive tax liabilities for higher earning consultants and GPs as a result of the NHS’s inflexible pension system. It is not at all clear that the proposed 50:50 solution will ease the problem, since the generous pension arrangements have been a major motivation for doctors to continue working within the NHS.
Are things really this bad? What are your experiences and suggestions? Do add a comment to this blog.